Manuscript Detail | Home Visiting Evidence of Effectiveness

Hruska, V., Darlington, G., Haines, J., & Ma, D. W.L. (2020). Parent stress as a consideration in childhood obesity prevention: Results from the Guelph Family Health Study, a pilot randomized controlled trial [Study 1: Four home visits]. Nutrients, 12(6), 1835. https://doi.org/10.3390/nu12061835

Manuscript screening details
Screening decision	Screening conclusion	HomVEE procedures and standards version
Passes screens	Eligible for review	Version 2

Study design details
Rating	Design	Attrition	Baseline equivalence	Compromised randomization	Confounding factors	Valid, reliable measure(s)
High	Randomized controlled trial	Low	Not assessed for randomized controlled trials with low attrition	No	No	Yes

Notes:

Findings for general life stress of mothers measured six and 18 months after enrollment received an indeterminate rating because HomVEE could not confirm the reliability of the measure. Findings for the paternal health outcomes (general stress, parenting distress, and depression) were ineligible for review because they are not in one of HomVEE's eligible outcome domains. The study sample includes participants from Phase I and II of the Guelph Family Health Study.

Study characteristics
Study participants	Study families were recruited from agencies that provide services for families with young children and postings on the Ontario Early Years Centre Facebook page and the University of Guelph webpage. Families were eligible for the study if they had at least one child between 18 and 60 months and ineligible if they planned to move within the following year or did not speak English. Families were randomized to either the Guelph Family Health Study intervention (41 families) or the comparison condition (28 families). Sixty-three families were included in the analyses in this manuscript (38 in the intervention group and 25 in the comparison group). Outcomes were measured six and 18 months after study enrollment. In the study, 82 percent of parents were White and 86 percent were married. Fifty-six percent possessed a college degree or some college, while 42 percent had postgraduate training. About 75 percent of families had annual household incomes of $60,000 or more.
Setting	The study took place in Guelph, Ontario, Canada.
Intervention services	The Guelph Family Health Study intervention consisted of four home visits with a health educator, emails, and mailed incentives. The initial home visit lasted for one hour and follow-up home visits lasted 30 to 60 minutes. The home visits were scheduled about four- to six-weeks apart. The content of the home visits, which was designed to change health behaviors, was informed by family systems theory and self-determination theory. All visits took place in the families’ homes. The health educator helped families to set, review, and discuss health behavior changes, goals, solutions, and challenges. Families were sent weekly emails that were tailored to the behavior change goals they set with the health educator.
Comparison conditions	Families assigned to the comparison condition were not eligible to receive intervention services through the Guelph Family Health Study. Families received monthly emails containing publicly available, general information on children’s health, such as the current Canadian physical activity guidelines.
Subgroups examined	This field lists subgroups examined in the manuscript (even if they were not replicated in other samples and not reported on the summary page for this model’s report). There were no subgroups reported in this manuscript.
Funding sources	Not reported
Author affiliation	The study authors are affiliated with the University of Guelph and are also the model developers.
Peer reviewed	Yes

Study Registration:

Clinicaltrials.gov Identifier: NCT02223234. Study registration was assessed by HomVEE for Clinicaltrials.gov beginning with the 2014 review, and for other registries beginning with the 2021 review.

Findings that rate moderate or high

Maternal health
Rating	Outcome measure	Effect	Sample	Timing of follow-up	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
High	Centre for Epidemiological Studies Depression Scale (CES-D), Depressive symptoms	FavorableUnfavorable or ambiguousNo Effect	Guelph Family Health Study (4HV) vs. comparison, Canada 2014-2018, Phase I/II sample	18 months after enrollment	62 mothers	Unadjusted mean = 6.57	Unadjusted mean = 6.73	Mean difference = 0.06	Not available	Not statistically significant, p= 0.91	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
High	Centre for Epidemiological Studies Depression Scale (CES-D), Depressive symptoms	FavorableUnfavorable or ambiguousNo Effect	Guelph Family Health Study (4HV) vs. comparison, Canada 2014-2018, Phase I/II sample	6 months after enrollment	62 mothers	Unadjusted mean = 6.19	Unadjusted mean = 6.67	Mean difference = -0.60	Not available	Not statistically significant, p= 0.65	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
High	Parenting Stress Index (PSI), Parenting distress subscale	FavorableUnfavorable or ambiguousNo Effect	Guelph Family Health Study (4HV) vs. comparison, Canada 2014-2018, Phase I/II sample	6 months after enrollment	62 mothers	Unadjusted mean = 27.06	Unadjusted mean = 28.13	Mean difference = -1.10	Not available	Not statistically significant, p= 0.63	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
High	Parenting Stress Index (PSI), Parenting distress subscale	FavorableUnfavorable or ambiguousNo Effect	Guelph Family Health Study (4HV) vs. comparison, Canada 2014-2018, Phase I/II sample	18 months after enrollment	62 mothers	Unadjusted mean = 29.74	Unadjusted mean = 30.91	Mean difference = -1.52	Not available	Not statistically significant, p= 0.41	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.

Positive parenting practices
Rating	Outcome measure	Effect	Sample	Timing of follow-up	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
High	Confusion, Hubbub, and Order Scale (CHAOS), Household chaos	FavorableUnfavorable or ambiguousNo Effect	Guelph Family Health Study (4HV) vs. comparison, Canada 2014-2018, Phase I/II sample	6 months after enrollment	60 families	Unadjusted mean = 30.89	Unadjusted mean = 31.74	Mean difference = -0.74	Not available	Not statistically significant, p= 0.57	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
High	Confusion, Hubbub, and Order Scale (CHAOS), Household chaos	FavorableUnfavorable or ambiguousNo Effect	Guelph Family Health Study (4HV) vs. comparison, Canada 2014-2018, Phase I/II sample	18 months after enrollment	60 families	Unadjusted mean = 30.57	Unadjusted mean = 33.00	Mean difference = -2.22	Not available	Not statistically significant, p= 0.14	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.