Doyle, O. (2020). The first 2,000 days and child skills. Journal of Political Economy, 128(6), 2067-2122.
| 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 |
Information on how certain measures were constructed and their reliability were based on correspondence with the author. Several findings not reported in the tables below received a low rating because they did not satisfy the reliability requirement. Findings reported when children in the sample were 36 months old and older are ineligible for review because high PFL families were offered Triple P, a parenting course promoting healthy parenting practices and positive parent-child attachment, when children were between 24 and 36 months old, and the low PFL group was not offered these services. HomVEE's calculations for statistical significance are used because authors' calculations are based on one-tailed statistical tests.
| Study participants | Study participants were pregnant women recruited in a maternity hospital or in the community. A total of 233 pregnant women were randomly assigned to either the Preparing for Life—Home Visiting group that received home visiting services (“high PFL”; 115 participants) or the comparison condition that did not receive home visiting services (“low PFL”; 118 participants). The study included a total of 166 participants, 82 in the high PFL group and 84 in the low PFL comparison group. Outcomes were measured when the children in the sample were 24, 36, and 48 months old. At intake, the average age of the mothers was 25. The percentage of mothers identifying as Irish was 96 percent, and 4 percent identified as Irish Traveller. About half of the women were first-time mothers. |
|---|---|
| Setting | The study took place in North Dublin, Ireland. |
| Intervention services | Preparing for Life—Home Visiting provided home visits that lasted 30 minutes to two hours during the mother’s pregnancy and until the child started school at age 5. The majority of participants received visits every two weeks, though some participants received services monthly. The home visitor was a trained Preparing for Life mentor. The mentor provided information by using tip sheets and worked with participants to resolve issues around the child’s development, including the child’s prebirth development, nutrition, rest and routine, and cognitive and social development. The mentor also addressed the mother and her supports. Participants had access to baby massage sessions until the child was 10 months old. Participants also received packages of materials, including home safety items (corner guards, angle latches, heat-sensitive spoons, and baby gym/play mats) and toys (puzzles, activity toys, and bricks), worth about 100 Euros per package. |
| Comparison conditions | Participants in the low PFL (comparison) group did not have access to the home visiting services or tip sheets. The comparison group did, however, receive some of the same resources made available to the high PFL (intervention) group, including the package of safety items and toys. These participants had access to an information officer who met with participants before the child’s birth and at various intervals after birth and provided information on Preparing for Life community events and other local services. Participants in the comparison group had access to public health workshops, such as a stress-control program and a healthy food program. |
| 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). • Child gender (boy or girl) • Parity (primiparous) |
| Funding sources | The Atlantic Philanthropies and the Department of Children and Youth Affairs (Ireland) supported the research. |
| Author affiliation | Dr. Doyle and the Preparing for Life Evaluation team are affiliated with the University College Dublin Geary Institute for Public Policy. The authors were contracted by the home visiting model developers to evaluate Preparing for Life—Home Visiting. |
| Peer reviewed | Yes |
Clinicaltrials.gov Identifier: None found. 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 | Ages and Stages Questionnaire (ASQ): Communication scores, Inverse Probability Weighted percentage below average |
FavorableUnfavorable or ambiguousNo Effect |
High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample |
24 months old |
166 children | Adjusted proportion = 0.10 | Adjusted proportion = 0.07 | Mean difference = 0.03 | Study reported = 0.13 | Not statistically significant, p = 0.48 |
Negative effect is favorable to the intervention. Statistical significance is based on HomVEE calculations. Finding from inverse probability weighted (IPW) model |
| High | Ages and Stages Questionnaire (ASQ): Communication scores, Inverse Probability Weighted results |
FavorableUnfavorable or ambiguousNo Effect |
High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample |
24 months old |
166 children | Adjusted mean = 100.41 | Adjusted mean = 100.59 | Mean difference = -0.18 | Study reported = -0.01 | Not statistically significant, p = 0.94 |
Statistical significance is based on HomVEE calculations. Finding from inverse probability weighted (IPW) model |
| High | Brief Infant-Toddler Social and Emotional Assessment (BITSEA): Competency score, Inverse Probability Weighted percentage cut-off: proportion at risk of clinically significant problems |
FavorableUnfavorable or ambiguousNo Effect |
High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample |
24 months old |
166 children | Adjusted proportion = 0.11 | Adjusted proportion = 0.09 | Mean difference = 0.02 | Study reported = 0.07 | Not statistically significant, p = 0.67 |
Negative effect is favorable to the intervention. Statistical significance is based on HomVEE calculations. Finding from inverse probability weighted (IPW) model |
| High | Brief Infant-Toddler Social and Emotional Assessment (BITSEA): Competency score, Inverse Probability Weighted results |
FavorableUnfavorable or ambiguousNo Effect |
High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample |
