Manuscript Detail

Paul, I. M., Savage, J. S., Anzman-Frasca, S., Marini, M. E., Mindell, J. A., & Birch, L. L. (2016). INSIGHT responsive parenting intervention and infant sleep. Pediatrics, 138(1), 1-10. doi:10.1542/peds.2016-0762

Manuscript screening details
Screening decision Screening conclusion HomVEE procedures and standards version
Passes screens Eligible for review Version 2
Study design details
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

Notes:

Information on sample sizes was obtained from Paul et al. (2014) and correspondence with the author. Information to characterize the statistical significance of some findings was based on correspondence with the author.

Study characteristics
Study participants Study participants were mother and infant dyads recruited after delivery in one Pennsylvania hospital. To be eligible, dyads had to include full-term, singleton births, with infants of normal birth weight. Mothers were English-speaking, primiparous, and at least 20 years old. A total of 291 dyads were randomly assigned to either the Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) intervention (145 dyads) or a comparison intervention (146 dyads). Mother–infant dyads were randomly assigned to the INSIGHT intervention or the comparison intervention two weeks after birth, and outcomes were measured until the children’s first birthday. In the study, 89 percent of mothers were White, 6 percent were Black, 3 percent were Asian, and 1 percent reported another race. Most mothers (56 percent) had annual household incomes between $25,000 and $99,000; 11 percent had annual household incomes below $25,000.
Setting The study took place in Hershey, Pennsylvania.
Intervention services INSIGHT consisted of home visits conducted when infants were 3 to 4, 16, 28, and 40 weeks old, followed by annual clinic-based visits at 1, 2, and 3 years old. The curriculum taught parents to respond promptly and in developmentally appropriate ways to infant cues across four behavioral states (drowsy, sleepy, fussy, and alert/calm). Research nurses provided parents with developmentally appropriate sleep guidance during each visit. The guidance addressed bedtime routines, sleep location, and night waking. During and between visits, caregivers were provided with information and resources on responsive feeding, lactation support, soothing practices, and home safety (including crib safety and choking hazards). When infants were 2 weeks old, participants received a mailed packet with information on infant feeding.
Comparison conditions Families assigned to the comparison condition were not eligible to receive intervention services through the INSIGHT program. However, these families received a similar number of home visits as the INSIGHT group (when infants were 3 to 4, 16, 28, and 40 weeks old) and annual clinic-based visits at 1, 2, and 3 years old. The home visits focused solely on home safety topics, including crib safety. When infants were 2 weeks old, participants received a mailed packet with information on infant feeding.
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 R01DK088244 and UL1TR000127 from the National Institutes of Health and 2011-67001-30117 from the U.S. Department of Agriculture. The research was also supported by the Children’s Miracle Network at Penn State Health Children’s Hospital and the Penn State Clinical and Translational Science Institute.  
Author affiliation The authors are affiliated with several universities, including Pennsylvania State University, and are developers of the INSIGHT program.
Peer reviewed Yes
Study Registration:

Clinicaltrials.gov Identifier: NCT01167270. 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

Child health
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High

Daytime sleep duration (minutes)

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 infants Not reported Not reported Not reported Not available

Not statistically significant, p >.05

High

Daytime sleep duration (minutes)

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

1 year old

245 infants Not reported Not reported Not reported Not available

Not statistically significant, p >.05

High

Daytime sleep duration (minutes)

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

8 weeks old

252 infants Not reported Not reported Not reported Not available

Not statistically significant, p >.05

High

Daytime sleep duration (minutes)

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 infants Not reported Not reported Not reported Not available

Not statistically significant, p >.05

High

Overnight sleep duration (minutes)

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 infants Unadjusted mean = 582.10 Unadjusted mean = 557.20 Difference = 24.90 HomVEE calculated = 0.31

Statistically significant, p= 0.01

High

Overnight sleep duration (minutes)

