Black or African American
33%
Source
Sadler, L. S., Slade, A., Close, N., Webb, D. L., Simpson, T., Fennie, K., & Mayes, L. C. (2013). Minding the Baby: Enhancing reflectiveness to improve early health and relationship outcomes in an interdisciplinary home-visiting program. Infant Mental Health Journal, 34(5), 391-405.
Model(s) Reviewed
Study Registration
Funding Sources
National Institutes of Health, the Irving B. Harris Foundation, the FAR Fund, the Annie E. Casey Foundation, the Pritzker Early Childhood Foundation, the Seedlings Foundation, the Edlow Family, and the Schneider Family
Study Design
| Design | Attrition | Baseline equivalence | Confounding factors | Valid, reliable measures? |
|---|---|---|---|---|
| Randomized controlled trial | High | Established on race/ethnicity and SES | None |
Notes
In 2020, HomVEE updated this review to remove the Child abuse/maltreatment: Open cases with CPS-24 months finding 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.
In 2018, HomVEE updated this review to move measures of attachment from the Positive Parenting Practices domain to the Child Development and School Readiness domain because they assess child behavior.
Study Participants
The authors used a cluster-randomized trial to test the effects of Minding the Baby®. First-time mothers who attended group prenatal care sessions at the Fair Haven Community Health Center were recruited to participate; all participants who met inclusion criteria were invited into the study and assigned to the condition to which their prenatal group had been randomly assigned. Inclusion criteria for the mother were (a) English oral and comprehension fluency; (b) 14 to 25 years of age; (c) having a first child; (d) no active heroin or cocaine use (already a criteria for participating in group prenatal care); (e) no diagnoses of a psychotic disorder, according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition; and (f) no major or terminal chronic condition (AIDS, cancer, and so on; already an eligibility criteria for group prenatal care participation).
One-hundred and thirty-nine families met criteria and were assigned to the program or control group based on the random assignment status of their prenatal care group (72 treatment and 67 control). Among eligible mothers, 30 declined the invitation to participate (9 treatment and 21 control). After some additional attrition, 60 (treatment) and 45 (control) mothers participated in data collection at baseline. However, the authors also note further attrition at later data collection points; 44 treatment group mothers completed 12- and 24-month data collection, and approximately 34 and 31 control group mothers, respectively, completed data collection at these time points. Mothers were followed for approximately 27 months in total, including the time before the child's birth. Overall, the study sample of mothers was 28 percent black, 62 percent Latina, and 10 percent of another race/ethnicity.
Setting
New Haven, Connecticut
Home Visiting Services
Home visitor teams conducted home visits to enhance parental reflective functioning and the development of secure attachment of the infant. Home visitors conducted a prenatal assessment of the mothers’ reflective functioning capacity. The home visitors also addressed maternal physical and mental health as well as infant mental health clinical care. Home visiting began in pregnancy and occurred weekly until the child’s first birthday, and then biweekly until the child’s second birthday.
Comparison Conditions
Mothers in the control group received routine health care (prenatal visits, well-woman care, and well-baby care) as dictated by clinical guidelines. Families also received monthly information sheets about child rearing and health, and birthday and holiday cards.
Subgroups examined
• Maternal age (less than 20 years) • Maternal education (less than high school education) • Mother has low reflective functioning (yes or no)
Study Participants
The authors used a cluster-randomized trial to test the effects of Minding the Baby®. First-time mothers who attended group prenatal care sessions at the Fair Haven Community Health Center were recruited to participate; all participants who met inclusion criteria were invited into the study and assigned to the condition to which their prenatal group had been randomly assigned. Inclusion criteria for the mother were (a) English oral and comprehension fluency; (b) 14 to 25 years of age; (c) having a first child; (d) no active heroin or cocaine use (already a criteria for participating in group prenatal care); (e) no diagnoses of a psychotic disorder, according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition; and (f) no major or terminal chronic condition (AIDS, cancer, and so on; already an eligibility criteria for group prenatal care participation).
One-hundred and thirty-nine families met criteria and were assigned to the program or control group based on the random assignment status of their prenatal care group (72 treatment and 67 control). Among eligible mothers, 30 declined the invitation to participate (9 treatment and 21 control). After some additional attrition, 60 (treatment) and 45 (control) mothers participated in data collection at baseline. However, the authors also note further attrition at later data collection points; 44 treatment group mothers completed 12- and 24-month data collection, and approximately 34 and 31 control group mothers, respectively, completed data collection at these time points. Mothers were followed for approximately 27 months in total, including the time before the child's birth. Overall, the study sample of mothers was 28 percent black, 62 percent Latina, and 10 percent of another race/ethnicity.
