Hash, J. B., Oxford, M. L., Fleming, C. B., Ward, T. M., Spieker, S. J., & Lohr, M. J. (2019). Impact of a home visiting program on sleep problems among young children experiencing adversity. Child Abuse & Neglect, 89, 143–154.
| Screening decision | Screening conclusion | HomVEE procedures and standards version |
|---|---|---|
| Passes screens | Eligible for review | Version 2 |
| Rating | Design | Attrition | Baseline equivalence | Compromised randomization | Confounding factors | Valid, reliable measure(s) |
|---|---|---|---|---|---|---|
| High | Randomized controlled trial | Low | Not assessed for randomized controlled trials with low attrition |
No | No |
Yes, details reported below for findings on valid, reliable outcomes that otherwise rate at least moderate |
Two findings, which examined parent sensitivity at post-intervention and three months post-intervention, were based on samples from a randomized controlled trial with low attrition. Therefore, these findings received a high rating. The manuscript also reported two findings that received a low rating. One finding (parent sensitivity at six months) was based on a sample with high attrition, and this sample did not satisfy the baseline equivalence requirement based on correspondence with the author. Another finding used a measure of children’s parent-perceived sleep problems that did not satisfy the reliability requirement for measures under HomVEE Version 2 standards. The findings from a structural equation model in the manuscript were ineligible for review because they reported indirect effects or latent outcomes, both of which are not eligible for review under current HomVEE standards. Additional information about the home visiting intervention and the sample characteristics was drawn from Oxford et al. (2016).
| Study participants | Study participants were caregiver and child dyads residing in Washington State and recruited from families referred to Child Protective Services (CPS). To be eligible, participants had to speak English and live in western Washington State—specifically, in King, Skagit, or Snohomish counties. The child had to be ages 10 to 24 months, and the family had to have an open maltreatment allegation case with CPS at least two weeks before enrollment. Of 514 families contacted after being identified in CPS, 384 were determined eligible, and 247 were randomly assigned to either the Promoting First Relationships – Home Visiting Intervention Model (124 dyads) or to the comparison group (123 dyads). Some children (14 in total) experienced a caregiver change during the study. These children remained in the study in their original intervention condition and completed study assessments with their new caregiver. At the time of enrollment, the average age of a child was 16 months. Most children were White (62 percent); 31 percent were of mixed race or another race, 4 percent were Black, 2 percent were Asian, and 1 percent were American Indian or Alaska Native. Approximately 32 percent of children were Hispanic or Latino. Most caregivers in dyads (90 percent) were women, and most reported their race as White (77 percent). |
|---|---|
| Setting | The study took place in Western Washington State in six Child Protective Services offices in Snohomish, southern Skagit, and northern King Counties. |
| Intervention services | Promoting First Relationships – Home Visiting Intervention Model consisted of 10 weekly sessions, each lasting 60 to 75 minutes. All sessions took place in the families’ homes. The content of home visits was informed by attachment theory and strategies to help caregivers read their child’s cues. During weekly home visits, home visitors video recorded caregiver-child interactions, including caregiver-child play and caregiving activities, and guided caregivers through reflective feedback about the video recordings. To lead this feedback activity, home visitors highlighted positive interactions and offered instructive comments to enhance caregiving, allowing caregivers to reflect on their behavior. Home visitors also helped caregivers explore their own feelings and needs during the interaction, as well as those of the child. Home visitors and caregivers discussed ways to handle challenging child behaviors and explored the caregiver’s own social-emotional development and how that influences caregiving. In addition, home visitors gave caregivers handouts that contained information on the social and emotional needs of young children and strategies to meet those needs. |
| Comparison conditions | The comparison group members were not offered intervention services through Promoting First Relationships. Instead, these dyads received a Resource and Referral program that included three phone-based sessions. During the first session, a social services provider conducted a 30-minute needs assessment, mailed a packet of referrals and resources, and followed up with two 10-minute check-in calls to the caregiver. The resource packet included about six resources tailored to each individual family based on the needs assessment. Resources included a listing of local service providers offering financial assistance, educational assistance, assistance obtaining household items, housing assistance, and parenting support services. |
| Subgroups examined |
This field lists subgroups examined in the manuscript (even if they were not replicated in other samples and not reported on the summary page for this model’s report). There were no subgroups reported in this manuscript. |
| Funding sources | This research was supported by Award Numbers R01 HD061362 and U54HD083091 from the National Institute of Child Health and Human Development, and Award Numbers T32NR016913 and P30NR016585 from the National Institute of Nursing Research. Additional support was provided by the University of Washington Warren G. Magnuson Scholarship Award. |
| Author affiliation | The authors are affiliated with the University of Washington, which sponsors Promoting First Relationships. Monica Oxford, one of the authors of the study, is the executive director of Promoting First Relationships. |
| Peer reviewed | Yes |
Clinicaltrials.gov Identifier: NCT01332851. SocialScienceRegistry.org Identifier: None found. Registry of Efficacy and Effectiveness Studies Identifier: None found. Study registration was assessed by HomVEE for Clinicaltrials.gov beginning with the 2014 review, and for other registries beginning with the 2021 review.
Findings that rate moderate or high
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | Parent sensitivity- Nursing Child Assessment Teaching Scale (NCATS) |
FavorableUnfavorable or ambiguousNo Effect |
PFR vs. R&R, Washington state 2011-2014 |
Post-intervention |
222 parent/child dyads | Unadjusted mean = 35.65 | Unadjusted mean = 35.07 | Mean difference = 0.58 | Study reported = 0.12 | Not statistically significant, p = 0.39 |
Statistical significance is based on HomVEE calculations. |
| High | Parent sensitivity- Nursing Child Assessment Teaching Scale (NCATS) |
FavorableUnfavorable or ambiguousNo Effect |
PFR vs. R&R, Washington state 2011-2014 |
3 months post-intervention |
213 parent/child dyads | Unadjusted mean = 36.46 | Unadjusted mean = 36.04 | Mean difference = 0.42 | Study reported = 0.09 | Not statistically significant, p = 0.53 |
Statistical significance is based on HomVEE calculations. |