American Indian or Alaska Native
1%
Source
Peer reviewed?
Yes
Mersky, J. P., Janczewski, C. E., Plummer Lee, C., & Yasin, T. (2022). Impact of home visiting programs on parenting stress in low income women: Findings from a community based trial at an urban health department. [Study 2]. Children and Youth Services Review, 142, 1–10. https://doi.org/10.1016/j.childyouth.2022.106638.
Model(s) Reviewed
Funding Sources
This research was supported by the Wisconsin Department of Children and Families, the Wisconsin Department of Public Health, and the U.S. Department of Health and Human Services, Health Resources and Services Administration award number 1D89MC26367-01-00.
Study Design
| Design | Attrition | Baseline equivalence | Confounding factors | Valid, reliable measures? |
|---|---|---|---|---|
| Non-experimental comparison group design | Not applicable | Established on race/ethnicity and SES; outcome(s) not feasible to assess at baseline |
No |
Yes |
Notes
The manuscript describes two studies: a randomized controlled trial (RCT) and a non-experimental comparison group design (NED). This review addresses the findings of the NED. The review of the RCT is addressed under Mersky et al. (2022; Study 1). Information on the measures and sample sizes—including information needed to demonstrate equivalence of the intervention and comparison groups and to establish measure reliability—is based on correspondence with the author.
Some findings in the manuscript are ineligible for review, including the authors' analyses of how pre-intervention levels of maternal depression and social support moderate the intervention's effects on parenting stress outcomes. These moderation analyses are ineligible for review under HomVEE Version 2 standards because they use continuous moderator terms.
Study Participants
Study participants were pregnant women with low incomes who were referred to the Milwaukee, Wisconsin, health department for home visiting services between April 2014 and March 2017. They were eligible if they spoke English or Spanish and did not previously receive home visiting services. Up to 136 mother-child dyads with complete, nonmissing data were included in the study: 55 in the Healthy Families America home visiting group, and 81 in the comparison group. Outcome data were measured at 14–60 days postpartum, six months postpartum, and 12 months postpartum. Forty-four percent of the mothers were Hispanic, 44 percent were Non-Hispanic Black, and 12 percent were another race. Twenty-two percent had completed postsecondary education at the time of study enrollment.
Setting
The study took place in Milwaukee, Wisconsin, and included women who were seeking services at a large, urban health department.
Home Visiting Services
As described in this manuscript, Healthy Families America (HFA) consists of regular, hourlong home visits starting during pregnancy and lasting until a child’s third birthday. HFA aims for services to start prenatally, with developmental and functional assessments of children and caregivers; parenting guidance; and referrals to community services. Each participant is assigned a home visitor who is a paraprofessional support worker. The home visitor receives auxiliary support from a public health nurse. Families are offered at least one visit per week until infants are six months old, the visits are less frequent thereafter.
Comparison Conditions
Participants in the comparison group received a referral to home visiting but elected not to enroll in home visiting through the health department.
Were any subgroups examined?
No
Subgroups examined
There were no subgroups reported in this manuscript.
Study Participants
Study participants were pregnant women with low incomes who were referred to the Milwaukee, Wisconsin, health department for home visiting services between April 2014 and March 2017. They were eligible if they spoke English or Spanish and did not previously receive home visiting services. Up to 136 mother-child dyads with complete, nonmissing data were included in the study: 55 in the Healthy Families America home visiting group, and 81 in the comparison group. Outcome data were measured at 14–60 days postpartum, six months postpartum, and 12 months postpartum. Forty-four percent of the mothers were Hispanic, 44 percent were Non-Hispanic Black, and 12 percent were another race. Twenty-two percent had completed postsecondary education at the time of study enrollment.
Setting
The study took place in Milwaukee, Wisconsin, and included women who were seeking services at a large, urban health department.
Home Visiting Services
As described in this manuscript, Healthy Families America (HFA) consists of regular, hourlong home visits starting during pregnancy and lasting until a child’s third birthday. HFA aims for services to start prenatally, with developmental and functional assessments of children and caregivers; parenting guidance; and referrals to community services. Each participant is assigned a home visitor who is a paraprofessional support worker. The home visitor receives auxiliary support from a public health nurse. Families are offered at least one visit per week until infants are six months old, the visits are less frequent thereafter.
Comparison Conditions
Participants in the comparison group received a referral to home visiting but elected not to enroll in home visiting through the health department.
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 (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Parenting Stress Index - Short Form (PSI-SF), parental distress |
14-60 days postpartum |
Moderate | 0.18 | Not statistically significant, p = 0.30 |
136 mothers | HFA vs. Quasi-experimental comparison group, Milwaukee, 2014-2017, full sample |
||
Parenting Stress Index - Short Form (PSI-SF), parental distress |
6 months postpartum |
Moderate | 0.32 | Not statistically significant, p = 0.07 |
133 mothers | HFA vs. Quasi-experimental comparison group, Milwaukee, 2014-2017, full sample |
||
Parenting Stress Index - Short Form (PSI-SF), parental distress |
12 months postpartum |
Moderate | 0.31 | Not statistically significant, p = 0.10 |
119 mothers | HFA vs. Quasi-experimental comparison group, Milwaukee, 2014-2017, full sample |
||
Parenting Stress Index - Short Form (PSI-SF), dysfunctional interaction |
14-60 days postpartum |
Moderate | 0.12 | Not statistically significant, p = 0.51 |
130 mothers | HFA vs. Quasi-experimental comparison group, Milwaukee, 2014-2017, full sample |
||
Parenting Stress Index - Short Form (PSI-SF), dysfunctional interaction |
6 months postpartum |
Moderate | 0.04 | Not statistically significant, p = 0.82 |
134 mothers | HFA vs. Quasi-experimental comparison group, Milwaukee, 2014-2017, full sample |
||
Parenting Stress Index - Short Form (PSI-SF), dysfunctional interaction |
12 months postpartum |
Moderate | 0.04 | Not statistically significant, p = 0.84 |
119 mothers | HFA vs. Quasi-experimental comparison group, Milwaukee, 2014-2017, full sample |
||
Parenting Stress Index - Short Form (PSI-SF), difficult child |
14-60 days postpartum |
Moderate | 0.05 | Not statistically significant, p = 0.78 |
125 mothers | HFA vs. Quasi-experimental comparison group, Milwaukee, 2014-2017, full sample |
||
Parenting Stress Index - Short Form (PSI-SF), difficult child |
6 months postpartum |
Moderate | 0.19 | Not statistically significant, p = 0.28 |
129 mothers | HFA vs. Quasi-experimental comparison group, Milwaukee, 2014-2017, full sample |
||
Parenting Stress Index - Short Form (PSI-SF), difficult child |
12 months postpartum |
Moderate | 0.07 | Not statistically significant, p = 0.69 |
117 mothers | HFA vs. Quasi-experimental comparison group, Milwaukee, 2014-2017, 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:
- Wisconsin