24 months old |
166 children | Adjusted mean = 99.26 | Adjusted mean = 100.12 | Mean difference = -0.86 | Study reported = -0.06 | Not statistically significant, p = 0.71 |
Statistical significance is based on HomVEE calculations. Finding from inverse probability weighted (IPW) model |
| High | Brief Infant-Toddler Social and Emotional Assessment (BITSEA): Problems score, Inverse Probability Weighted percentage cut-off: proportion at risk of clinically significant problems |
FavorableUnfavorable or ambiguousNo Effect |
High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample |
24 months old |
166 children | Adjusted proportion = 0.13 | Adjusted proportion = 0.23 | Mean difference = -0.10 | Study reported = -0.24 | Not statistically significant, p = 0.10 |
Negative effect is favorable to the intervention. Statistical significance is based on HomVEE calculations. Finding from inverse probability weighted (IPW) model |
| High | Brief Infant-Toddler Social and Emotional Assessment (BITSEA): Problems score, Inverse Probability Weighted results |
FavorableUnfavorable or ambiguousNo Effect |
High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample |
24 months old |
166 children | Adjusted mean = 98.61 | Adjusted mean = 101.88 | Mean difference = -3.27 | Study reported = -0.19 | Not statistically significant, p = 0.16 |
Negative effect is favorable to the intervention. Statistical significance is based on HomVEE calculations. Finding from inverse probability weighted (IPW) model |
| High | Child Behavior Checklist (CBCL): Externalizing scores, Inverse Probability Weighted percentage cut-off: proportion at risk of clinically significant problems |
FavorableUnfavorable or ambiguousNo Effect |
High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample |
24 months old |
164 children | Adjusted proportion = 0.00 | Adjusted proportion = 0.04 | Mean difference = -0.04 | Study reported = -0.21 | Not statistically significant, p = 0.08 |
Negative effect is favorable to the intervention. Statistical significance is based on HomVEE calculations. Finding from inverse probability weighted (IPW) model |
| High | Child Behavior Checklist (CBCL): Externalizing scores, Inverse Probability Weighted results |
FavorableUnfavorable or ambiguousNo Effect |
High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample |
24 months old |
164 children | Adjusted mean = 99.10 | Adjusted mean = 100.89 | Mean difference = -1.79 | Study reported = -0.11 | Not statistically significant, p = 0.44 |
Negative effect is favorable to the intervention. Statistical significance is based on HomVEE calculations. Finding from inverse probability weighted (IPW) model |
| High | Child Behavior Checklist (CBCL): Internalizing scores, Inverse Probability Weighted percentage cut-off: proportion at risk of clinically significant problems |
FavorableUnfavorable or ambiguousNo Effect |
High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample |
24 months old |
164 children | Adjusted proportion = 0.02 | Adjusted proportion = 0.09 | Mean difference = -0.07 | Study reported = -0.24 | Not statistically significant, p = 0.06 |
Negative effect is favorable to the intervention. Statistical significance is based on HomVEE calculations. Finding from inverse probability weighted (IPW) model |
| High | Child Behavior Checklist (CBCL): Internalizing scores, Inverse Probability Weighted results |
FavorableUnfavorable or ambiguousNo Effect |
High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample |
24 months old |
164 children | Adjusted mean = 100.03 | Adjusted mean = 101.17 | Mean difference = -1.14 | Study reported = -0.07 | Not statistically significant, p = 0.63 |
Negative effect is favorable to the intervention. Statistical significance is based on HomVEE calculations. Finding from inverse probability weighted (IPW) model |
| High | Child Behavior Checklist (CBCL): Total score, Inverse Probability Weighted percentage cut-off: proportion at risk of clinically significant problems |
FavorableUnfavorable or ambiguousNo Effect |
High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample |
24 months old |
164 children | Adjusted proportion = 0.00 | Adjusted proportion = 0.09 | Mean difference = -0.09 | Study reported = -0.32 | Statistically significant, p = 0.01 |
Negative effect is favorable to the intervention. Statistical significance is based on HomVEE calculations. Finding from inverse probability weighted (IPW) model |
| High | Child Behavior Checklist (CBCL): Total score, Inverse Probability Weighted results |
FavorableUnfavorable or ambiguousNo Effect |
High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample |
24 months old |
164 children | Adjusted mean = 98.74 | Adjusted mean = 101.81 | Mean difference = -3.07 | Study reported = -0.18 | Not statistically significant, p = 0.20 |
Negative effect is favorable to the intervention. Statistical significance is based on HomVEE calculations. Finding from inverse probability weighted (IPW) model |
| High | Development Profile cognitive development score (DP-3), Inverse Probability Weighted percentage above average |
FavorableUnfavorable or ambiguousNo Effect |
High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample |
24 months old |
166 children | Adjusted proportion = 0.64 | Adjusted proportion = 0.52 | Mean difference = 0.12 | Study reported = 0.42 | Not statistically significant, p = 0.12 |
Statistical significance is based on HomVEE calculations. Finding from inverse probability weighted (IPW) model |
| High | Development Profile cognitive development score (DP-3), Inverse Probability Weighted results |
FavorableUnfavorable or ambiguousNo Effect |
High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample |
24 months old |
166 children | Adjusted mean = 101.64 | Adjusted mean = 98.16 | Mean difference = 3.48 | Study reported = 0.22 | Not statistically significant, p = 0.13 |
Statistical significance is based on HomVEE calculations. Finding from inverse probability weighted (IPW) model |