Manuscript Details

Kirkland, K., & Mitchell-Herzfeld, S. (2012). Evaluating the effectiveness of home visiting services in promoting children’s adjustment in school: Final report to the Pew Center on the States. Rensselaer, NY: New York State Office of Children and Family Services, Bureau of Evaluation and Research.

Moderate rating
Study reviewed under: Handbook of Procedures and Standards, Version 1
Author Affiliation

None of the study authors are developers of this model.

Funding Sources

The Pew Charitable Trusts, The Pew Center on the States, Grant #2010-0588.

Study Design
Design Attrition Baseline equivalence Confounding factors Valid, reliable measures?
Randomized controlled trial High

Established on race and SES. Baseline equivalence on outcomes not feasible.

None

Not assessed in manuscripts reviewed under Handbook of Procedures and Standards, Version 1

Findings that rate moderate or high in this manuscript

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
Retained in first grade 1st grade Moderate
0.44 Statistically significant, p < 0.05 577 mother/child dyads Healthy Families New York (HFNY) RCT, Year 7
Excelling academically 1st grade Moderate
0.19 Not statistically significant, p ≥ 0.05 577 mother/child dyads Healthy Families New York (HFNY) RCT, Year 7
Excelling academically - Reading and Math 1st grade Moderate
0.01 Not statistically significant, p ≥ 0.05 577 mother/child dyads Healthy Families New York (HFNY) RCT, Year 7
Excelling academically - All 3 behaviors that promote learning 1st grade Moderate
0.36 Statistically significant, p < 0.05 577 mother/child dyads Healthy Families New York (HFNY) RCT, Year 7
Doing poorly academically 1st grade Moderate
0.07 Not statistically significant, p ≥ 0.05 577 mother/child dyads Healthy Families New York (HFNY) RCT, Year 7
Doing poorly academically - Reading or Math 1st grade Moderate
0.14 Not statistically significant, p ≥ 0.05 577 mother/child dyads Healthy Families New York (HFNY) RCT, Year 7
Doing poorly academically - Any of the 3 behaviors that promote learning 1st grade Moderate
0.03 Not statistically significant, p ≥ 0.05 577 mother/child dyads Healthy Families New York (HFNY) RCT, Year 7
Days absent 1st grade Moderate
1.37 Not statistically significant, p ≥ 0.05 577 mother/child dyads Healthy Families New York (HFNY) RCT, Year 7
Effect rating key
Favorable finding / Statistically significant
Unfavorable finding / Statistically significant
Ambiguous finding / Statistically significant
No effect / Not statistically significant
Study Participants

Community agencies, including prenatal care providers and hospitals, screened expectant parents and parents with an infant younger than 3 months of age who lived in high-risk target areas and who were considered to be at risk for child abuse or neglect. Women were selected for the study following the same screening and assessment procedures used to determine eligibility for Healthy Families New York (HFNY). Family assessment workers (FAWs) obtained informed consent from women before the administration of a well-established risk assessment tool. In total 1,254 mothers were randomly assigned (intervention, n = 621; control, n = 633), and 1,173 mothers (intervention, n = 579; control, n = 594) completed baseline interviews. This study reported on the Year 7 follow-up for this study sample, with the authors matching Grade 1 school records when possible for study children whose mothers provided consent for the record collection. This results in an analysis sample size of 577 children (intervention, n = 288; control, n = 289). In this analysis sample, 36 percent of the mothers were white, non-Latina; 46 percent were African American, non-Latina; and 16 percent were Latina. Fifty-six percent of the study children were the first child for mothers in the study; 47 percent of mothers had a high school diploma or equivalent, and 28 percent were receiving cash assistance at random assignment. The authors’ estimation of annual earnings for mothers in the analysis sample was $5,173.

Setting

This study took place in three sites within the HFNY home visiting program.

Home Visiting Services

HFNY, which is based on the Healthy Families America (HFA) model, was established as a strengths-based, intensive home visitation program with the explicit goals of (1) promoting positive parenting skills and parent-child interaction; (2) preventing child abuse and neglect; (3) supporting optimal prenatal care, and child health and development; and (4) improving parents’ self-sufficiency.

Families are provided intensive home visitation services bi-weekly during the prenatal period, weekly until the child is at least 6 months old, and periodically thereafter based on the needs of the family until the child begins school or Head Start. Home visits typically emphasize content that is appropriate to the particular service level on which the family is currently assigned. For example, visits on the prenatal level focus on promoting adequate prenatal care and providing information regarding fetal development, as well as preparing the family for childbirth and providing instruction on the care and safety of a newborn. Postnatal visits focus primarily on promoting positive parent-child interactions, educating parents about child growth and development, and enhancing family functioning and self-sufficiency.

HFNY programs determine the most appropriate curricula to use during home visits based on the specific needs and characteristics of individual families. At all stages, home visitors provide support, education, information, and activities designed to promote healthy parenting behaviors and child growth, including proper nutrition, age-appropriate behaviors, and positive discipline strategies. Home visitors also help mothers access health care and other services as needed; identify and address issues regarding positive family functioning; and discuss child care, education, training, and employment options.

Comparison Conditions

The control group was given information on and received referrals to appropriate services other than home visiting.

Were any subgroups examined?
No

This study included participants with the following characteristics at enrollment:

Race/Ethnicity

The race and ethnicity categories may sum to more than 100 percent if Hispanic ethnicity was reported separately or respondents could select two or more race or ethnicity categories.

Black or African American
46%
Hispanic or Latino
16%
White
36%
Unknown
2%

Maternal Education

Less than a high school diploma
53%
High school diploma or GED
47%

Other Characteristics

Enrollment in means-tested programs
38%