Hispanic or Latino
100.00%
Source
Peer reviewed?
Yes
Lutenbacher, M., Elkins, T., Dietrich, M. S., & Riggs, A. (2018). The efficacy of using peer mentors to improve maternal and infant health outcomes in Hispanic families: Findings from a randomized clinical trial. Maternal & Child Health Journal, 22(1), 92-104. https://doi.org/10.1007/s10995-018-2532-z
Model(s) Reviewed
Funding Sources
This research was supported by Award Numbers D89MC23542 and UL1TR000445 from the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program and the National Center for Advancing Translational Sciences of the National Institutes of Health.
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, details reported below for findings on valid, reliable outcomes that otherwise rate at least moderate |
Notes
Findings with high attrition ("receiving prenatal care," Edinburgh Postnatal Depression Scale (EPDS) prenatal scores, and "referred to resources" at 35 weeks prenatal) are assigned a low rating because baseline equivalence was not demonstrated on a socioeconomic status indicator for these specific analytic samples. Furthermore, findings on child co-sleeping and whether mother receiving social and emotional support receive a low rating because reliability statistics could not be obtained for the measures. Information on baseline equivalence, reliability of measures, and other details about the study is based on correspondence with the authors and information reported in Lutenbacher et al. (2016). HomVEE determined that one finding, "time to first prenatal visit (weeks)," is ineligible for review because it may not reflect post-intervention impacts.
Study Participants
Pregnant Hispanic women older than 18 were recruited to participate in the study through word of mouth, agency referrals, and distributing flyers in locations with a high concentration of Hispanic individuals. A total of 188 participants were randomly assigned to either the Maternal Infant Health Outreach Worker (MIHOW) intervention (94 women) or the comparison group (94 women). The average age of the study participants was 30, and about two-thirds of the participants were from Mexico. When the study began, 10 percent were employed full time, and 16 percent were employed part time. Most (about 80 percent) did not have a high school diploma, and more than half (about 56 percent) had never been married.
Setting
The study was conducted in Davidson County, an urban area of Tennessee.
Home Visiting Services
The MIHOW intervention sends health outreach workers to provide one-on-one services to pregnant women. The health outreach workers form relationships with the expectant parents and provide support, parenting education, and referrals through monthly hourlong home visits and group activities. Health outreach workers worked with parents to demonstrate positive parenting practices, and provided information about children's development, health, and nutrition. The program services typically last until the child is 36 months old, but services in this study ended when the child reached the age of 6 months due to funding constraints. Despite the reduced length of service, there were no adaptations to the content or intensity of the intervention. Intervention participants also received the educational materials sent to those in the comparison group.
Comparison Conditions
Pregnant women assigned to the comparison group were given educational materials about maternal and child health and development during the 35th week of pregnancy and when the infant was 2 weeks, 2 months, and 6 months old. These materials were also provided to the intervention group.
Were any subgroups examined?
No
Subgroups examined
There were no subgroups reported in this manuscript.
Findings that rate moderate or high in this manuscript
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Ever breastfed the child |
2 weeks postpartum |
High | 0.13 | Not statistically significant, p= 0.57 |
177 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
||
Breastfeeding at 6 months postpartum |
6 months postpartum |
High | 0.01 | Not statistically significant, p = 0.94 |
175 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
||
Never breastfed the child |
6 months postpartum |
High | -0.14 | Not statistically significant, p = 0.56 |
175 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
||
Stopped breastfeeding by 2 weeks postpartum |
2 weeks postpartum |
High | -0.04 | Not statistically significant, p = 0.95 |
175 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
||
Stopped breastfeeding by 2 months postpartum |
2 months postpartum |
High | 0.35 | Not statistically significant, p = 0.23 |
175 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
||
Stopped breastfeeding by 6 months postpartum |
6 months postpartum |
High | -0.13 | Not statistically significant, p = 0.57 |
175 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
||
Never breastfed exclusively |
6 months postpartum |
High | -0.67 | Statistically significant, p < .05 |
176 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
||
Stopped breastfeeding exclusively by 2 weeks postpartum |
2 weeks postpartum |
High | 0.51 | Statistically significant, p < .05 |
176 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
||
Stopped breastfeeding exclusively by 2 months postpartum |
2 months postpartum |
High | 0.59 | Statistically significant, p < .05 |
176 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
||
Still exclusive breastfeeding 6 months postpartum |
6 months postpartum |
High | 0.40 | Not statistically significant, p >= .05 |
176 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
||
Median number of weeks of exclusive breastfeeding |
6 months postpartum |
High | 0.04 | Statistically significant, p= 0.01 |
175 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Child sleeps on back at 2 weeks postpartum |
2 weeks postpartum |
High | 2.32 | Statistically significant, p = 0.00 |
177 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
||
Child sleeps on back at 2 months postpartum |
2 months postpartum |
High | 1.88 | Statistically significant, p = 0.00 |
176 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
||
Child sleeps on back at 6 months postpartum |
6 months postpartum |
High | 1.64 | Statistically significant, p = 0.00 |
178 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
||
Median Home Observation for Measurement of the Environment (HOME) Inventory Score |
2 weeks postpartum |
High | Statistically significant, p <.001 |
177 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
|||
Median Home Observation for Measurement of the Environment (HOME) Inventory Score |
2 months postpartum |
High | Statistically significant, p <.001 |
175 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
|||
Median Home Observation for Measurement of the Environment (HOME) Inventory Score |
6 months postpartum |
High | Statistically significant, p <.001 |
178 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
|||
Median number of days during prior week singing or telling stories to child |
2 weeks postpartum |
High | Statistically significant, p <.001 |
176 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
|||
Median number of days during prior week reading to child |
2 weeks postpartum |
High | Statistically significant, p <.001 |
176 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
|||
Reads stories at least three times per week |
2 months postpartum |
High | 1.82 | Statistically significant, p = 0.00 |
176 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
||
Reads stories at least three times per week |
6 months postpartum |
High | 2.69 | Statistically significant, p = 0.00 |
176 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Edinburgh Postpartum Depression Scale (EPDS) |
2 weeks postpartum |
High | -1.41 | Statistically significant, p <.01 |
177 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
||
Edinburgh Postpartum Depression Scale (EPDS) |
2 months postpartum |
High | -1.08 | Statistically significant, p <.01 |
176 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
||
Edinburgh Postpartum Depression Scale (EPDS) |
6 months postpartum |
High | -0.76 | Statistically significant, p <.01 |
178 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
||
Parenting Stress Index 4 (PSI): Total stress score |
2 weeks postpartum |
High | -0.45 | Statistically significant, p= 0.00 |
177 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
||
Parenting Stress Index 4 (PSI): Total stress score |
2 months postpartum |
High | -0.46 | Statistically significant, p= 0.00 |
176 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
||
Parenting Stress Index 4 (PSI): Total stress score |
6 months postpartum |
High | -0.72 | Statistically significant, p <.01 |
178 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Referred to resources at 6 months postpartum |
6 months postpartum |
High | 4.77 | Statistically significant, p = 0.02 |
178 mothers | MIHOW vs. MEI, Davidson County, Tennessee, 2014-2016, full sample |
This study included participants with the following characteristics at enrollment:
Race/Ethnicity
Maternal Education
Other Characteristics
This study included participants from the following locations:
- Tennessee