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 1-EHS 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 Early Head Start (EHS). 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 about children’s language skills, psychological and physical assault, and quality of the home environment received an indeterminate rating because HomVEE could not assess whether the measures were reliable according to HomVEE standards. Information on sample sizes and reliability of measures is based on correspondence with the authors.
| Study participants | Study participants were recruited into the Mother and Infant Home Visiting Program Evaluation (MIHOPE) 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 573 participants were randomly assigned to either the Early Head Start–Home-based option (EHS–HBO) intervention group (285 participants) or the comparison condition (288 participants). Up to 535 participants and one focal child each were included in the study: 264 in EHS–HBO and 271 in the comparison group. Outcomes were measured when the focal child was 15 months old. In the study, 17 percent of mothers were of Mexican origin, 7 percent were another Hispanic ethnicity, 31 percent were non-Hispanic White, 34 percent were non-Hispanic Black, and 11 percent identified as another race. Thirty-eight percent of mothers did not have a high school diploma at study enrollment. At enrollment, the average of participating mothers was 25. |
|---|---|
| Setting | The study took place in 12 states: California, Georgia, Illinois, Iowa, Kansas, Michigan, Nevada, New Jersey, Pennsylvania, South Carolina, Washington, and Wisconsin. The study selected 19 local program affiliates that operated EHS–HBO and met program eligibility criteria. |
| Intervention services | Early Head Start–Home-based option (EHS–HBO) consisted of weekly home visits. The manuscript does not provide any other information on the EHS–HBO programs in the study, including the intensity or length of services offered to participating families. Generally, the content and delivery of EHS–HBO vary, but the intervention has historically focused on providing continuous, intensive, and comprehensive child development and family support services; and families are eligible to receive services until the child’s third birthday. |
| Comparison conditions | Families assigned to the comparison condition were not eligible to enroll in the Early Head Start–Home-based option. They could receive other services available in the 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, 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. 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 | Brief Infant Toddler Social and Emotional Assessment (BITSEA), total problem score (fixed effect random slope analysis) |
FavorableUnfavorable or ambiguousNo Effect |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
470 children | Not reported | Not reported | Not reported | Study reported = -0.01 | Not statistically significant, p= 0.88 |
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 |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
470 children | Not reported | Not reported | Not reported | Study reported = -0.01 | Not statistically significant, p= 0.92 |
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 |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
470 children | Not reported | Not reported | Difference = -0.10 | Study reported = -0.10 | Not statistically significant, p= 0.27 |
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 |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
445 children | Not reported | Not reported | Difference = 0.30 | Not available | Not statistically significant, p= 0.07 |
|
| High | Number of Medicaid-paid child emergency department visits (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
445 children | Not reported | Not reported | Difference = 0.30 | Not available | Not statistically significant, p= 0.26 |
|
| High | Number of Medicaid-paid child emergency department visits (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
445 children | Not reported | Not reported | Difference = 0.20 | Not available | Not statistically significant, p= 0.36 |
|
| High | Number of Medicaid-paid well-child visits (fixed effect random slope analysis) |
FavorableUnfavorable or ambiguousNo Effect |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
445 children | Not reported | Not reported | Difference = 0.50 | Not available | Not statistically significant, p= 0.06 |
|
| High | Number of Medicaid-paid well-child visits (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
445 children | Not reported | Not reported | Difference = 0.40 | Not available | Not statistically significant, p= 0.23 |
|
| High | Number of Medicaid-paid well-child visits (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
445 children | Not reported | Not reported | Difference = 0.10 | Not available | Not statistically significant, p= 0.64 |
| 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 |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
535 children | Not reported | Not reported | Difference = 0.01 | Not available | Not statistically significant, p= 0.45 |
|
| High | Health insurance coverage for the child, % (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
535 children | Not reported | Not reported | Difference = 0.01 | Not available | Not statistically significant, p= 0.55 |
|
| High | Health insurance coverage for the child, % (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
535 children | Not reported | Not reported | Difference = 0.01 | HomVEE calculated = 0.21 | Not statistically significant, p= 0.49 |
|
| High | Receiving education or training, % (fixed effect random slope analysis) |
FavorableUnfavorable or ambiguousNo Effect |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
458 mothers | Not reported | Not reported | Difference = 0.03 | Not available | Not statistically significant, p= 0.47 |
|
| High | Receiving education or training, % (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
458 mothers | Not reported | Not reported | Difference = 0.03 | Not available | Not statistically significant, p= 0.51 |
|
| High | Receiving education or training, % (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
458 mothers | Not reported | Not reported | Difference = 0.01 | HomVEE calculated = 0.04 | Not statistically significant, p= 0.80 |
| 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 |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
457 mothers | Not reported | Not reported | Difference = 0.03 | Not available | Not statistically significant, p= 0.54 |
|
| High | New pregnancy after study entry, % (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
457 mothers | Not reported | Not reported | Difference = 0.03 | Not available | Not statistically significant, p= 0.52 |
|
| High | New pregnancy after study entry, % (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
457 mothers | Not reported | Not reported | Difference = 0.03 | HomVEE calculated = 0.14 | 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 |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
397 mothers | Not reported | Not reported | Not reported | Study reported = 0.05 | Not statistically significant, p= 0.62 |
|
| High | Three-Bag Task composite score of parental supportiveness (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
397 mothers | Not reported | Not reported | Not reported | Study reported = 0.05 | Not statistically significant, p= 0.64 |
|
| High | Three-Bag Task composite score of parental supportiveness (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
397 mothers | Not reported | Not reported | Difference = 0.00 | Study reported = 0.00 | Not statistically significant, p= 0.99 |
| 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 |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
442 children | Not reported | Not reported | Difference = -0.03 | Not available | Not statistically significant, p= 0.61 |
|
| High | Any Medicaid-paid health care encounter for injury or ingestion, % (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
442 children | Not reported | Not reported | Difference = -0.01 | Not available | Not statistically significant, p= 0.89 |
|
| High | Any Medicaid-paid health care encounter for injury or ingestion, % (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample |
15 months old |
442 children | Not reported | Not reported | Difference = 0.00 | HomVEE calculated = 0.00 | Not statistically significant, p= 0.98 |