Hispanic or Latino
100%
Lutenbacher, M., Elkins, T., & Dietrich, M. S. (unpublished manuscript). Using community health workers to improve health outcomes in a sample of Hispanic women and their infants: Findings from a randomized clinical trial.
Study design characteristics contributing to rating
| 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 from the review of this manuscript
Several findings receive a moderate rating because they have high attrition but establish baseline equivalence. Findings on some outcomes—including Edinburgh Postnatal Depression Scale (EPDS) scores at 2, 6, 12, and 15 months postpartum—receive a low rating because attrition is high, and baseline equivalence is not established. Measures of social and emotional support receive a low rating due to insufficient reliability. Information on baseline equivalence, measures of findings at specific time points, reliability of measures, and other details about the study is based on correspondence with the authors. One outcome, "prior breastfeeding", is not a post-intervention outcome, and therefore was ineligible for review.
Child Health
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description |
|---|---|---|---|---|---|---|---|
| Breastfeeding initiated (ever breastfed the child) | 2 weeks postpartum | Moderate | 0.30 | Not statistically significant, p= 0.11 | 113 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Child given solid food by 2 months postpartum | 2 months postpartum | Moderate | 0.85 | Not statistically significant, p= 0.12 | 112 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Child given solid food by 6 months postpartum | 6 months postpartum | Moderate | 0.22 | Not statistically significant, p= 0.61 | 111 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Child given solid food by 9 months postpartum | 9 months postpartum | High | 1.80 | Not statistically significant, p= 0.23 | 109 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Currently breastfeeding at 12 months postpartum | 12 months postpartum | Moderate | 0.74 | Statistically significant, p <.01 | 110 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Currently breastfeeding at 15 months postpartum | 15 months postpartum | Moderate | 1.09 | Not statistically significant, p= 0.05 | 110 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Currently breastfeeding at 2 months postpartum | 2 months postpartum | Moderate | 0.25 | Not statistically significant, p= 0.26 | 113 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Currently breastfeeding at 2 weeks postpartum | 2 weeks postpartum | Moderate | 0.10 | Not statistically significant, p= 0.73 | 106 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Currently breastfeeding at 6 months postpartum | 6 months postpartum | Moderate | 0.40 | Not statistically significant, p= 0.06 | 111 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Currently breastfeeding at 9 months postpartum | 9 months postpartum | High | 0.46 | Statistically significant, p= 0.04 | 109 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample |
Linkages and Referrals
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description |
|---|---|---|---|---|---|---|---|
| Referred to resources (postpartum) | 15 months postpartum | Moderate | 2.43 | Statistically significant, p <.01 | 110 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Referred to resources (prenatal) | 35 weeks gestation | High | 1.49 | Statistically significant, p <.01 | 105 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample |
Maternal Health
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description |
|---|---|---|---|---|---|---|---|
| Edinburgh Postnatal Depression Scale (EPDS) | 35 weeks gestation | High | 0.06 | Not statistically significant, p= 0.75 | 102 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Edinburgh Postnatal Depression Scale (EPDS) | 2 weeks postpartum | High | 0.01 | Not statistically significant, p= 0.95 | 109 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Edinburgh Postnatal Depression Scale (EPDS) | 9 months postpartum | High | 0.56 | Statistically significant, p <.01 | 109 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Had a postpartum checkup | 2 months postpartum | Moderate | 0.23 | Not statistically significant, p= 0.56 | 110 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Had a postpartum checkup | 6 months postpartum | Moderate | 0.41 | Not statistically significant, p= 0.09 | 110 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Parenting Stress Index 4 (PSI): Total stress score | 2 weeks postpartum | High | 0.09 | Not statistically significant, p= 0.64 | 109 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Parenting Stress Index 4 (PSI): Total stress score | 2 months postpartum | High | 0.14 | Not statistically significant, p = 0.43 | 109 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Parenting Stress Index 4 (PSI): Total stress score | 6 months postpartum | High | 0.00 | Not statistically significant, p = 1.00 | 109 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Parenting Stress Index 4 (PSI): Total stress score | 9 months postpartum | High | 0.35 | Statistically significant, p = 0.04 | 108 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Parenting Stress Index 4 (PSI): Total stress score | 12 months postpartum | High | 0.77 | Statistically significant, p <.01 | 109 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Parenting Stress Index 4 (PSI): Total stress score | 15 months postpartum | High | 1.19 | Statistically significant, p <.01 | 109 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, 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 |
|---|---|---|---|---|---|---|---|
