Black or African American
25%
Love, J., Kisker, E., Ross, C., Schochet, P., Brooks-Gunn, J., Boller, K., et al. (2001). Building their futures: How Early Head Start programs are enhancing the lives of infants and toddlers in low-income families. Summary report. Report to Commissioner’s Office of Research and Evaluation, Head Start Bureau, Administration on Children, Youth and Families, and Department of Health and Human Services. Princeton, NJ: Mathematica Policy Research.
Model(s): Early Head Start—Home-based option
Study design characteristics contributing to rating
| Design | Attrition | Baseline equivalence | Confounding factors? | Valid, reliable measures? |
|---|---|---|---|---|
| Randomized controlled trial | Low |
Established on race/ethnicity and socioeconomic status; Established on many relevant outcomes |
None |
Not assessed in manuscripts reviewed under Handbook of Procedures and Standards, Version 1 |
Notes from the review of this manuscript
The study expressed some effect sizes as a percentage of the standard deviation. To be consistent with other studies, HomVEE divided the study-reported effect size by 100 and rounded to two decimal places.
This study received a mixed rating. Outcomes from the 24-month parent interview have low attrition and receive a high rating, except parent’s overall health and maternal depression outcomes, which were assessable at baseline but did not demonstrate baseline equivalence and were not controlled, and therefore rate moderate. Outcomes from the Parent Services Interview had low attrition, but baseline equivalence for race/ethnicity and SES was not established on the analytic sample, so these outcomes rate moderate. Outcomes from the Child Assessment (Bayley) and Parent/Child Interactions have high attrition and were not assessable at baseline, so those outcomes receive a moderate rating.
Child Development and School Readiness
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description |
|---|---|---|---|---|---|---|---|
| CBCL – Aggression | Age 2 | High | 0.01 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| BSID Mental Development Index (MDI)standard score | Age 2 | Moderate | 0.08 | Not statistically significant, p ≥ 0.05 | 814 children | EHS-HBO impact study | |
| Average MacArthur CDI – Sentence Complexity | Age 2 | High | 0.08 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Bayley BRS – Emotional Regulation | Age 2 | Moderate | 0.07 | Not statistically significant, p ≥ 0.05 | 814 children | EHS-HBO impact study | |
| Bayley BRS – Orientation/Engagement | Age 2 | Moderate | 0.01 | Not statistically significant, p ≥ 0.05 | 814 children | EHS-HBO impact study | |
| MacArthur CDI – Vocabulary Production | Age 2 | High | 0.13 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Parent-Child Structured Play: Child Engagement | Age 2 | Moderate | 0.02 | Not statistically significant, p ≥ 0.05 | 794 children | EHS-HBO impact study | |
| Parent-Child Structured Play: Child Negativity Toward Parent | Age 2 | Moderate | 0.02 | Not statistically significant, p ≥ 0.05 | 794 children | EHS-HBO impact study | |
| Parent-Child Structured Play: Child Sustained Attention with Objects | Age 2 | Moderate | 0.05 | Not statistically significant, p ≥ 0.05 | 794 children | EHS-HBO impact study | |
| Percentage MacArthur CDI combining words | Age 2 | High | 0.04 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Percentage with MDI < 100 | Age 2 | Moderate | 0.03 | Not statistically significant, p ≥ 0.05 | 814 children | EHS-HBO impact study | |
| Percentage with MDI < 85 | Age 2 | Moderate | 0.02 | Not statistically significant, p ≥ 0.05 | 814 children | EHS-HBO impact study | |
| Percentage with sentence complexity | Age 2 | High | 0.04 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Percentage with vocabulary production | Age 2 | High | 0.01 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study |
Child Health
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description |
|---|---|---|---|---|---|---|---|
| Any child health services | 7 to 16 months after assignment | Moderate | 0.05 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact sample | |
| Any dentist visits | 7 to 16 months after assignment | Moderate | 0.01 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact sample | |
| Any doctor visits | 7 to 16 months after assignment | Moderate | 0.02 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact sample | |
| Any emergency room visits | 7 to 16 months after assignment | Moderate | 0.05 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact sample | |
| Any immunizations | 7 to 16 months after assignment | Moderate | 0.35 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact sample | |
| Any screening tests | 7 to 16 months after assignment | Moderate | 0.07 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact sample |
Family Economic Self-Sufficiency
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description |