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

1 year old

245 infants Not reported Not reported Not reported Not available

Not statistically significant, p >.05

High

Overnight sleep duration (minutes)

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 infants Unadjusted mean = 624.60 Unadjusted mean = 602.90 Difference = 21.70 HomVEE calculated = 0.30

Statistically significant, p= 0.01

High

Overnight sleep duration (minutes)

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

8 weeks old

252 infants Unadjusted mean = 532.30 Unadjusted mean = 497.20 Difference = 35.10 HomVEE calculated = 0.42

Statistically significant, p <.01

High

Sleep 12 to 14 hours per day

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

1 year old

245 infants Not reported Not reported Odds ratio = 1.89 HomVEE calculated = 0.38

Not statistically significant, p >.05

Submitted by barbara on

HomVEE calculated the effect size based on the study-reported odds ratio.

High

Total daily sleep duration (minutes)

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 infants Unadjusted mean = 808.80 Unadjusted mean = 785.30 Difference = 23.50 HomVEE calculated = 0.21

Not statistically significant, p= 0.08

High

Total daily sleep duration (minutes)

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 infants Not reported Not reported Not reported Not available

Not statistically significant, p >.05

High

Total daily sleep duration (minutes)

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

8 weeks old

248 infants Unadjusted mean = 866.30 Unadjusted mean = 839.20 Difference = 27.10 HomVEE calculated = 0.20

Not statistically significant, p= 0.10

Positive parenting practices
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High

Bedtime 8 PM or earlier

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 infants Unadjusted proportion = 0.66 Unadjusted proportion = 0.47 Difference = 0.19 HomVEE calculated = 0.47

Statistically significant, p <.01

High

Bedtime 8 PM or earlier

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

1 year old

245 infants Unadjusted proportion = 0.61 Unadjusted proportion = 0.52 Difference = 0.09 HomVEE calculated = 0.22

Not statistically significant, p= 0.11

High

Bedtime 8 PM or earlier

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 infants Unadjusted proportion = 0.46 Unadjusted proportion = 0.24 Difference = 0.22 HomVEE calculated = 0.60

Statistically significant, p <.01

High

Bedtime routine: bath

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 mother/child dyads Unadjusted proportion = 0.61 Unadjusted proportion = 0.55 Difference = 0.06 HomVEE calculated = 0.15

Not statistically significant, p= 0.34

High

Bedtime routine: bath

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 mother/child dyads Unadjusted proportion = 0.66 Unadjusted proportion = 0.69 Difference = -0.03 HomVEE calculated = -0.08

Not statistically significant, p= 0.65

High

Bedtime routine: bottle feed/breastfeed

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 mother/child dyads Unadjusted proportion = 0.94 Unadjusted proportion = 0.90 Difference = 0.04 HomVEE calculated = 0.34

Not statistically significant, p= 0.16

High

Bedtime routine: bottle feed/breastfeed

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 mother/child dyads Unadjusted proportion = 0.91 Unadjusted proportion = 0.92 Difference = -0.01 HomVEE calculated = -0.08

Not statistically significant, p= 0.85

High

Bedtime routine: cereal in bottle

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 mother/child dyads Unadjusted proportion = 0.13 Unadjusted proportion = 0.18 Difference = -0.05 HomVEE calculated = -0.23

Not statistically significant, p= 0.37

Submitted by user on

Negative effect is favorable to the intervention.

High

Bedtime routine: cereal in bottle

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 mother/child dyads Unadjusted proportion = 0.15 Unadjusted proportion = 0.14 Difference = 0.01 HomVEE calculated = 0.05

Not statistically significant, p= 0.86

Submitted by user on

Negative effect is favorable to the intervention.

