Manuscript Detail | Home Visiting Evidence of Effectiveness

Mersky, J. P., Janczewski, C. E., Plummer Lee, C., Gilbert, R. M., McAtee, C., & Yasin, T. (2021). Home visiting effects on breastfeeding and bedsharing in a low-income sample. [Study 2]. Health Education & Behavior, 48(4), 488–495. https://doi.org/10.1177/1090198120964197.

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)
Moderate	Non-experimental comparison group design	Not applicable	Established on race/ethnicity and SES; outcome(s) not feasible to assess at baseline	Not applicable	No	Yes

Notes:

The manuscript describes two studies: a randomized controlled trial (RCT) and a non-experimental comparison group design (NED). This review addresses the findings of the NED. The review of the RCT is addressed under Mersky et al. (2021; Study 1). Information on the measures and sample sizes—including information that was needed to demonstrate equivalence of the intervention and comparison groups and to establish measure reliability—is based on correspondence with the author.

Study characteristics
Study participants	Study participants were pregnant women with low incomes who were referred to the Milwaukee, Wisconsin, health department for home visiting services between April 2014 and March 2017. They were eligible if they spoke English or Spanish and did not previously receive home visiting services. A total of 154 mother-child dyads had complete data and were included in the study: 69 in the Healthy Families America home visiting group, and 85 in the comparison group. Outcomes were measured at 14–60 days postpartum, six months postpartum, and 12 months postpartum. Forty percent of mothers were Hispanic, 47 percent were African American or Black, and 12 percent were another race. Twenty-three percent had completed postsecondary education at the time of study enrollment.
Setting	The study took place in Milwaukee, Wisconsin, and focused on women who were seeking services at a large, urban health department.
Intervention services	As described in this manuscript, Healthy Families America (HFA) consists of regular, hourlong home visits starting during pregnancy and lasting until a child’s third birthday. HFA aims to start its support of families prenatally, with developmental and functional assessments of children and caregivers; parenting guidance; and referrals to community services. Each participant is assigned a home visitor who is a paraprofessional family support worker. The home visitor receives auxiliary support from a public health nurse. Families are offered at least one visit per week until infants are six months old, with visits becoming less frequent thereafter. On average for the sample in this evaluation, mothers enrolled during the 24th week of pregnancy, and their mean length of receiving services was 26.8 weeks.
Comparison conditions	Participants in the comparison group received a referral to home visiting but elected not to enroll in home visiting through the health department.
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	Not reported
Author affiliation	Authors are affiliated with the University of Wisconsin–Milwaukee and the University of Wisconsin–Madison. HomVEE is not aware of any relationship between the authors and the home visiting model developer or distributor.
Peer reviewed	Yes

Study Registration:

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

Child health
Rating	Outcome measure	Effect	Sample	Timing of follow-up	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Moderate	Breastfeeding duration (weeks)	FavorableUnfavorable or ambiguousNo Effect	HFA vs. Quasi-experimental comparison group, Milwaukee, 2014-2017, full sample	12 months postpartum	154 mother/child dyads	Adjusted mean = 13.40	Adjusted mean = 9.10	Incidence rate ratio = 4.30	Study reported = 1.30	Not statistically significant, p= 0.11	Manuscript reports effect size as a hazard ratio.
Moderate	Ever breastfed	FavorableUnfavorable or ambiguousNo Effect	HFA vs. Quasi-experimental comparison group, Milwaukee, 2014-2017, full sample	12 months postpartum	154 mother/child dyads	Adjusted proportion = 0.88	Adjusted proportion = 0.77	Odds ratio = 2.70	HomVEE calculated = 0.60	Statistically significant, p= 0.04	Submitted by barbara on Fri, 04/12/2019 - 18:55 HomVEE calculated the effect size based on the study-reported odds ratio.

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
Moderate	Any bedsharing by 12 months	FavorableUnfavorable or ambiguousNo Effect	HFA vs. Quasi-experimental comparison group, Milwaukee, 2014-2017, full sample	12 months postpartum	154 mother/child dyads	Adjusted proportion = 0.57	Adjusted proportion = 0.39	Odds ratio = 2.00	HomVEE calculated = 0.42	Statistically significant, p= 0.03	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention. Submitted by barbara on Fri, 04/12/2019 - 18:55 HomVEE calculated the effect size based on the study-reported odds ratio.