Less than a high school diploma
24%
Peer reviewed?
Yes
Goldfeld, S., Price, A., Smith, C., Bruce, T., Bryson, H., Mensah, F., Orsini, F., Gold, L., Hiscock, H., Bishop, L., Smith, A., Perlen, S., & Kemp, L. (2019). Nurse home visiting for families experiencing adversity: A randomized trial. Pediatrics, 143(1).
Screening Conclusion
Eligible for review
Model(s) Reviewed
Funding Sources
This research was supported by the state governments of Victoria and Tasmania, the Ian Potter Foundation, Sabemo Trust, the Sidney Myer Fund, the Vincent Fairfax Family Foundation, and the National Health and Medical Research Council by Award Number 1079418.
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 |
Notes
Information to demonstrate equivalence of the intervention and comparison groups was based on correspondence with the author. Several findings received a low rating because the measures did not meet HomVEE’s reliability standards or reliability was not calculated. These included several subscales of the Home Observation for Measurement of the Environment (HOME) scale, measures of child’s mealtimes and food choices, bedtime routines, mother and child health, and language behaviors. In addition, several findings at 24 months old received an indeterminate rating—measures of mother’s planning future study, child stress, and sibling mental health—because the findings were high attrition and HomVEE could not assess whether the findings satisfied the baseline equivalence requirement based on the available information. Two outcomes were not eligible for review: Patient Satisfaction Index and Parent Enablement Index. These are measures of implementation of the home visiting evaluation, which are not eligible for review in one of HomVEE’s outcome domains.
Findings that rate moderate or high in this manuscript
Child Development and School Readiness
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description | |
|---|---|---|---|---|---|---|---|---|
| Child - Does things to get mother to laugh | 24 months old | High | 0.63 | Statistically significant, p= 0.01 | 586 children | MECSH vs. comparison, Australia, 2013-2017, full sample | ||
| Child - Engages in pretend play | 24 months old | High | 0.31 | Not statistically significant, p= 0.05 | 589 children | MECSH vs. comparison, Australia, 2013-2017, full sample | ||
| Child - Gets mother to notice things | 24 months old | High | 0.46 | Not statistically significant, p= 0.08 | 590 children | MECSH vs. comparison, Australia, 2013-2017, full sample | ||
| Child - Nods to indicate yes | 24 months old | High | 0.12 | Not statistically significant, p= 0.25 | 581 children | MECSH vs. comparison, Australia, 2013-2017, full sample | ||
| Child - Puts 2 words together | 24 months old | High | 0.23 | Not statistically significant, p= 0.14 | 587 children | MECSH vs. comparison, Australia, 2013-2017, full sample | ||
| Child - Waves to greet people | 24 months old | High | 0.08 | Not statistically significant, p= 0.64 | 584 children | MECSH vs. comparison, Australia, 2013-2017, full sample |
Child Health
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description | |
|---|---|---|---|---|---|---|---|---|
| Child - Ate breakfast today | 24 months old | High | 0.50 | Statistically significant, p= 0.01 | 589 children | MECSH vs. comparison, Australia, 2013-2017, full sample | ||
| Child - Began solid foods at ages 4–6 months | 24 months old | High | 0.15 | Not statistically significant, p= 0.33 | 635 children | MECSH vs. comparison, Australia, 2013-2017, full sample | ||
| Child - Only given water, milk, formula to drink | 12 months old | High | 0.04 | Not statistically significant, p= 0.93 | 633 children | MECSH vs. comparison, Australia, 2013-2017, full sample | ||
| Mother - Breastfed until age 6 months | 24 months old | High | 0.17 | Not statistically significant, p= 0.16 | 566 mothers | MECSH vs. comparison, Australia, 2013-2017, full sample | ||
| Mother - Ever breastfed | 24 months old | High | 0.05 | Not statistically significant, p= 0.64 | 668 mothers | MECSH vs. comparison, Australia, 2013-2017, full sample |
Family Economic Self-Sufficiency
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description | |
|---|---|---|---|---|---|---|---|---|
| Mother - Currently studying | 24 months old | High | 0.06 | Not statistically significant, p= 0.65 | 582 mothers | MECSH vs. comparison, Australia, 2013-2017, full sample | ||
| Mother - Employed | 24 months old | High | 0.13 | Not statistically significant, p= 0.13 | 581 mothers | MECSH vs. comparison, Australia, 2013-2017, full sample |
Maternal Health
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description | |
|---|---|---|---|---|---|---|---|---|
| Assessment of Quality of Life (AQoL) | 24 months old | High | 0.03 | Not statistically significant, p= 0.78 | 571 mothers | MECSH vs. comparison, Australia, 2013-2017, full sample | ||