|---|---|---|---|---|---|---|---|
| Average hours per week employed | 7 to 16 months after assignment | Moderate | 0.07 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Average hours per week in any employment, education, or training activity | 7 to 16 months after assignment | Moderate | 0.01 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Average hours per week in education or training | 7 to 16 months after assignment | Moderate | 0.16 | Statistically significant,p < 0.01 | 1059 mothers | EHS-HBO impact study | |
| Employed: 1st quarter | 7 to 16 months after assignment | Moderate | 0.06 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Employed: 2nd quarter | 7 to 16 months after assignment | Moderate | 0.13 | Statistically significant,p < 0.05 | 1059 mothers | EHS-HBO impact study | |
| Employed: 3rd quarter | 7 to 16 months after assignment | Moderate | 0.08 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Employed: 4th quarter | 7 to 16 months after assignment | Moderate | 0.02 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Employed: 5th quarter | 7 to 16 months after assignment | Moderate | 0.08 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Employment, education, or training: 1st quarter | 7 to 16 months after assignment | Moderate | 0.00 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Employment, education, or training: 2nd quarter | 7 to 16 months after assignment | Moderate | 0.04 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Employment, education, or training: 3rd quarter | 7 to 16 months after assignment | Moderate | 0.03 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Employment, education, or training: 4th quarter | 7 to 16 months after assignment | Moderate | 0.04 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Employment, education, or training: 5th quarter | 7 to 16 months after assignment | Moderate | 0.03 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Ever employed | 7 to 16 months after assignment | Moderate | 0.06 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Ever employed or in education/training | 7 to 16 months after assignment | Moderate | 0.03 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Ever in ESL class (percentage) | 7 to 16 months after assignment | Moderate | 0.15 | Statistically significant,p < 0.05 | 1059 mothers | EHS-HBO impact study | |
| Ever in education or training (percentage) | 7 to 16 months after assignment | Moderate | 0.12 | Statistically significant,p < 0.05 | 1059 mothers | EHS-HBO impact study | |
| Ever in high school (percentage) | 7 to 16 months after assignment | Moderate | 0.18 | Statistically significant,p < 0.01 | 1059 mothers | EHS-HBO impact study | |
| Ever in vocational program (percentage) | 7 to 16 months after assignment | Moderate | 0.15 | Statistically significant,p < 0.05 | 1059 mothers | EHS-HBO impact study | |
| Ever received AFDC or TANF | 7 to 16 months after assignment | Moderate | 0.03 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Ever received food stamps | 7 to 16 months after assignment | Moderate | 0.04 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Ever received welfare | 7 to 16 months after assignment | Moderate | 0.06 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Have GED | 7 to 16 months after assignment | Moderate | 0.03 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Have high school diploma | 7 to 16 months after assignment | Moderate | 0.01 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| In education or training: 1st quarter | 7 to 16 months after assignment | Moderate | 0.03 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| In education or training: 2nd quarter | 7 to 16 months after assignment | Moderate | 0.10 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| In education or training: 3rd quarter | 7 to 16 months after assignment | Moderate | 0.06 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| In education or training: 4th quarter | 7 to 16 months after assignment | Moderate | 0.13 | Statistically significant,p < 0.05 | 1059 mothers | EHS-HBO impact study | |
| In education or training: 5th quarter | 7 to 16 months after assignment | Moderate | 0.16 | Statistically significant,p < 0.05 | 1059 mothers | EHS-HBO impact study | |
| Income above poverty line, (percentage) | 7 to 16 months after assignment | Moderate | 0.02 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Received AFDC or TANF: 1st quarter | 7 to 16 months after assignment | Moderate | 0.06 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Received AFDC or TANF: 2nd quarter | 7 to 16 months after assignment | Moderate | 0.01 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Received AFDC or TANF: 3rd quarter | 7 to 16 months after assignment | Moderate | 0.05 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Received AFDC or TANF: 4th quarter | 7 to 16 months after assignment | Moderate | 0.01 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Received AFDC or TANF: 5th quarter | 7 to 16 months after assignment | Moderate | 0.02 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Total AFDC or TANF benefits ($) | 7 to 16 months after assignment | Moderate | 0.02 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Total food stamps benefits ($) | 7 to 16 months after assignment | Moderate | 0.02 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Total welfare benefits ($) | 7 to 16 months after assignment | Moderate | 0.05 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study |
