Manuscript Details

Peer reviewed?
Yes

Doyle O., Fitzpatrick N., Lovett J., & Rawdon C. (2015). Early intervention and child physical health: Evidence from a Dublin-based randomized controlled trial. Economics and Human Biology, 19, 224-245.

High rating
Study reviewed under: Handbook of Procedures and Standards, Version 2
Author Affiliation

Dr. Doyle and the Preparing for Life Evaluation team are affiliated with the University College Dublin Geary Institute for Public Policy. The authors were contracted by the home visiting model developers to evaluate Preparing for Life—Home Visiting.

Funding Sources

The Atlantic Philanthropies and the Department of Children and Youth Affairs (Ireland) supported the research.

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

Not assessed for randomized controlled trials with low attrition

No

Yes

Information on how certain measures were constructed and their reliability, information to satisfy the baseline equivalence requirement for findings with high attrition, and information on the regression imputation method were based on correspondence with the author. Several findings not reported in the tables below received a low rating because they had high attrition and did not satisfy the baseline requirement or did not satisfy the reliability requirement. Findings reported when children in the sample were 36 months old are ineligible for review because high PFL families were offered Triple P, a parenting course promoting healthy parenting practices and positive parent-child attachment, when children were between 24 and 36 months old, and the low PFL group was not offered these services. Findings that are aggregated over multiple time points (that is, hospitalizations at six, 12, 18, and 24 months) are ineligible because they combine multiple time points.

Findings that rate moderate or high in this manuscript

Child health
Outcome measure Timing of follow-up Rating Direction of Effect Effect size (absolute value) Stastical significance Sample size Sample description
Child number of health problems taken to doctor/health center/casualty, unweighted 6 months old High
0.07 Not statistically significant, p= 0.65 173 children High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample
Child number of health problems taken to doctor/health center/casualty, unweighted 12 months old High
0.11 Not statistically significant, p= 0.48 164 children High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample
Child number of health problems taken to doctor/health center/casualty, unweighted 24 months old High
0.34 Statistically significant, p= 0.03 165 children High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample
Hospital stay, 6 months old, unweighted 6 months old High
0.01 Not statistically significant, p= 0.87 173 children High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample
Hospital stay, 12 months old, unweighted 12 months old High
0.00 Not statistically significant, p= 0.98 165 children High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample
Hospital stay, 24 months old, unweighted 24 months old High
0.04 Not statistically significant, p= 0.28 165 children High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample
Immunization, 6 months old, unweighted 12 months old High
0.02 Not statistically significant, p= 0.34 165 children High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample
Child received medical attention for wheezing or asthma, unweighted 12 months old High
0.02 Not statistically significant, p= 0.65 165 children High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample
Child received medical attention for wheezing or asthma, unweighted 24 months old High
0.14 Statistically significant, p= 0.01 165 children High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample
Chest infection, 12 months old, unweighted 12 months old High
0.09 Not statistically significant, p= 0.19 165 children High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample
Chest infection, 24 months old, unweighted 24 months old High
0.12 Not statistically significant, p= 0.10 165 children High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample
Child number of health problems taken to doctor/health center/casualty, Inverse Probability Weighted results 6 months old High
0.10 Not statistically significant, p= 0.41 173 children High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample
Child number of health problems taken to doctor/health center/casualty, Inverse Probability Weighted results 12 months old High
0.02 Not statistically significant, p= 0.71 164 children High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample
Child number of health problems taken to doctor/health center/casualty, Inverse Probability Weighted results 24 months old High
0.31 Not statistically significant, p= 0.26 165 children High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample
Hospital stay, 6 months old, Inverse Probability Weighted results 6 months old High
0.02 Not statistically significant, p= 0.63 173 children High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample
Hospital stay, 12 months old, Inverse Probability Weighted results 12 months old High
0.00 Not statistically significant, p= 0.99 165 children High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample
Hospital stay, 24 months old, Inverse Probability Weighted results 24 months old High
0.02 Not statistically significant, p= 0.60 165 children High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample
Immunization, 6 months old, Inverse Probability Weighted results 12 months old High
0.02 Not statistically significant, p= 0.58 165 children High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample
Child received medical attention for wheezing or asthma, Inverse Probability Weighted results 12 months old High
0.01 Not statistically significant, p= 0.81 165 children High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample
Child received medical attention for wheezing or asthma, Inverse Probability Weighted results 24 months old High
0.16 Statistically significant, p= 0.02 165 children High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample
Chest infection, 12 months old, Inverse Probability Weighted results 12 months old High
0.18 Not statistically significant, p= 0.10 165 children High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample
Chest infection, 24 months old, Inverse Probability Weighted results 24 months old High
0.12 Not statistically significant, p= 0.13 165 children High PFL vs. Low PFL; Dublin, Ireland 2008-2010; full sample
Effect rating key
Favorable finding / Statistically significant
Unfavorable finding / Statistically significant
Ambiguous finding / Statistically significant
No effect / Not statistically significant
Study Participants

Study participants were pregnant women recruited in a maternity hospital or in the community. A total of 233 pregnant women were randomly assigned to either the Preparing for Life—Home Visiting group that received home visiting services (“high PFL”; 115 participants) or the comparison condition that did not receive home visiting services (“low PFL”; 118 participants). The study included a total of 165 participants, 81 in the high PFL group and 84 in the low PFL comparison group. Outcomes were measured when the children in the sample were six, 12, 18, 24, and 36 months old. At intake, the average age of the mothers was 25. The percentage of mothers identifying as Irish was 96 percent, and 4 percent identified as Irish Traveller. About half of the women were first-time mothers.

Setting

The study took place in North Dublin, Ireland.

Home Visiting Services

Preparing for Life—Home Visiting provided home visits that lasted 30 minutes to two hours during the mother’s pregnancy and until the child started school at age 5. The majority of participants received visits every two weeks, though some participants received services monthly. The home visitor was a trained Preparing for Life mentor. The mentor provided information by using tip sheets and worked with participants to resolve issues around the child’s development, including the child’s prebirth development, nutrition, rest and routine, and cognitive and social development. The mentor also addressed the mother and her supports. Participants had access to baby massage sessions until the child was 10 months old. Participants also received packages of materials, including home safety items (corner guards, angle latches, heat-sensitive spoons, and baby gym/play mats) and toys (puzzles, activity toys, and bricks), worth about 100 Euros per package.

Comparison Conditions

Participants in the low PFL (comparison) group did not have access to the home visiting services or tip sheets. The comparison group did, however, receive some of the same resources made available to the high PFL (intervention) group, including the package of safety items and toys. These participants had access to an information officer who met with participants before the child’s birth and at various intervals after birth and provided information on Preparing for Life community events and other local services. Participants in the comparison group had access to public health workshops, such as a stress-control program and a healthy food program.

Were any subgroups examined?
No
Subgroups examined

• Child gender (boy or girl)