High

Bedtime routine: duration less than or equal to 45 minutes

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 mother/child dyads Unadjusted proportion = 0.51 Unadjusted proportion = 0.37 Difference = 0.14 HomVEE calculated = 0.35

Statistically significant, p= 0.03

High

Bedtime routine: duration less than or equal to 45 minutes

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 mother/child dyads Unadjusted proportion = 0.57 Unadjusted proportion = 0.44 Difference = 0.13 HomVEE calculated = 0.32

Statistically significant, p= 0.04

High

Bedtime routine: fed as last activity before bed

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 mother/child dyads Unadjusted proportion = 0.20 Unadjusted proportion = 0.40 Difference = -0.20 HomVEE calculated = -0.59

Statistically significant, p <.01

Submitted by user on

Negative effect is favorable to the intervention.

High

Bedtime routine: fed as last activity before bed

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 mother/child dyads Unadjusted proportion = 0.22 Unadjusted proportion = 0.33 Difference = -0.11 HomVEE calculated = -0.34

Not statistically significant, p= 0.05

Submitted by user on

Negative effect is favorable to the intervention.

High

Bedtime routine: music

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 mother/child dyads Unadjusted proportion = 0.24 Unadjusted proportion = 0.21 Difference = 0.03 HomVEE calculated = 0.10

Not statistically significant, p= 0.59

High

Bedtime routine: music

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 mother/child dyads Unadjusted proportion = 0.24 Unadjusted proportion = 0.26 Difference = -0.02 HomVEE calculated = -0.06

Not statistically significant, p= 0.57

High

Bedtime routine: read book

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 mother/child dyads Unadjusted proportion = 0.47 Unadjusted proportion = 0.28 Difference = 0.19 HomVEE calculated = 0.50

Statistically significant, p <.01

High

Bedtime routine: read book

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 mother/child dyads Unadjusted proportion = 0.61 Unadjusted proportion = 0.49 Difference = 0.12 HomVEE calculated = 0.30

Not statistically significant, p= 0.05

High

Bedtime routine: rocking

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 mother/child dyads Unadjusted proportion = 0.67 Unadjusted proportion = 0.59 Difference = 0.08 HomVEE calculated = 0.21

Not statistically significant, p= 0.23

Submitted by user on

Negative effect is favorable to the intervention.

High

Bedtime routine: rocking

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 mother/child dyads Unadjusted proportion = 0.54 Unadjusted proportion = 0.54 Difference = 0.00 HomVEE calculated = 0.00

Not statistically significant, p= 0.89

Submitted by user on

Negative effect is favorable to the intervention.

High

Bedtime routine: watch television

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 mother/child dyads Unadjusted proportion = 0.13 Unadjusted proportion = 0.12 Difference = 0.01 HomVEE calculated = 0.06

Not statistically significant, p= 0.93

Submitted by user on

Negative effect is favorable to the intervention.

High

Bedtime routine: watch television

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 mother/child dyads Unadjusted proportion = 0.07 Unadjusted proportion = 0.12 Difference = -0.05 HomVEE calculated = -0.36

Not statistically significant, p= 0.13

Submitted by user on

Negative effect is favorable to the intervention.

High

Bedtime Routines Questionnaire (BRQ): Overall score

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

1 year old

242 infants Not reported Not reported Not reported Not available

Statistically significant, p= 0.02

High

Bedtime Routines Questionnaire (BRQ): Routine Behaviors subscale

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

1 year old

242 infants Not reported Not reported Not reported Not available

Not statistically significant, p= 0.05

High

Bedtime Routines Questionnaire (BRQ): Routine Environment subscale

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

1 year old

242 infants Not reported Not reported Not reported Not available

Statistically significant, p= 0.03

High

Dream feeds: nighttime feeding initiated by parent

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 mothers Unadjusted proportion = 0.39 Unadjusted proportion = 0.19 Difference = 0.20 HomVEE calculated = 0.61

Statistically significant, p <.01

High

Dream feeds: nighttime feeding initiated by parent

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 mothers Unadjusted proportion = 0.25 Unadjusted proportion = 0.10 Difference = 0.15 HomVEE calculated = 0.67

Statistically significant, p <.01

For infants at this age, a negative effect is favorable to the intervention.

