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 3-NFP 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 the Nurse-Family Partnership and the findings in Michalopoulos et al. 2019. HomVEE has reviewed additional analyses from the MIHOPE evaluation in Knox & Michalopoulos, 2023. Findings in the manuscript that were pooled across various home visiting models were 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 pregnant or had children younger than 6 months old, were age 15 or older at enrollment, spoke English or Spanish proficiently, and met the relevant eligibility criteria for the local home visiting model. A total of 1,235 participants were recruited for the study through Nurse-Family Partnership (NFP) programs were randomly assigned to either the NFP home visiting intervention group (615 participants) or the comparison condition (620 participants). Up to 911 participants recruited for the study through NFP programs were included in the analyses: 455 in NFP and 456 in the comparison group. Similarly, up to 1,113 children of these participants were included in the analyses: 554 in NFP and 559 in the comparison group. Outcomes were measured when children were 15 months old. For the MIHOPE participants recruited through NFP programs, 30 percent of participants were of Mexican origin, 18 percent were another Hispanic ethnicity, 17 percent were White, 24 percent were Black, and 10 percent were another race. Forty-one percent did not have a high school diploma at study entry. At enrollment, the average age of participants recruited through NFP programs was 21. |
|---|---|
| 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 22 local program affiliates that operated Nurse-Family Partnership and met program eligibility criteria. |
| Intervention services | As described in this manuscript, the Nurse-Family Partnership (NFP) intervention consists of activities designed to help participants obtain prenatal care, improve their diets, reduce their use of harmful substances, provide responsible and competent care for their children, plan future pregnancies, continue their education, and find work. The content and delivery of NFP vary, with flexibility of the visit, content, and frequency based on families’ strengths, risks, and needs. Participants enroll in NFP when they are no more than 28 weeks pregnant. NFP participants in this evaluation enrolled before the end of the 28th week of pregnancy and were offered weekly visits during critical periods (for example, shortly after birth). Participants were offered NFP services through the child’s second birthday. |
| Comparison conditions | Participants assigned to the comparison group were not eligible to receive Nurse-Family Partnership 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, and 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, and New York 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 |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
929 children | Not reported | Not reported | Not reported | Study reported = -0.12 | Not statistically significant, p= 0.11 |
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 |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
929 children | Not reported | Not reported | Not reported | Study reported = -0.12 | Not statistically significant, p= 0.16 |
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 |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
929 children | Not reported | Not reported | Difference = 0.02 | Study reported = 0.02 | Not statistically significant, p= 0.69 |
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 |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
895 children | Not reported | Not reported | Difference = -0.50 | Not available | Statistically significant, p= 0.02 |
|
| High | Number of Medicaid-paid child emergency department visits (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
895 children | Not reported | Not reported | Difference = -0.50 | Not available | Statistically significant, p= 0.03 |
|
| High | Number of Medicaid-paid child emergency department visits (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
895 children | Not reported | Not reported | Difference = -0.50 | Not available | Statistically significant, p= 0.01 |
|
| High | Number of Medicaid-paid well-child visits (fixed effect random slope analysis) |
FavorableUnfavorable or ambiguousNo Effect |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
895 children | Not reported | Not reported | Difference = -0.30 | Not available | Not statistically significant, p= 0.43 |
|
| High | Number of Medicaid-paid well-child visits (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
895 children | Not reported | Not reported | Difference = -0.20 | Not available | Not statistically significant, p= 0.45 |
|
| High | Number of Medicaid-paid well-child visits (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
895 children | Not reported | Not reported | Difference = -0.30 | Not available | Not statistically significant, p= 0.10 |
| 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 |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,113 children | Not reported | Not reported | Difference = -0.01 | Not available | Not statistically significant, p= 0.58 |
|
| High | Health insurance coverage for the child, % (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,113 children | Not reported | Not reported | Difference = -0.01 | Not available | Not statistically significant, p= 0.65 |
|
| High | Health insurance coverage for the child, % (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
1,113 children | Not reported | Not reported | Difference = -0.01 | HomVEE calculated = -0.17 | Not statistically significant, p= 0.40 |
|
| High | Receiving education or training, % (fixed effect random slope analysis) |
FavorableUnfavorable or ambiguousNo Effect |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
909 mothers | Not reported | Not reported | Difference = -0.06 | Not available | Not statistically significant, p= 0.08 |
|
| High | Receiving education or training, % (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
909 mothers | Not reported | Not reported | Difference = -0.06 | Not available | Not statistically significant, p= 0.15 |
|
| High | Receiving education or training, % (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
909 mothers | Not reported | Not reported | Difference = -0.04 | HomVEE calculated = -0.12 | Not statistically significant, p= 0.18 |
| 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 |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
903 mothers | Not reported | Not reported | Difference = 0.00 | Not available | Not statistically significant, p= 0.97 |
|
| High | New pregnancy after study entry, % (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
903 mothers | Not reported | Not reported | Difference = 0.00 | Not available | Not statistically significant, p= 0.98 |
|
| High | New pregnancy after study entry, % (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
903 mothers | Not reported | Not reported | Difference = 0.02 | HomVEE calculated = 0.09 | Not statistically significant, p= 0.40 |
| 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 |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
723 mothers | Not reported | Not reported | Not reported | Study reported = 0.08 | Not statistically significant, p= 0.40 |
|
| High | Three-Bag Task composite score of parental supportiveness (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
723 mothers | Not reported | Not reported | Not reported | Study reported = 0.08 | Not statistically significant, p= 0.41 |
|
| High | Three-Bag Task composite score of parental supportiveness (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
723 mothers | Not reported | Not reported | Difference = 0.14 | Study reported = 0.14 | Statistically significant, p= 0.04 |
| 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 |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
895 children | Not reported | Not reported | Difference = -0.04 | Not available | Not statistically significant, p= 0.42 |
|
| High | Any Medicaid-paid health care encounter for injury or ingestion, % (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
895 children | Not reported | Not reported | Difference = -0.04 | Not available | Not statistically significant, p= 0.35 |
|
| High | Any Medicaid-paid health care encounter for injury or ingestion, % (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
15 months old |
895 children | Not reported | Not reported | Difference = -0.03 | HomVEE calculated = -0.10 | Not statistically significant, p= 0.29 |