Michalopoulos, C., Faucetta, K., Hill, C. J., Portilla, X., Burrell, L., Lee, H., Duggan, A., & Knox, V. (2019). Impacts on family outcomes of evidence-based early childhood home visiting: Results from the Mother and Infant Home Visiting Program Evaluation (OPRE Report 2019-07). [Study 2-HFA contrast]. U.S. Department of Health and Human Services, Administration for Children and Families, Office of Planning, Research, and Evaluation. https://www.acf.hhs.gov/sites/default/files/documents/opre/mihope_impac….
| 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 |
The Mother and Infant Home Visiting Program Evaluation (MIHOPE) included four evidence-based home visiting models; this review focuses on Healthy Families America (HFA) and the findings in Michalopoulos et al. 2019. HomVEE has reviewed additional analyses from the MIHOPE evaluation under Knox & Michalopoulos, 2023. Findings in the manuscript that are pooled across various home visiting models are ineligible for review because HomVEE only reviews findings that isolate the effects of a specific model. Findings from the manuscript about quality of the home environment, receptive language skills, and child maltreatment outcomes related to physical assault or psychological aggression received a rating of indeterminate because HomVEE could not assess whether the measures were reliable according to HomVEE standards. Information on sample sizes and reliability and validity of measures is based on correspondence with the authors.
| Study participants | The Mother and Infant Home Visiting Program Evaluation (MIHOPE) is a national evaluation of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program. MIHOPE study participants were recruited from 2012 to 2015. Participants were eligible for the MIHOPE evaluation if they were age 15 or older at enrollment, were pregnant or had children younger than six months old, spoke English or Spanish proficiently, and met the relevant eligibility criteria for the local home visiting model. A total of 1,458 participants were recruited for the study in Healthy Families America (HFA) programs and randomly assigned to either the HFA home visiting intervention group (725 participants) or the comparison condition (733 participants). Up to 1,102 participants recruited for the study through HFA programs were included in the analyses: 541 in HFA and 561 in the comparison group. Similarly, up to 1,370 children of these participants were included in the analyses: 680 in HFA and 690 in the comparison group. Outcomes were measured when children were 15 months old. For the MIHOPE participants recruited through HFA programs, 22 percent of women were of Mexican origin, 12 percent were another Hispanic ethnicity, 27 percent were White, 31 percent were Black, and 8 percent were another race. Forty-three percent had less than a high school diploma at study entry. At enrollment, the average age of participants recruited through HFA programs was 24. |
|---|---|
| Setting | The study took place in 12 states: California, Georgia, Illinois, Iowa, Kansas, Michigan, Nevada, New Jersey, Pennsylvania, South Carolina, Washington, and Wisconsin. The evaluation selected 26 local program affiliates that operated Healthy Families America (HFA) and met program eligibility criteria. |
| Intervention services | As described in this manuscript, Healthy Families America (HFA) consists of activities designed to assess family needs, educate and support parents, and refer families to community services. The content and delivery of HFA vary, but the intervention has historically focused on preventing child maltreatment and is typically geared toward families at risk of child maltreatment or with behavioral health issues. HFA participants in this evaluation enrolled during pregnancy or within the first three months after a child’s birth and were offered weekly visits during critical periods (for example, shortly after birth). Participants were offered HFA services through the child’s third birthday, but services could be extended until the child reached age five. |
| Comparison conditions | Women assigned to the comparison group were not eligible to receive Healthy Families America (HFA) services. They received information about other appropriate services in their local community. |
| 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 Administration for Children and Families, funded by the U.S. Department of Health and Human Services under a competitive award, Contract No. HHS-HHSP23320095644WC. |
| Author affiliation | Authors are affiliated with MDRC and subcontractors James Bell Associates, Johns Hopkins University, Mathematica, the University of Georgia, and Columbia University. HomVEE is not aware of any relationship between the authors and the home visiting model developer or distributor. |
| Peer reviewed | No |
Clinicaltrials.gov Identifier: NCT02069782. 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 | Brief Infant Toddler Social and Emotional Assessment (BITSEA), total problem score (fixed effect random slope analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,126 children | Not reported | Not reported | Not reported | Study reported = -0.07 | Not statistically significant, p= 0.15 |
Negative effect is favorable to the intervention. |
| High | Brief Infant Toddler Social and Emotional Assessment (BITSEA), total problem score (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,126 children | Not reported | Not reported | Not reported | Study reported = -0.07 | Not statistically significant, p= 0.23 |
Negative effect is favorable to the intervention. |