Linkages and Referrals
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description |
|---|---|---|---|---|---|---|---|
| Any education-related services | 7 to 16 months after assignment | Moderate | 1.09 | Statistically significant, p < 0.01 | 1059 mothers | EHS-HBO impact study | |
| Any employment-related services | 7 to 16 months after assignment | Moderate | 1.00 | Statistically significant, p < 0.01 | 1059 mothers | EHS-HBO impact study | |
| Any family health services | 7 to 16 months after assignment | Moderate | 0.18 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Any family mental health services | 7 to 16 months after assignment | Moderate | 0.05 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Housing assistance | 7 to 16 months after assignment | Moderate | 0.03 | Not statistically significant, p ≥ 0.05 | 1059 mothers | EHS-HBO impact study | |
| Identification of child’s disability | 7 to 16 months after assignment | Moderate | 0.45 | Statistically significant, p < 0.05 | 1059 mothers | EHS-HBO impact study | |
| Services for child with disability | 7 to 16 months after assignment | Moderate | 0.50 | Statistically significant, p < 0.05 | 1059 mothers | EHS-HBO impact study | |
| Transportation assistance | 7 to 16 months after assignment | Moderate | 0.29 | Statistically significant, p < 0.01 | 1059 mothers | EHS-HBO impact study |
Maternal Health
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description |
|---|---|---|---|---|---|---|---|
| CIDI short screening scales: Major depression (probability) | 24 months postpartum | Moderate | 0.09 | Not statistically significant, p ≥ 0.05 | 966 mothers | EHS-HBO impact sample | |
| FES: Family conflict | 24 months postpartum | High | 0.12 | Not statistically significant, p ≥ 0.05 | 966 mothers | EHS-HBO impact sample | |
| PSI Parent-Child dysfunctional interaction | 24 months postpartum | High | 0.07 | Not statistically significant, p ≥ 0.05 | 966 mothers | EHS-HBO impact sample | |
| PSI parental distress | 24 months postpartum | High | 0.11 | Not statistically significant, p ≥ 0.05 | 966 mothers | EHS-HBO impact sample | |
| Parent’s health status | 24 months postpartum | Moderate | 0.00 | Not statistically significant, p ≥ 0.05 | 966 mothers | EHS-HBO impact sample |
Positive Parenting Practices
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description |
|---|---|---|---|---|---|---|---|
| HOME absence of punitive interactions | Age 2 | High | 0.01 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| HOME emotional responsivity | Age 2 | High | 0.10 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| HOME maternal verbal/social skills | Age 2 | High | 0.05 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| HOME support of cognitive, language, and literacy environment | Age 2 | High | 0.10 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| HOME total score | Age 2 | High | 0.13 | Statistically significant,p < 0.05 | 966 children | EHS-HBO impact study | |
| KIDI | Age 2 | High | 0.17 | Statistically significant,p < 0.05 | 966 children | EHS-HBO impact study | |
| Covers electric outlets (percentage) | Age 2 | High | 0.08 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Has gates or doors in front of stairs (percentage) | Age 2 | High | 0.07 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Has poison control number (percentage) | Age 2 | High | 0.00 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Has syrup of Ipecac at home (percentage) | Age 2 | High | 0.01 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Home has working smoke alarm (percentage) | Age 2 | High | 0.00 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Index of discipline severity | Age 2 | High | 0.06 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Observed child play area is safe (percentage) | Age 2 | High | 0.01 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Parent-child activities to stimulate cognitive and language development | Age 2 | High | 0.05 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Parent-child structured play: Negative regard | Age 2 | Moderate | 0.05 | Not statistically significant, p ≥ 0.05 | 794 children | EHS-HBO impact study | |
| Parent-child structured play: Parent detachment | Age 2 | Moderate | 0.15 | Not statistically significant, p ≥ 0.05 | 794 children | EHS-HBO impact study | |
