American Indian or Alaska Native
1.30%
Source
Green, B., Sanders, M. B., & Tarte, J. M. (2018). Effects of home visiting program implementation on preventive health care access and utilization: Results from a randomized trial of Healthy Families Oregon. Advance online publication. Prevention Science. https://doi.org/10.1007/s11121-018-0964-8
Model(s) Reviewed
Funding Sources
The study was funded by the U.S. Department of Health and Human Services, Children's Bureau (grant no. 90CA1782).
Study Design
| Design | Attrition | Baseline equivalence | Confounding factors | Valid, reliable measures? |
|---|---|---|---|---|
| Randomized controlled trial | Low | Established on race/ethnicity and SES; outcomes not feasible to assess at baseline | None |
Notes
Information on baseline equivalence and additional details about the study enrollment and context came from Green et al. (2017). Models controlled for the Healthy Families Oregon (HFO) program site, caregiver’s race and ethnicity, and total number of risk factors related to child maltreatment at baseline (as defined in the New Baby Questionnaire [NBQ]).
Study Participants
Families were eligible to participate if they were first-time parents and considered to be at high risk for child maltreatment based on the NBQ. The questionnaire defined high risk as having two or more risk factors on the NBQ; for example, being a teenage parent, having symptoms of depression, or having less than a high school education. The program screened a total of 8,520 parents using the NBQ and found 4,646 eligible. The final sample consisted of 2,727 parents (others declined participation, could not be located, or received a study wavier allowing them to bypass random assignment). The program randomly assigned a total of 1,438 parents to the HFO program and 1,289 to the comparison group. At enrollment, 61.6 percent of parents (99.5 percent of whom were mothers) identified as White, 26.9 percent as Hispanic, 2.3 percent as Asian/Pacific Islander, and 6.5 percent as multiracial. About one-third (32.3 percent) had less than a high school education.
Setting
The study took place in seven Healthy Families Oregon program sites, three of which served primarily rural communities and four of which served mixed urban and rural communities.
Home Visiting Services
Healthy Families Oregon is an accredited state home-visiting program that uses the Healthy Families America program model. Families enroll prenatally or up to 90 days after birth and receive home visiting services through the children’s third birthday. Families receive weekly individualized home visits for at least six months that typically focus on child development and positive parent–child interactions. Families also receive case management services that identify their needs and link them to relevant services. Intervention take-up was low; of those assigned to the home-visiting group, only 44 percent received at least one home visit.
Comparison Conditions
Families assigned to the comparison group were not eligible to receive home-visiting services through the HFO program.
Were any subgroups examined?
No
Subgroups examined
• Public benefit receipt (family had Oregon Health Plan coverage)
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 | |
|---|---|---|---|---|---|---|---|---|
Percentage of parents ever enrolled in Oregon Health Plan |
2 years |
Moderate | 0.02 | Not statistically significant, p= 0.77 |
2707 parents | Oregon, 2010-2012, full sample |
||
Percentage of children ever enrolled in Oregon Health Plan |
2 years |
High | 0.01 | Not statistically significant, p= 0.93 |
2707 children | Oregon, 2010-2012, full sample |
||
Total number of days enrolled in Oregon Health Plan (parents) |
2 years |
Moderate | 0.00 | Not statistically significant, p= 0.62 |
2707 parents | Oregon, 2010-2012, full sample |
||
Total number of days enrolled in Oregon Health Plan (children) |
2 years |
High | -0.02 | Not statistically significant, p= 0.61 |
2707 children | Oregon, 2010-2012, 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:
- Oregon