Black or African American
31%
Source
Peer reviewed?
No
Michalopoulos, C., Faucetta, K., Hill, C. J., Portilla, X., Burrell, L., Lee, H., Duggan, A., & Knox, V. (2019). Impacts on family outcomes of evidence-based early childhood home visiting: Results from the Mother and Infant Home Visiting Program Evaluation (OPRE Report 2019-07). [Study 2-HFA contrast]. U.S. Department of Health and Human Services, Administration for Children and Families, Office of Planning, Research, and Evaluation. https://www.acf.hhs.gov/sites/default/files/documents/opre/mihope_impac….
Model(s) Reviewed
Study Registration
Funding Sources
This research was supported by the Administration for Children and Families, funded by the U.S. Department of Health and Human Services under a competitive award, Contract No. HHS-HHSP23320095644WC.
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 |
Notes
The Mother and Infant Home Visiting Program Evaluation (MIHOPE) included four evidence-based home visiting models; this review focuses on Healthy Families America (HFA) and the findings in Michalopoulos et al. 2019. HomVEE has reviewed additional analyses from the MIHOPE evaluation under Knox & Michalopoulos, 2023. Findings in the manuscript that are pooled across various home visiting models are ineligible for review because HomVEE only reviews findings that isolate the effects of a specific model. Findings from the manuscript about quality of the home environment, receptive language skills, and child maltreatment outcomes related to physical assault or psychological aggression received a rating of indeterminate because HomVEE could not assess whether the measures were reliable according to HomVEE standards. Information on sample sizes and reliability and validity of measures is based on correspondence with the authors.
Study Participants
The Mother and Infant Home Visiting Program Evaluation (MIHOPE) is a national evaluation of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program. MIHOPE study participants were recruited from 2012 to 2015. Participants were eligible for the MIHOPE evaluation if they were age 15 or older at enrollment, were pregnant or had children younger than six months old, spoke English or Spanish proficiently, and met the relevant eligibility criteria for the local home visiting model. A total of 1,458 participants were recruited for the study in Healthy Families America (HFA) programs and randomly assigned to either the HFA home visiting intervention group (725 participants) or the comparison condition (733 participants). Up to 1,102 participants recruited for the study through HFA programs were included in the analyses: 541 in HFA and 561 in the comparison group. Similarly, up to 1,370 children of these participants were included in the analyses: 680 in HFA and 690 in the comparison group. Outcomes were measured when children were 15 months old. For the MIHOPE participants recruited through HFA programs, 22 percent of women were of Mexican origin, 12 percent were another Hispanic ethnicity, 27 percent were White, 31 percent were Black, and 8 percent were another race. Forty-three percent had less than a high school diploma at study entry. At enrollment, the average age of participants recruited through HFA programs was 24.
Setting
The study took place in 12 states: California, Georgia, Illinois, Iowa, Kansas, Michigan, Nevada, New Jersey, Pennsylvania, South Carolina, Washington, and Wisconsin. The evaluation selected 26 local program affiliates that operated Healthy Families America (HFA) and met program eligibility criteria.
Home Visiting Services
As described in this manuscript, Healthy Families America (HFA) consists of activities designed to assess family needs, educate and support parents, and refer families to community services. The content and delivery of HFA vary, but the intervention has historically focused on preventing child maltreatment and is typically geared toward families at risk of child maltreatment or with behavioral health issues. HFA participants in this evaluation enrolled during pregnancy or within the first three months after a child’s birth and were offered weekly visits during critical periods (for example, shortly after birth). Participants were offered HFA services through the child’s third birthday, but services could be extended until the child reached age five.
Comparison Conditions
Women assigned to the comparison group were not eligible to receive Healthy Families America (HFA) services. They received information about other appropriate services in their local community.
Were any subgroups examined?
No
Subgroups examined
There were no subgroups reported in this manuscript.
Study Participants
The Mother and Infant Home Visiting Program Evaluation (MIHOPE) is a national evaluation of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program. MIHOPE study participants were recruited from 2012 to 2015. Participants were eligible for the MIHOPE evaluation if they were age 15 or older at enrollment, were pregnant or had children younger than six months old, spoke English or Spanish proficiently, and met the relevant eligibility criteria for the local home visiting model. A total of 1,458 participants were recruited for the study in Healthy Families America (HFA) programs and randomly assigned to either the HFA home visiting intervention group (725 participants) or the comparison condition (733 participants). Up to 1,102 participants recruited for the study through HFA programs were included in the analyses: 541 in HFA and 561 in the comparison group. Similarly, up to 1,370 children of these participants were included in the analyses: 680 in HFA and 690 in the comparison group. Outcomes were measured when children were 15 months old. For the MIHOPE participants recruited through HFA programs, 22 percent of women were of Mexican origin, 12 percent were another Hispanic ethnicity, 27 percent were White, 31 percent were Black, and 8 percent were another race. Forty-three percent had less than a high school diploma at study entry. At enrollment, the average age of participants recruited through HFA programs was 24.