| Parent-child structured play: Parent intrusiveness | Age 2 | Moderate | 0.07 | Not statistically significant, p ≥ 0.05 | 794 children | EHS-HBO impact study | |
| Parent-child structured play: Parent supportiveness | Age 2 | Moderate | 0.14 | Not statistically significant, p ≥ 0.05 | 794 children | EHS-HBO impact study | |
| Percentage of parents and children that have regular bedtime routines | Age 2 | High | 0.09 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Percentage of parents suggesting only mild responses to the hypothetical conflicts | Age 2 | High | 0.06 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Percentage of parents that read to child as part of bedtime routine | Age 2 | High | 0.16 | Statistically significant,p < 0.05 | 966 children | EHS-HBO impact study | |
| Percentage of parents that read to child daily | Age 2 | High | 0.02 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Percentage of parents that set a regular bedtime for child | Age 2 | High | 0.09 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Percentage of parents that suggest responses to hypothetical conflict with child: Physical punishment | Age 2 | High | 0.07 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Percentage of parents that suggest responses to hypothetical conflict with child: Prevent or distract | Age 2 | High | 0.07 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Percentage of parents that suggest responses to hypothetical conflict with child: Remove child or object | Age 2 | High | 0.05 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Percentage of parents that suggest responses to hypothetical conflict with child: Shout | Age 2 | High | 0.11 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Percentage of parents that suggest responses to hypothetical conflict with child: Talk and explain | Age 2 | High | 0.13 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Percentage of parents that suggest responses to hypothetical conflict with child: Threaten or command | Age 2 | High | 0.01 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Reading frequency | Age 2 | High | 0.01 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Spanked child in last week (percentage) | Age 2 | High | 0.07 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Uses a car seat (percentage) | Age 2 | High | 0.01 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study | |
| Uses guards or gates for windows (percentage) | Age 2 | High | 0.06 | Not statistically significant, p ≥ 0.05 | 966 children | EHS-HBO impact study |
This study included participants from the following locations:
- State not reported or international
Study Participants
This study relies on data from a randomized controlled trial of 17 Early Head Start (EHS) programs that began in 1995. Seven of the programs served clients through a home-based option (though other clients in other EHS options also received home visits) and are the focus of this report (EHS-HBO). The study randomly assigned 1,385 families, who applied to those 7 programs, either to receive home-based EHS or a comparison condition. This study included outcomes reported for the 2-year-old follow-up (other years of follow-up are reported in separate studies). For this follow-up, 966 parents (500 in EHS-HBO and 466 in the comparison group) provided data for parent interviews. Among parent interview participants, 45 percent were white, 25 percent were black, and 27 percent were Hispanic. One in four parents had more than a high school education, and one in 10 were in families living above the poverty line; one-third to one-half of families were receiving Aid to Families with Dependent Children (AFDC) or Food Stamps.
Setting
The study was conducted in 17 EHS programs throughout the United States, including 7 programs with home-based options, which are the focus of this report. Four programs were located in urban areas, and three programs were located in rural areas. The seven programs represented a mix of implementation timing; one early implementer had all EHS-HBO elements in place by 1997, and three later implementers had all elements in place by 1999; three programs did not have all elements in place by 1999. The early-implementing program had fully implemented both child and family development services early and continued to have those services in place in 1999.
Intervention condition
Note: Navigate to the model page for more information about the home visiting model. See the source manuscript for more information about how the model was implemented in this study.
Comparison Conditions
Control group families could not receive EHS-HBO services, but could receive other services available in their community.
Funding Sources
Administration for Children and Families (ACF), the Child Outcomes Research and Evaluation team (CORE)within ACF’s Office of Planning, Research and Evaluation (OPRE), and the Head Start Bureau in the Administration on Children, Youth and Families (ACYF)