Manuscript Details

Source

Williams, C. M., Asaolu, I., English, B., Jewell, T., Smith, K., & Robl, J. (2014). Maternal and child health improvement by HANDS home visiting program in the KIPDA area development district, Kentucky (Unpublished manuscript).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. Outcome measures were not assessable at baseline. None
Notes
Study Participants
This study examined 376 mother–infant pairs. Among these, 188 were HANDS participants and 188 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 59 percent white, Non-Hispanic; 37 percent black, Non-Hispanic; 4 percent Hispanic; and 1 percent some other race. Most (81 percent) of the sample had Medicaid coverage at the time of referral, and 23 percent of the mothers in the sample had less than 12 years of education.
Setting
KIPDA Area Development District, Kentucky
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
Low birth weight Birth Moderate -0.50 Statistically significant, p = 0.02 376 mother/child dyads Kentucky 2011-2012 matched, KIPDA
Preterm birth Birth Moderate -0.17 Not statistically significant, p = 0.36 376 mother/child dyads Kentucky 2011-2012 matched, KIPDA
Breastfeeding Birth Moderate 0.47 Statistically significant, p = 0.00 376 mother/child dyads Kentucky 2011-2012 matched, KIPDA
Effect rating key
Favorable finding / Statistically significant
UnFavorable finding / Statistically significant
Ambiguous finding / Statistically significant
No effect / Not statistically significant
Maternal health
Outcome measure Timing of follow-up Rating Effect size Stastical significance Sample size Sample description
Pregnancy-induced hypertension Birth Moderate -0.35 Statistically significant, p = 0.02 376 mother/child dyads Kentucky 2011-2012 matched, KIPDA
Adequate prenatal care Birth Moderate -0.15 Not statistically significant, p = 0.17 376 mother/child dyads Kentucky 2011-2012 matched, KIPDA
Effect rating key
Favorable finding / Statistically significant
UnFavorable finding / Statistically significant
Ambiguous finding / Statistically significant
No effect / Not statistically significant
Family economic self-sufficiency
Outcome measure Timing of follow-up Rating Effect size Stastical significance Sample size Sample description
Maternal receipt of WIC Birth Moderate -0.40 Statistically significant, p = 0.04 376 mother/child dyads Kentucky 2011-2012 matched, KIPDA
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
36.70%
Hispanic or Latino
3.70%
White
58.50%
Some other race
1.10%

Maternal Education

Less than a high school diploma
22.90%
Unknown
77.10%

Other Characteristics

Enrollment in means-tested programs
81.40%