Black or African American
18%
Source
Peer reviewed?
No
Oxford, M. L., Hash, J. B., Lohr, M. J., Bleil, M., Unützer, J., & Spieker, S. J. (2020). Randomized trial of Promoting First Relationships® for new mothers who received community mental health services in pregnancy. Unpublished manuscript submitted to HomVEE.
Model(s) Reviewed
Study Registration
Funding Sources
Not reported.
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 |
Notes
Baseline assessments were completed when infants were between 6 and 12 weeks old. Follow-up measures were completed when infants were 6 and 12 months old. Findings for "Infant difficultness" when infants were 6-months old received a low evidence rating because the outcome did not satisfy HomVEE's reliability requirements. All other reviewed findings received a high evidence rating. The authors' analyses controlled for intervention condition, mother's preferred language, and baseline measures of outcomes. Baseline measures were available for all measures except those using the Infant Toddler Social Emotional Assessment (ITSEA), which were not feasible to assess at baseline. Information that demonstrated the reliability of the outcome measures and baseline equivalence of the intervention and comparison groups was based on correspondence with the authors.
Study Participants
Study participants were pregnant women and mothers of children younger than 3 months old recruited from two community mental health programs in King County, Washington. Mothers were eligible to participate in the study if they received mental health services during pregnancy at one of the community programs, spoke English or Spanish, had access to a telephone, and were planning to stay in the area for the duration of the follow-up period. Mother-child dyads were randomly assigned to the intervention group or a comparison group. A total of 252 mother-child dyads were included in the study: 127 in the Promoting First Relationships intervention group and 125 in the comparison group.
Over half (58 percent) of the participating children were Caucasian, 15 percent were Black, 23 percent were multiracial, and 4 percent were another race. Most children in the study (53 percent) were Hispanic or Latino. Annual household income was $10,000 or less for 29 percent of dyads; $10,001 to $20,000 for 21 percent; $20,001 to $30,000 for 19 percent; $30,001 to $40,000 for 13 percent; and $40,001 or more for 11 percent. The remaining households did not report income.
Setting
The study took place in Seattle and King County, Washington.
Home Visiting Services
Promoting First Relationships – Home Visiting Intervention Model consisted of 10 weekly sessions with a mental health professional. The home visit content was informed by attachment theory and aimed to increase parenting sensitivity. All sessions took place in the families' homes. The home visitor videotaped caregiver-child interactions during five of the weekly sessions and watched the videos with the caregiver on alternating weeks. After they watched the videos, the home visitor gave reflective video feedback through a guided discussion on the caregiver's strengths.
Comparison Conditions
Families assigned to the comparison group were not eligible to receive services through Promoting First Relationships. Families received a packet of information including handouts on child development and parenting and a list of local resources.
Were any subgroups examined?
No
Subgroups examined
There were no subgroups reported in the manuscript.
Study Participants
Study participants were pregnant women and mothers of children younger than 3 months old recruited from two community mental health programs in King County, Washington. Mothers were eligible to participate in the study if they received mental health services during pregnancy at one of the community programs, spoke English or Spanish, had access to a telephone, and were planning to stay in the area for the duration of the follow-up period. Mother-child dyads were randomly assigned to the intervention group or a comparison group. A total of 252 mother-child dyads were included in the study: 127 in the Promoting First Relationships intervention group and 125 in the comparison group.
Over half (58 percent) of the participating children were Caucasian, 15 percent were Black, 23 percent were multiracial, and 4 percent were another race. Most children in the study (53 percent) were Hispanic or Latino. Annual household income was $10,000 or less for 29 percent of dyads; $10,001 to $20,000 for 21 percent; $20,001 to $30,000 for 19 percent; $30,001 to $40,000 for 13 percent; and $40,001 or more for 11 percent. The remaining households did not report income.
Setting
The study took place in Seattle and King County, Washington.
Home Visiting Services
Promoting First Relationships – Home Visiting Intervention Model consisted of 10 weekly sessions with a mental health professional. The home visit content was informed by attachment theory and aimed to increase parenting sensitivity. All sessions took place in the families' homes. The home visitor videotaped caregiver-child interactions during five of the weekly sessions and watched the videos with the caregiver on alternating weeks. After they watched the videos, the home visitor gave reflective video feedback through a guided discussion on the caregiver's strengths.
Comparison Conditions
Families assigned to the comparison group were not eligible to receive services through Promoting First Relationships. Families received a packet of information including handouts on child development and parenting and a list of local resources.
Were any subgroups examined?
No
Subgroups examined
There were no subgroups reported in the manuscript.
