Manuscript Details

Source

Williams, C. M., Asaolu, I., English, B., Jewell, T., Smith, K., & Robl, J. (2014). Child health improvement by HANDS home visiting program (Unpublished manuscript). University of Kentucky Department of Obstetrics and Gynecology, Lexington, KY.
Rating
Moderate
Author Affiliation

Two of the authors are affiliated with the University of Kentucky Department of Obstetrics and Gynecology and four with the Kentucky Department for Public Health. The Kentucky Department for Public Health developed the HANDS model.

Funding Sources

Kentucky Department for Public Health, funded through MIECHV grants D89MC23538 and X02MC27402.

Study Design

Design Attrition Baseline equivalence Confounding factors Valid, reliable measures?
Non-experimental comparison group design Not applicable Established on race; established on SES; no outcome measures were assessable at baseline. None
Notes

The findings in the unpublished manuscript are also in the peer reviewed journal article cited as an additional source.

Study Participants

This study examined 4,506 mother–infant pairs. Among these, 2,253 were HANDS participants and 2,253 were in a comparison group. All study participants were first-time parents, had at least two risk factors, and were either pregnant or had a child who was age 3 months or younger. Risk factors included unemployment, isolation, history of substance abuse, unstable housing, limited parental education, domestic violence, poor prenatal care, and maternal depression. Study participants were 88 percent white, non-Hispanic; 9 percent black, non-Hispanic; 2 percent Hispanic; and 1 percent some other race. Most (78 percent) study participants had Medicaid coverage at the time of referral to HANDS, and 33 percent of the mothers had less than 12 years of education.

Setting

Kentucky (statewide)

Home Visiting Services

Women could enroll in HANDS during pregnancy or until the infant was 3 months old. Home visiting services continued until the child's second birthday. Home visiting services included education and development of parenting skills, linking families to medical homes, assisting families to meet basic needs, and direct service delivery for the mother and child.

Comparison Conditions

Mother–infant pairs in the comparison groups were selected from the group of mothers referred to HANDS. Mothers in the comparison condition completed a screening tool and were found to be eligible for home visits, but chose not to participate and did not receive any home visits.

Findings that rate moderate or high in this manuscript

Child health
Outcome measure Timing of follow-up Rating Effect size Stastical significance Sample size Sample description
Preterm birth (proportion) Birth Moderate -0.18 Statistically significant, p = 0.00 4506 infants Kentucky 2011-2012 matched
Low birth weight (proportion) Birth Moderate -0.37 Statistically significant, p = 0.00 4506 infants Kentucky 2011-2012 matched
Infant deceased in hospital (proportion) Birth Moderate -1.70 Statistically significant, p = 0.00 4506 infants Kentucky 2011-2012 matched
Effect rating key
Favorable finding / Statistically significant
UnFavorable finding / Statistically significant
Ambiguous finding / Statistically significant
No effect / Not statistically significant
Reductions in child maltreatment
Outcome measure Timing of follow-up Rating Effect size Stastical significance Sample size Sample description
Substantiated reports of child maltreatment (proportion) Unknown Moderate -0.38 Statistically significant, p = 0.00 4506 infants Kentucky 2011-2012 matched
Effect rating key
Favorable finding / Statistically significant
UnFavorable finding / Statistically significant
Ambiguous finding / Statistically significant
No effect / Not statistically significant

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
8.70%
Hispanic or Latino
2.30%
White
87.60%
Some other race
1.40%

Maternal Education

Less than a high school diploma
33.00%
Unknown
67.00%

Other Characteristics

Enrollment in means-tested programs
78.20%