Mersky, J. P., Janczewski, C. E., Plummer Lee, C., & Yasin, T. (2022). Impact of home visiting programs on parenting stress in low income women: Findings from a community based trial at an urban health department. [Study 2]. Children and Youth Services Review, 142, 1–10. https://doi.org/10.1016/j.childyouth.2022.106638.
Screening decision | Screening conclusion | HomVEE procedures and standards version |
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Passes screens | Eligible for review | Version 2 |
Rating | Design | Attrition | Baseline equivalence | Compromised randomization | Confounding factors | Valid, reliable measure(s) |
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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 |
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. (2022; Study 1). Information on the measures and sample sizes—including information needed to demonstrate equivalence of the intervention and comparison groups and to establish measure reliability—is based on correspondence with the author.
Some findings in the manuscript are ineligible for review, including the authors' analyses of how pre-intervention levels of maternal depression and social support moderate the intervention's effects on parenting stress outcomes. These moderation analyses are ineligible for review under HomVEE Version 2 standards because they use continuous moderator terms.
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. Up to 136 mother-child dyads with complete, nonmissing data were included in the study: 55 in the Healthy Families America home visiting group, and 81 in the comparison group. Outcome data were measured at 14–60 days postpartum, six months postpartum, and 12 months postpartum. Forty-four percent of the mothers were Hispanic, 44 percent were Non-Hispanic Black, and 12 percent were another race. Twenty-two percent had completed postsecondary education at the time of study enrollment. |
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Setting | The study took place in Milwaukee, Wisconsin, and included 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 for services to start 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 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, the visits are less frequent thereafter. |
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 | This research was supported by the Wisconsin Department of Children and Families, the Wisconsin Department of Public Health, and the U.S. Department of Health and Human Services, Health Resources and Services Administration award number 1D89MC26367-01-00. |
Author affiliation | Authors are affiliated with the University of Wisconsin–Milwaukee. HomVEE is not aware of any relationship between the authors and the home visiting model developer or distributor. |
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 |
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Moderate | Parenting Stress Index - Short Form (PSI-SF), difficult child |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Quasi-experimental comparison group, Milwaukee, 2014-2017, full sample |
14-60 days postpartum |
125 mothers | Adjusted mean = 23.70 | Adjusted mean = 23.30 | Mean difference = 0.40 | HomVEE calculated = 0.05 | Not statistically significant, p = 0.78 |
Negative effect is favorable to the intervention. Statistical significance is based on HomVEE calculations. |
Moderate | Parenting Stress Index - Short Form (PSI-SF), difficult child |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Quasi-experimental comparison group, Milwaukee, 2014-2017, full sample |
6 months postpartum |
129 mothers | Adjusted mean = 23.90 | Adjusted mean = 22.70 | Mean difference = 1.20 | HomVEE calculated = 0.19 | Not statistically significant, p = 0.28 |
Negative effect is favorable to the intervention. Statistical significance is based on HomVEE calculations. |
Moderate | Parenting Stress Index - Short Form (PSI-SF), difficult child |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Quasi-experimental comparison group, Milwaukee, 2014-2017, full sample |
12 months postpartum |
117 mothers | Adjusted mean = 24.50 | Adjusted mean = 25.00 | Mean difference = -0.50 | HomVEE calculated = -0.07 | Not statistically significant, p = 0.69 |
Negative effect is favorable to the intervention. Statistical significance is based on HomVEE calculations. |
Moderate | Parenting Stress Index - Short Form (PSI-SF), dysfunctional interaction |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Quasi-experimental comparison group, Milwaukee, 2014-2017, full sample |
6 months postpartum |
134 mothers | Adjusted mean = 23.10 | Adjusted mean = 22.90 | Mean difference = 0.20 | HomVEE calculated = 0.04 | Not statistically significant, p = 0.82 |
Negative effect is favorable to the intervention. Statistical significance is based on HomVEE calculations. |
Moderate | Parenting Stress Index - Short Form (PSI-SF), dysfunctional interaction |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Quasi-experimental comparison group, Milwaukee, 2014-2017, full sample |
12 months postpartum |
119 mothers | Adjusted mean = 23.30 | Adjusted mean = 23.50 | Mean difference = -0.20 | HomVEE calculated = -0.04 | Not statistically significant, p = 0.84 |
Negative effect is favorable to the intervention. Statistical significance is based on HomVEE calculations. |
Moderate | Parenting Stress Index - Short Form (PSI-SF), dysfunctional interaction |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Quasi-experimental comparison group, Milwaukee, 2014-2017, full sample |
14-60 days postpartum |
130 mothers | Adjusted mean = 22.80 | Adjusted mean = 23.50 | Mean difference = -0.70 | HomVEE calculated = -0.12 | Not statistically significant, p = 0.51 |
Negative effect is favorable to the intervention. Statistical significance is based on HomVEE calculations. |
Moderate | Parenting Stress Index - Short Form (PSI-SF), parental distress |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Quasi-experimental comparison group, Milwaukee, 2014-2017, full sample |
14-60 days postpartum |
136 mothers | Adjusted mean = 27.30 | Adjusted mean = 28.90 | Mean difference = -1.60 | HomVEE calculated = -0.18 | Not statistically significant, p = 0.30 |
Negative effect is favorable to the intervention. Statistical significance is based on HomVEE calculations. |
Moderate | Parenting Stress Index - Short Form (PSI-SF), parental distress |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Quasi-experimental comparison group, Milwaukee, 2014-2017, full sample |
6 months postpartum |
133 mothers | Adjusted mean = 29.30 | Adjusted mean = 26.60 | Mean difference = 2.70 | HomVEE calculated = 0.32 | Not statistically significant, p = 0.07 |
Negative effect is favorable to the intervention. Statistical significance is based on HomVEE calculations. |
Moderate | Parenting Stress Index - Short Form (PSI-SF), parental distress |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Quasi-experimental comparison group, Milwaukee, 2014-2017, full sample |
12 months postpartum |
119 mothers | Adjusted mean = 29.90 | Adjusted mean = 27.30 | Mean difference = 2.60 | HomVEE calculated = 0.31 | Not statistically significant, p = 0.10 |
Negative effect is favorable to the intervention. Statistical significance is based on HomVEE calculations. |