Setting
The study took place in 12 states: California, Georgia, Illinois, Iowa, Kansas, Michigan, Nevada, New Jersey, Pennsylvania, South Carolina, Washington, and Wisconsin. The evaluation selected 26 local program affiliates that operated Healthy Families America (HFA) and met program eligibility criteria.
Home Visiting Services
As described in this manuscript, Healthy Families America (HFA) consists of activities designed to assess family needs, educate and support parents, and refer families to community services. The content and delivery of HFA vary, but the intervention has historically focused on preventing child maltreatment and is typically geared toward families at risk of child maltreatment or with behavioral health issues. HFA participants in this evaluation enrolled during pregnancy or within the first three months after a child’s birth and were offered weekly visits during critical periods (for example, shortly after birth). Participants were offered HFA services through the child’s third birthday, but services could be extended until the child reached age five.
Comparison Conditions
Women assigned to the comparison group were not eligible to receive Healthy Families America (HFA) services. They received information about other appropriate services in their local community.
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 | |
|---|---|---|---|---|---|---|---|---|
New pregnancy after study entry, % (fixed effect random slope analysis) |
15 months old |
High | Not statistically significant, p= 0.73 |
1091 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
|||
New pregnancy after study entry, % (restricted maximum likelihood analysis) |
15 months old |
High | Not statistically significant, p= 0.79 |
1091 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
|||
New pregnancy after study entry, % (split-sample analysis) |
15 months old |
High | 0.05 | Not statistically significant, p= 0.62 |
1091 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Receiving education or training, % (fixed effect random slope analysis) |
15 months old |
High | Not statistically significant, p= 0.49 |
1102 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
|||
Health insurance coverage for the child, % (fixed effect random slope analysis) |
15 months old |
High | Not statistically significant, p= 0.51 |
1370 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
|||
Receiving education or training, % (restricted maximum likelihood analysis) |
15 months old |
High | Not statistically significant, p= 0.52 |
1102 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
|||
Health insurance coverage for the child, % (restricted maximum likelihood analysis) |
15 months old |
High | Not statistically significant, p= 0.45 |
1370 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
|||
Receiving education or training, % (split-sample analysis) |
15 months old |
High | 0.07 | Not statistically significant, p= 0.43 |
1102 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
Health insurance coverage for the child, % (split-sample analysis) |
15 months old |
High | 0.12 | Not statistically significant, p= 0.39 |
1370 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Three-Bag Task composite score of parental supportiveness (fixed effect random slope analysis) |
15 months old |
High | 0.09 | Not statistically significant, p= 0.15 |
888 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
Three-Bag Task composite score of parental supportiveness (restricted maximum likelihood analysis) |
15 months old |
High | Not statistically significant, p= 0.21 |
888 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
|||
Three-Bag Task composite score of parental supportiveness (split-sample analysis) |
15 months old |
High | 0.07 | Not statistically significant, p= 0.26 |
888 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Number of Medicaid-paid well-child visits (fixed effect random slope analysis) |
15 months old |
High | Not statistically significant, p= 0.25 |
1210 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
|||
Number of Medicaid-paid child emergency department visits (fixed effect random slope analysis) |
15 months old |
High | Not statistically significant, p= 0.22 |
1210 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
|||
Number of Medicaid-paid well-child visits (restricted maximum likelihood analysis) |
15 months old |
High | Not statistically significant, p= 0.34 |
1210 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
|||
Number of Medicaid-paid child emergency department visits (restricted maximum likelihood analysis) |
15 months old |
High | Not statistically significant, p= 0.30 |
1210 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
|||
Number of Medicaid-paid well-child visits (split-sample analysis) |
15 months old |
High | Not statistically significant, p= 0.46 |
1210 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
|||
Number of Medicaid-paid child emergency department visits (split-sample analysis) |
15 months old |
High | Not statistically significant, p= 0.21 |
1210 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Any Medicaid-paid health care encounter for injury or ingestion, % (fixed effect random slope analysis) |
15 months old |
High | Not statistically significant, p= 0.35 |
1210 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
|||
Any Medicaid-paid health care encounter for injury or ingestion, % (restricted maximum likelihood analysis) |
15 months old |
High | Not statistically significant, p= 0.47 |
1210 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
|||
Any Medicaid-paid health care encounter for injury or ingestion, % (split-sample analysis) |
15 months old |
High | 0.06 | Not statistically significant, p= 0.42 |
1210 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Brief Infant Toddler Social and Emotional Assessment (BITSEA), total problem score (fixed effect random slope analysis) |
15 months old |
High | 0.07 | Not statistically significant, p= 0.15 |
1126 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
Brief Infant Toddler Social and Emotional Assessment (BITSEA), total problem score (restricted maximum likelihood analysis) |
15 months old |
High | 0.07 | Not statistically significant, p= 0.23 |
1126 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
Brief Infant Toddler Social and Emotional Assessment (BITSEA), total problem score (split-sample analysis) |
15 months old |
High | 0.10 | Not statistically significant, p= 0.08 |
1126 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, 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:
- California
- Georgia
- Illinois
- Iowa
- Kansas
- Michigan
- Nevada
- New Jersey
- Pennsylvania
- South Carolina
- Washington
- Wisconsin