| Child sleeps on back at 2 months postpartum | 2 months postpartum | Moderate | 1.27 | Statistically significant, p= 0.01 | 113 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Child sleeps on back at 2 weeks postpartum | 2 weeks postpartum | Moderate | 0.19 | Not statistically significant, p= 0.63 | 113 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Child sleeps on back at 6 months postpartum | 6 months postpartum | Moderate | 0.35 | Not statistically significant, p= 0.16 | 111 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Child sleeps on back at 9 months postpartum | 9 months postpartum | High | 0.54 | Statistically significant, p= 0.02 | 109 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Median Home Observation for Measurement of the Environment (HOME) Inventory Score | 2 weeks postpartum | Moderate | 0.11 | Not statistically significant, p= 0.52 | 105 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Median Home Observation for Measurement of the Environment (HOME) Inventory Score | 2 months postpartum | Moderate | 0.47 | Statistically significant, p= 0.01 | 109 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Median Home Observation for Measurement of the Environment (HOME) Inventory Score | 6 months postpartum | Moderate | 1.44 | Statistically significant, p <.01 | 108 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Median Home Observation for Measurement of the Environment (HOME) Inventory Score | 9 months postpartum | High | 1.53 | Statistically significant, p <.01 | 108 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Median Home Observation for Measurement of the Environment (HOME) Inventory Score | 12 months postpartum | Moderate | 1.74 | Statistically significant, p <.01 | 108 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Median Home Observation for Measurement of the Environment (HOME) Inventory Score | 15 months postpartum | Moderate | 1.78 | Statistically significant, p <.01 | 108 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Median number of days during prior week reading to child | 2 months postpartum | Moderate | 0.30 | Not statistically significant, p= 0.09 | 113 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Median number of days during prior week reading to child | 6 months postpartum | Moderate | 0.66 | Statistically significant, p <.01 | 111 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Median number of days during prior week reading to child | 9 months postpartum | High | 1.29 | Statistically significant, p <.01 | 109 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Median number of days during prior week reading to child | 12 months postpartum | Moderate | 1.85 | Statistically significant, p <.01 | 110 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Median number of days during prior week reading to child | 15 months postpartum | Moderate | 1.79 | Statistically significant, p <.01 | 110 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Median number of days during prior week singing or telling stories to child | 2 months postpartum | Moderate | 0.08 | Not statistically significant, p= 0.67 | 113 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Median number of days during prior week singing or telling stories to child | 6 months postpartum | Moderate | 0.18 | Not statistically significant, p= 0.33 | 111 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Parenting Sense of Competence (PSOC) score | 2 weeks postpartum | Moderate | 0.11 | Not statistically significant, p= 0.55 | 108 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Parenting Sense of Competence (PSOC) score | 2 months postpartum | High | 0.41 | Statistically significant, p = 0.03 | 107 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Parenting Sense of Competence (PSOC) score | 6 months postpartum | High | 0.47 | Statistically significant, p = 0.02 | 107 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Parenting Sense of Competence (PSOC) score | 9 months postpartum | High | 0.98 | Statistically significant, p <.01 | 107 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Parenting Sense of Competence (PSOC) score | 12 months postpartum | Moderate | 1.51 | Statistically significant, p <.01 | 108 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Parenting Sense of Competence (PSOC) score | 15 months postpartum | Moderate | 2.02 | Statistically significant, p <.01 | 108 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Reads stories at least three times per week | 2 months postpartum | Moderate | 0.53 | Statistically significant, p= 0.02 | 112 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Reads stories at least three times per week | 6 months postpartum | Moderate | 1.18 | Statistically significant, p <.01 | 108 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Reads stories at least three times per week | 9 months postpartum | High | 1.56 | Statistically significant, p <.01 | 109 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Reads stories at least three times per week | 12 months postpartum | Moderate | 2.13 | Statistically significant, p <.01 | 109 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample | |
| Reads stories at least three times per week | 15 months postpartum | Moderate | 1.75 | Statistically significant, p <.01 | 109 mothers | MIHOW vs. MEI, Tennessee, 2018-2020, full sample |
This study included participants from the following locations:
- Tennessee
Study Participants
Research staff visited community businesses and agencies to recruit pregnant Hispanic women for the study. There were also referrals from other study participants through word of mouth. Participants were randomly assigned to the Maternal Infant Health Outreach Worker (MIHOW) intervention (66 women) or the comparison group (66 women). The average age was 30, and the highest percentage of participants were from Mexico (49 percent). When the study began, 8 percent were employed full time, and 12 percent were employed part time. Most (66 percent) did not have a high school diploma, and more than half (53 percent) had never been married.
Setting
The study took place in six counties in central Tennessee.
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
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.
Subgroups examined
• Mothers with children at baseline
Funding Sources
This research was supported by Award Numbers 1X10MC31171-01-00 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.