Manuscript Detail | Home Visiting Evidence of Effectiveness

Source

Fergusson, D. M., Horwood, L. J., Grant, H., & Ridder, E. M. (2005). Early start evaluation report. Christchurch, NZ: Early Start Project Ltd.

Rating

Moderate

Model(s) Reviewed

Early Start (New Zealand)

Author Affiliation

David M. Fergusson, a study author, is a board member of Early Start. Hildegard Grant, another study author, is the general manager of the program.

Funding Sources

Major funders are The Department of Child, Youth, and Family, Ministry of Health, Canterbury District Health Board, Christchurch City Council, Trustbank Community Trust and Health Research Council of New Zealand. Hyman Marks Trust, Mayor’s Welfare Fund, McKenzie Trust, Telecom New Zealand and UMC Ltd. provided other financial and non-financial support.

Study Design

Design	Attrition	Baseline equivalence	Confounding factors	Valid, reliable measures?
Randomized controlled trial	High	Established on race/ethnicity, SES, and outcomes	None

Notes

All findings from the peer-reviewed journal article that is cited as an additional source were included in the review of the Early start evaluation report. Both manuscripts report an intersecting set of findings, while the Early start evaluation report contains additional findings not included in the peer-reviewed article. Several maternal outcomes describing employment, hardship factors, contraceptive use, and stressful life events received a low rating because they were assessable at baseline but were not assessed.

In 2020, HomVEE updated this review in three ways. First, HomVEE removed mother's partnership status/family structure findings from the Family Economic Self-Sufficiency domain because ACF determined that mother's partnership status is ineligible for review by HomVEE. Second, HomVEE removed the finding "percent parental report of agency contact for abuse/neglect" from the Reductions in Child Maltreatment domain because some cases measured may be unsubstantiated. In this domain, HomVEE reviews only outcomes focused on substantiated cases of abuse and neglect. Finally, HomVEE clarified that the direction for the finding on duration of attendance for early childhood education is ambiguous, rather than favorable.

Study Participants

Nurses screened all families in the Christchurch area who had new infants. Screening included an 11-point assessment of family stress and an evaluation of the client's need for Early Start services. A total of 588 families were determined to be eligible and 443 families agreed to participate. Those 443 families were then randomly assigned to either the treatment or comparison group. The analysis sample consisted of 184 families in the treatment group and 207 in the comparison group. Approximately one quarter of the analysis sample was Māori, and weekly income in both the Early Start and comparison groups averaged about $340 per week (according to information provided by the authors). Results are reported as of the 36-month follow-up (certain outcomes have fewer than 391 respondents at this follow-up).

Setting

The study was conducted in Christchurch, New Zealand.

Home Visiting Services

Trained family support workers engaged in home visits to encourage positive family change in the following areas: child health, maternal well-being, parenting skills, family economic functioning, and crisis management. The services were tailored to each family’s particular circumstances. Initially, families received two hours of contact with a home visitor per week. Some families in crisis received more contact. The intensity of services decreased as families made progress. Once families became self-reliant, they received a home visit every three months.

Comparison Conditions

Comparison participants were not offered any services beyond what is typically available to families in the Christchurch, NZ area.

Subgroups examined

• Race/ethnicity (Māori or Non-Māori) • Parity (primiparous or multiparous) • Maternal age (less than 20 years or 20 or older) • Family disadvantage (low or high)