Findings that rate moderate or high in this manuscript
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Parenting sensitivity |
6 months of age |
High | 0.30 | Statistically significant, p = 0.02 |
238 mothers | PFR vs. comparison, Washington 2015-2020, full sample |
||
Dyadic synchronicity |
6 months of age |
High | 0.05 | Not statistically significant, p = 0.68 |
239 mother/child dyads | PFR vs. comparison, Washington 2015-2020, full sample |
||
Understanding of toddlers |
6 months of age |
High | 0.38 | Statistically significant, p = 0.00 |
244 mothers | PFR vs. comparison, Washington 2015-2020, full sample |
||
Maternal confidence |
6 months of age |
High | 0.23 | Not statistically significant, p = 0.07 |
244 mothers | PFR vs. comparison, Washington 2015-2020, full sample |
||
Parenting sensitivity |
12 months of age |
High | 0.32 | Statistically significant, p = 0.02 |
225 mothers | PFR vs. comparison, Washington 2015-2020, full sample |
||
Dyadic synchronicity |
12 months of age |
High | 0.21 | Not statistically significant, p = 0.12 |
225 mother/child dyads | PFR vs. comparison, Washington 2015-2020, full sample |
||
Understanding of toddlers |
12 months of age |
High | 0.64 | Statistically significant, p = 0.00 |
243 mothers | PFR vs. comparison, Washington 2015-2020, full sample |
||
Maternal confidence |
12 months of age |
High | 0.11 | Not statistically significant, p = 0.38 |
243 mothers | PFR vs. comparison, Washington 2015-2020, full sample |
||
Parenting sensitivity |
6 months of age |
High | 0.25 | Statistically significant, p= 0.05 |
252 mothers | PFR vs. comparison, Washington 2015-2020, full sample |
||
Dyadic synchronicity |
6 months of age |
High | 0.00 | Not statistically significant, p= 0.98 |
252 mother/child dyads | PFR vs. comparison, Washington 2015-2020, full sample |
||
Understanding of toddlers |
6 months of age |
High | 0.21 | Statistically significant, p= 0.03 |
252 mothers | PFR vs. comparison, Washington 2015-2020, full sample |
||
Maternal confidence |
6 months of age |
High | 0.12 | Not statistically significant, p= 0.10 |
252 mothers | PFR vs. comparison, Washington 2015-2020, full sample |
||
Parenting sensitivity |
12 months of age |
High | 0.26 | Statistically significant, p= 0.03 |
252 mothers | PFR vs. comparison, Washington 2015-2020, full sample |
||
Dyadic synchronicity |
12 months of age |
High | 0.19 | Not statistically significant, p= 0.15 |
252 mother/child dyads | PFR vs. comparison, Washington 2015-2020, full sample |
||
Understanding of toddlers |
12 months of age |
High | 0.45 | Statistically significant, p <0.001 |
252 mothers | PFR vs. comparison, Washington 2015-2020, full sample |
||
Maternal confidence |
12 months of age |
High | 0.05 | Not statistically significant, p= 0.52 |
252 mothers | PFR vs. comparison, Washington 2015-2020, full sample |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Difficultness |
12 months of age |
High | 0.22 | Not statistically significant, p = 0.11 |
225 infants | PFR vs. comparison, Washington 2015-2020, full sample |
||
Externalizing behavior |
12 months of age |
High | 0.28 | Statistically significant, p = 0.03 |
243 infants | PFR vs. comparison, Washington 2015-2020, full sample |
||
Internalizing behavior |
12 months of age |
High | 0.12 | Not statistically significant, p = 0.37 |
243 infants | PFR vs. comparison, Washington 2015-2020, full sample |
||
Dysregulation |
12 months of age |
High | 0.04 | Not statistically significant, p = 0.77 |
243 infants | PFR vs. comparison, Washington 2015-2020, full sample |
||
Difficultness |
12 months of age |
High | 0.16 | Not statistically significant, p= 0.09 |
252 infants | PFR vs. comparison, Washington 2015-2020, full sample |
||
Externalizing behavior |
12 months of age |
High | 0.28 | Statistically significant, p= 0.03 |
252 infants | PFR vs. comparison, Washington 2015-2020, full sample |
||
Internalizing behavior |
12 months of age |
High | 0.11 | Not statistically significant, p= 0.39 |
252 infants | PFR vs. comparison, Washington 2015-2020, full sample |
||
Dysregulation |
12 months of age |
High | 0.04 | Not statistically significant, p= 0.75 |
252 infants | PFR vs. comparison, Washington 2015-2020, full sample |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Maternal GAD-7 anxiety severity score |
6 months of age |
High | 0.19 | Not statistically significant, p= 0.05 |
252 mothers | PFR vs. comparison, Washington 2015-2020, full sample |
||
Maternal PHQ-9 depression severity score |
12 months of age |
High | 0.18 | Not statistically significant, p= 0.09 |
252 mothers | PFR vs. comparison, Washington 2015-2020, 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:
- Washington