High

Falls asleep alone in room, in crib (self-soothes)

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 infants Unadjusted proportion = 0.44 Unadjusted proportion = 0.28 Difference = 0.16 HomVEE calculated = 0.43

Statistically significant, p= 0.01

High

Falls asleep alone in room, in crib (self-soothes)

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 infants Unadjusted proportion = 0.59 Unadjusted proportion = 0.46 Difference = 0.13 HomVEE calculated = 0.32

Statistically significant, p= 0.04

High

Falls asleep being held

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 infants Unadjusted proportion = 0.21 Unadjusted proportion = 0.38 Difference = -0.17 HomVEE calculated = -0.51

Statistically significant, p <.01

Submitted by user on

Negative effect is favorable to the intervention.

High

Falls asleep being held

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 infants Unadjusted proportion = 0.36 Unadjusted proportion = 0.48 Difference = -0.12 HomVEE calculated = -0.30

Not statistically significant, p= 0.06

Submitted by user on

Negative effect is favorable to the intervention.

High

Falls asleep in less than or equal to 15 minutes

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 infants Unadjusted proportion = 0.66 Unadjusted proportion = 0.55 Difference = 0.11 HomVEE calculated = 0.28

Not statistically significant, p= 0.07

High

Falls asleep in less than or equal to 15 minutes

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 infants Unadjusted proportion = 0.75 Unadjusted proportion = 0.64 Difference = 0.11 HomVEE calculated = 0.32

Not statistically significant, p= 0.06

High

Falls asleep swaddled

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 infants Unadjusted proportion = 0.33 Unadjusted proportion = 0.20 Difference = 0.13 HomVEE calculated = 0.41

Statistically significant, p= 0.01

High

Falls asleep swaddled

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 infants Unadjusted proportion = 0.02 Unadjusted proportion = 0.01 Difference = 0.01 HomVEE calculated = 0.43

Not statistically significant, p= 0.57

High

Falls asleep with pacifier

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 infants Unadjusted proportion = 0.36 Unadjusted proportion = 0.31 Difference = 0.05 HomVEE calculated = 0.14

Not statistically significant, p= 0.46

High

Falls asleep with pacifier

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 infants Unadjusted proportion = 0.35 Unadjusted proportion = 0.32 Difference = 0.03 HomVEE calculated = 0.08

Not statistically significant, p= 0.66

High

Falls asleep with white noise

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 infants Unadjusted proportion = 0.30 Unadjusted proportion = 0.25 Difference = 0.05 HomVEE calculated = 0.15

Not statistically significant, p= 0.42

High

Falls asleep with white noise

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 infants Unadjusted proportion = 0.34 Unadjusted proportion = 0.21 Difference = 0.13 HomVEE calculated = 0.40

Statistically significant, p= 0.02

High

Give few minutes to fall back to sleep

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 mothers Unadjusted proportion = 0.57 Unadjusted proportion = 0.56 Difference = 0.01 HomVEE calculated = 0.02

Not statistically significant, p= 0.93

High

Greater than or equal to 2 night feedings

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 infants Unadjusted proportion = 0.34 Unadjusted proportion = 0.30 Difference = 0.04 HomVEE calculated = 0.11

Not statistically significant, p= 0.50

Submitted by user on

Negative effect is favorable to the intervention.

High

Greater than or equal to 2 night feedings

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 infants Unadjusted proportion = 0.14 Unadjusted proportion = 0.15 Difference = -0.01 HomVEE calculated = -0.05

Not statistically significant, p= 0.70

Submitted by user on

Negative effect is favorable to the intervention.

High

Greater than or equal to 2 wakings per night

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 infants Unadjusted proportion = 0.37 Unadjusted proportion = 0.33 Difference = 0.04 HomVEE calculated = 0.11

Not statistically significant, p= 0.53

Submitted by user on

Negative effect is favorable to the intervention.