| Depression, Anxiety, and Stress Scale (DASS), Anxiety (reverse coded) | 24 months old | High | 0.07 | Not statistically significant, p= 0.34 | 574 mothers | MECSH vs. comparison, Australia, 2013-2017, full sample | ||
| Depression, Anxiety, and Stress Scale (DASS), Depression (reverse coded) | 24 months old | High | 0.04 | Not statistically significant, p= 0.55 | 573 mothers | MECSH vs. comparison, Australia, 2013-2017, full sample | ||
| Depression, Anxiety, and Stress Scale (DASS), Overall (reverse coded) | 24 months old | High | 0.05 | Not statistically significant, p= 0.52 | 571 mothers | MECSH vs. comparison, Australia, 2013-2017, full sample | ||
| Depression, Anxiety, and Stress Scale (DASS), Stress (reverse coded) | 24 months old | High | 0.10 | Not statistically significant, p= 0.26 | 573 mothers | MECSH vs. comparison, Australia, 2013-2017, full sample | ||
| Maternal stress (hair cortisol, pg/mg; logtransformed) | 24 months old | High | 0.08 | Not statistically significant, p= 0.25 | 438 mothers | MECSH vs. comparison, Australia, 2013-2017, full sample | ||
| Mother - Does not smoke | 24 months old | High | 0.12 | Not statistically significant, p= 0.14 | 587 mothers | MECSH vs. comparison, Australia, 2013-2017, full sample | ||
| Mother - Does not smoke | 12 months old | High | 0.02 | Not statistically significant, p= 0.86 | 635 mothers | MECSH vs. comparison, Australia, 2013-2017, full sample | ||
| Mother - High self-efficacy (item drawn from Longitudinal Study of Australian Children) | 24 months old | High | 0.08 | Not statistically significant, p= 0.25 | 568 mothers | MECSH vs. comparison, Australia, 2013-2017, full sample | ||
| Personal Wellbeing Index (PWI) | 24 months old | High | 0.04 | Not statistically significant, p= 0.46 | 559 mothers | MECSH vs. comparison, Australia, 2013-2017, full sample |
Positive Parenting Practices
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description | |
|---|---|---|---|---|---|---|---|---|
| Home Observation for Measurement of the Environment (HOME), Parental Responsivity | 24 months old | High | 0.02 | Not statistically significant, p= 0.74 | 546 mothers | MECSH vs. comparison, Australia, 2013-2017, full sample | ||
| Hostile parenting (items drawn from Longitudinal Study of Australian Children; reverse coded) | 24 months old | High | 0.24 | Statistically significant, p= <.001 | 588 mothers | MECSH vs. comparison, Australia, 2013-2017, full sample | ||
| Parenting Self-Efficacy Scale (items drawn from Longitudinal Study of Australian Children) | 24 months old | High | 0.14 | Statistically significant, p= 0.04 | 587 mothers | MECSH vs. comparison, Australia, 2013-2017, full sample | ||
| Warm parenting (items drawn from Longitudinal Study of Australian Children) | 24 months old | High | 0.20 | Statistically significant, p= 0.01 | 582 mothers | MECSH vs. comparison, Australia, 2013-2017, full sample |
This study included participants from the following locations:
- State not reported or international
International Locations
Australia
Study Participants
Study participants were pregnant women recruited from prenatal clinics in public maternity hospitals across two states in Australia. To be eligible, women had to be at no more than 36 weeks of gestation, have sufficient knowledge of English to complete interviews, have two or more risk factors identified at screening from a list of 10 for poor child outcomes, and their home addresses had to be within travel boundaries of the participating areas. A total of 722 pregnant women were randomly assigned to either the home visiting intervention (363 women) or the comparison condition (359 women). Outcomes were measured when children were 12 and 24 months. Up to 668 women were included in the analyses at 24 months (339 in the intervention group and 329 in the comparison group). In the study, 24 percent of mothers did not complete high school, 65 percent completed high school or vocational training, and 11 percent had a university degree.
Setting
The study took place in Victoria and Tasmania in Australia.
Intervention condition
Note: Navigate to the model page for more information about the home visiting model. See the source manuscript for more information about how the model was implemented in this study.
Comparison Conditions
Mothers in the comparison group received six to nine consultations with a nurse until the child reached 24 months. The first consultation occurred in families’ homes and other occurred at local centers. The consultations focused on broad-ranging supports for child health and development as well as parental well-being.
Were any subgroups examined?
No
Subgroups examined
• Parity (primiparous or multiparous) • Antenatal risk factors (2 or fewer risk factors or 3 or more risk factors) • Overall mental health (higher than the 85th percentile for mental health or less than the 85th percentile) • Maternal self-efficacy (high or low)