Setting
New Haven, Connecticut
Home Visiting Services
Home visitor teams conducted home visits to enhance parental reflective functioning and the development of secure attachment of the infant. Home visitors conducted a prenatal assessment of the mothers’ reflective functioning capacity. The home visitors also addressed maternal physical and mental health as well as infant mental health clinical care. Home visiting began in pregnancy and occurred weekly until the child’s first birthday, and then biweekly until the child’s second birthday.
Comparison Conditions
Mothers in the control group received routine health care (prenatal visits, well-woman care, and well-baby care) as dictated by clinical guidelines. Families also received monthly information sheets about child rearing and health, and birthday and holiday cards.
Subgroups examined
• Maternal age (less than 20 years) • Maternal education (less than high school education) • Mother has low reflective functioning (yes or no)
Findings that rate moderate or high in this manuscript
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Immunizations - up-to-date - 12 months | 12 months | Moderate | p < 0.05 | 78 mothers | Minding the Baby pilot - 12 months | |||
| Immunizations - up-to-date - 24 months | 24 months | Moderate | p > 0.05 | 75 mothers | Minding the Baby pilot - 24 months |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Rapid subsequent childbearing - birth of second child within 24 months of the index birth | 24 months | Moderate | 1.42 | p = 0.019 | 75 mothers | Minding the Baby pilot - 24 months | ||
| Atypical Maternal Behavior Instrument for Assessment and Classification (AMBIANCE) Scale - response of Disrupted Communication | 4 months | Moderate | 0.35 | p = 0.2 | 76 mothers | Minding the Baby pilot - 4 months | ||
| Center for Epidemiological Studies Depression Scale (CES-D) - 12 months | 12 months | Moderate | 0.21 | p > 0.05 | 78 mothers | Minding the Baby pilot - 12 months | ||
| Center for Epidemiological Studies Depression Scale (CES-D) - 24 months | 24 months | Moderate | 0.20 | p > 0.05 | 75 mothers | Minding the Baby pilot - 24 months | ||
| Brief Symptom Inventory (BSI) - Global Severity Index (GSI) - 12 months | 12 months | Moderate | 0.10 | p > 0.05 | 78 mothers | Minding the Baby pilot - 12 months | ||
| Brief Symptom Inventory (BSI) - Global Severity Index (GSI) - 24 months | 24 months | Moderate | 0.12 | p > 0.05 | 75 mothers | Minding the Baby pilot - 24 months | ||
| Brief Symptom Inventory (BSI) - Somatization subscale - 12 months | 12 months | Moderate | 0.20 | p > 0.05 | 78 mothers | Minding the Baby pilot - 12 months | ||
| Brief Symptom Inventory (BSI) - Somatization subscale - 24 months | 24 months | Moderate | 0.01 | p > 0.05 | 75 mothers | Minding the Baby pilot - 24 months | ||
| Brief Symptom Inventory (BSI) - Depression subscale - 12 months | 12 months | Moderate | 0.20 | p > 0.05 | 78 mothers | Minding the Baby pilot - 12 months | ||
| Brief Symptom Inventory (BSI) - Depression subscale - 24 months | 24 months | Moderate | 0.23 | p > 0.05 | 75 mothers | Minding the Baby pilot - 24 months | ||
| Brief Symptom Inventory (BSI) - Anxiety subscale - 12 months | 12 months | Moderate | 0.23 | p > 0.05 | 78 mothers | Minding the Baby pilot - 12 months | ||
| Brief Symptom Inventory (BSI) - Anxiety subscale - 24 months | 24 months | Moderate | 0.20 | p > 0.05 | 75 mothers | Minding the Baby pilot - 24 months |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Strange Situation Procedure - Secure attachment | 12 months | Moderate | 0.39 | p = 0.28 | 71 mothers | Minding the Baby pilot - 12 months | ||
| Strange Situation Procedure - Disorganized attachment | 12 months | Moderate | 0.30 | p = 0.49 | 71 mothers | Minding the Baby pilot - 12 months |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Parent Development Interview - maternal reflexive functioning | 24 months | Moderate | 0.09 | p = 0.38 | 75 mothers | Minding the Baby pilot - 24 months |
This study included participants with the following characteristics at enrollment:
Race/Ethnicity
Maternal Education
Other Characteristics
This study included participants from the following locations:
- Connecticut