High

Greater than or equal to 2 wakings per night

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 infants Unadjusted proportion = 0.28 Unadjusted proportion = 0.32 Difference = -0.04 HomVEE calculated = -0.12

Not statistically significant, p= 0.50

Submitted by user on

Negative effect is favorable to the intervention.

High

Night waking: rub/pat but do not pick up

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 mothers Unadjusted proportion = 0.24 Unadjusted proportion = 0.19 Difference = 0.05 HomVEE calculated = 0.18

Not statistically significant, p= 0.29

High

Night waking: change diaper

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 mothers Unadjusted proportion = 0.35 Unadjusted proportion = 0.37 Difference = -0.02 HomVEE calculated = -0.05

Not statistically significant, p= 0.82

High

Night waking: change diaper

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 mothers Unadjusted proportion = 0.65 Unadjusted proportion = 0.64 Difference = 0.01 HomVEE calculated = 0.03

Not statistically significant, p= 0.86

High

Night waking: feed back to sleep

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 mothers Unadjusted proportion = 0.24 Unadjusted proportion = 0.41 Difference = -0.17 HomVEE calculated = -0.48

Statistically significant, p= 0.01

For infants at this age, a negative effect is favorable to the intervention.

High

Night waking: feed back to sleep

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 mothers Unadjusted proportion = 0.54 Unadjusted proportion = 0.72 Difference = -0.18 HomVEE calculated = -0.48

Statistically significant, p <.01

High

Night waking: give few minutes to fall back to sleep

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 mothers Unadjusted proportion = 0.56 Unadjusted proportion = 0.45 Difference = 0.11 HomVEE calculated = 0.27

Not statistically significant, p= 0.09

High

Night waking: give pacifier

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 mothers Unadjusted proportion = 0.40 Unadjusted proportion = 0.35 Difference = 0.05 HomVEE calculated = 0.13

Not statistically significant, p= 0.42

High

Night waking: give pacifier

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 mothers Unadjusted proportion = 0.41 Unadjusted proportion = 0.38 Difference = 0.03 HomVEE calculated = 0.08

Not statistically significant, p= 0.50

High

Night waking: pick up and hold/rock back to sleep

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 mothers Unadjusted proportion = 0.33 Unadjusted proportion = 0.48 Difference = -0.15 HomVEE calculated = -0.38

Statistically significant, p= 0.02

Submitted by user on

Negative effect is favorable to the intervention.

High

Night waking: pick up and hold/rock back to sleep

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 mothers Unadjusted proportion = 0.35 Unadjusted proportion = 0.36 Difference = -0.01 HomVEE calculated = -0.03

Not statistically significant, p= 0.76

Submitted by user on

Negative effect is favorable to the intervention.

High

Night waking: rub/pat but do not pick up

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 mothers Unadjusted proportion = 0.48 Unadjusted proportion = 0.27 Difference = 0.21 HomVEE calculated = 0.55

Statistically significant, p <.01

High

Put to bed for the night while still awake

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

8 weeks old

257 infants Unadjusted proportion = 0.35 Unadjusted proportion = 0.16 Difference = 0.19 HomVEE calculated = 0.63

Statistically significant, p <.01

High

Same bedtime routine every night

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

1 year old

244 infants Unadjusted proportion = 0.55 Unadjusted proportion = 0.34 Difference = 0.21 HomVEE calculated = 0.52

Statistically significant, p <.01

High

Sleeps in own room

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

16 weeks old

262 infants Unadjusted proportion = 0.59 Unadjusted proportion = 0.55 Difference = 0.04 HomVEE calculated = 0.10

Not statistically significant, p= 0.65

High

Sleeps in own room

FavorableUnfavorable or ambiguousNo Effect

INSIGHT vs. comparison, Pennsylvania 2012-2014, full sample

40 weeks old

251 infants Unadjusted proportion = 0.80 Unadjusted proportion = 0.83 Difference = -0.03 HomVEE calculated = -0.12

Not statistically significant, p= 0.37