| High | Brief Infant Toddler Social and Emotional Assessment (BITSEA), total problem score (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,126 children | Not reported | Not reported | Difference = -0.10 | Study reported = -0.10 | Not statistically significant, p= 0.08 |
Negative effect is favorable to the intervention. |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | Number of Medicaid-paid child emergency department visits (fixed effect random slope analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,210 children | Not reported | Not reported | Difference = -0.20 | Not available | Not statistically significant, p= 0.22 |
|
| High | Number of Medicaid-paid child emergency department visits (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,210 children | Not reported | Not reported | Difference = -0.20 | Not available | Not statistically significant, p= 0.30 |
|
| High | Number of Medicaid-paid child emergency department visits (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,210 children | Not reported | Not reported | Difference = -0.20 | Not available | Not statistically significant, p= 0.21 |
|
| High | Number of Medicaid-paid well-child visits (fixed effect random slope analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,210 children | Not reported | Not reported | Difference = -0.20 | Not available | Not statistically significant, p= 0.25 |
|
| High | Number of Medicaid-paid well-child visits (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,210 children | Not reported | Not reported | Difference = -0.20 | Not available | Not statistically significant, p= 0.34 |
|
| High | Number of Medicaid-paid well-child visits (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,210 children | Not reported | Not reported | Difference = -0.10 | Not available | Not statistically significant, p= 0.46 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | Health insurance coverage for the child, % (fixed effect random slope analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,370 children | Not reported | Not reported | Difference = -0.01 | Not available | Not statistically significant, p= 0.51 |
|
| High | Health insurance coverage for the child, % (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,370 children | Not reported | Not reported | Difference = -0.01 | Not available | Not statistically significant, p= 0.45 |
|
| High | Health insurance coverage for the child, % (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,370 children | Not reported | Not reported | Difference = -0.01 | HomVEE calculated = -0.12 | Not statistically significant, p= 0.39 |
|
| High | Receiving education or training, % (fixed effect random slope analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,102 mothers | Not reported | Not reported | Difference = 0.02 | Not available | Not statistically significant, p= 0.49 |
|
| High | Receiving education or training, % (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,102 mothers | Not reported | Not reported | Difference = 0.02 | Not available | Not statistically significant, p= 0.52 |
|
| High | Receiving education or training, % (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,102 mothers | Not reported | Not reported | Difference = 0.02 | HomVEE calculated = 0.07 | Not statistically significant, p= 0.43 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | New pregnancy after study entry, % (fixed effect random slope analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,091 mothers | Not reported | Not reported | Difference = 0.01 | Not available | Not statistically significant, p= 0.73 |
|
| High | New pregnancy after study entry, % (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,091 mothers | Not reported | Not reported | Difference = 0.01 | Not available | Not statistically significant, p= 0.79 |
|
| High | New pregnancy after study entry, % (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,091 mothers | Not reported | Not reported | Difference = -0.01 | HomVEE calculated = -0.05 | Not statistically significant, p= 0.62 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | Three-Bag Task composite score of parental supportiveness (fixed effect random slope analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
888 mothers | Not reported | Not reported | Not reported | Study reported = -0.09 | Not statistically significant, p= 0.15 |
|
| High | Three-Bag Task composite score of parental supportiveness (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
888 mothers | Not reported | Not reported | Difference = -0.09 | Not available | Not statistically significant, p= 0.21 |
|
| High | Three-Bag Task composite score of parental supportiveness (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
888 mothers | Not reported | Not reported | Difference = -0.07 | Study reported = -0.07 | Not statistically significant, p= 0.26 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | Any Medicaid-paid health care encounter for injury or ingestion, % (fixed effect random slope analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,210 children | Not reported | Not reported | Difference = 0.03 | Not available | Not statistically significant, p= 0.35 |
|
| High | Any Medicaid-paid health care encounter for injury or ingestion, % (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,210 children | Not reported | Not reported | Difference = 0.02 | Not available | Not statistically significant, p= 0.47 |
|
| High | Any Medicaid-paid health care encounter for injury or ingestion, % (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,210 children | Not reported | Not reported | Difference = 0.02 | HomVEE calculated = 0.06 | Not statistically significant, p= 0.42 |