Black or African American
31%
Peer reviewed?
No
Knox, V., & Michalopoulos, C. (2023). Mother and Infant Home Visiting Program Evaluation (MIHOPE), United States, 2012-2019. MIHOPE Model Results Documentation [Study 2-HFA contrast]. Inter-University Consortium for Political and Social Research. https://doi.org/10.3886/ICPSR37848.v3.
Model(s) Reviewed
Navigate to model page for more information about the home visiting model.
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 |
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 Knox & Michalopoulos, 2023. HomVEE has reviewed additional analyses from the MIHOPE evaluation under Michalopoulos et al., 2019.
One finding in this set of analyses, on a measure of breastfeeding duration, received a moderate rating because the finding demonstrated high attrition but satisfied the baseline equivalence requirement. Findings on measures of maternal health status and depression; food insecurity; parental unsupportiveness, engagement, and discipline; awareness of health and safety hazards; child behavior; and physical abuse received a rating of indeterminate because HomVEE could not assess whether the measures were reliable according to HomVEE standards. One finding on a measure of any report of child maltreatment was deemed to be ineligible for review because HomVEE does not review unsubstantiated reports of child maltreatment. Information on sample sizes and reliability and validity of measures, along with information necessary to demonstrate equivalence of the intervention and comparison groups, 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 1,407 participants recruited for the study through HFA programs were included in the analyses: 691 in HFA and 716 in the comparison group. Similarly, up to 1,375 children of these participants were included in the analyses: 683 in HFA and 692 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. The manuscript does not provide additional information on the HFA programs in the study, including the intensity or length of services offered to participating families.
Model(s) Reviewed
Navigate to model page for more information about the home visiting model.
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
Family economic self-sufficiency
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Health insurance coverage for the mother |
15 months old |
High | 0.18 | Not statistically significant, p ≥ 0.05 |
1391 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
Received SNAP during the past month |
15 months old |
High | 0.03 | Not statistically significant, p ≥ 0.05 |
1097 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
Received disability insurance during the past month |
15 months old |
High | 0.03 | Not statistically significant, p ≥ 0.05 |
1098 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
Received TANF during the past month |
15 months old |
High | 0.05 | Not statistically significant, p ≥ 0.05 |
1096 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
Received WIC during the past month |
15 months old |
High | 0.06 | Not statistically significant, p ≥ 0.05 |
1100 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
Received any transportation services |
15 months old |
High | 0.10 | Not statistically significant, p ≥ 0.05 |
1093 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
Maternal health
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Current smoker |
15 months old |
High | 0.04 | Not statistically significant, p ≥ 0.05 |
1091 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
Substance use during the past three months |
15 months old |
High | 0.03 | Not statistically significant, p ≥ 0.05 |
1084 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
Received any behavioral health services |
15 months old |
High | 0.03 | Not statistically significant, p ≥ 0.05 |
1094 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
Parenting Stress Index - Short Form (PSI-SF), parental distress |
15 months old |
High | Not statistically significant, p ≥ 0.05 |
1108 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
|||
Parenting Stress Index - Short Form (PSI-SF), parent-child dysfunctional interaction |
15 months old |
High | Not statistically significant, p ≥ 0.05 |
1106 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
Child development and school readiness
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Use of nonparental child care |
15 months old |
High | 0.04 | Not statistically significant, p ≥ 0.05 |
1096 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
Brief Infant Toddler Social and Emotional Assessment (BITSEA), total competence score |
15 months old |
High | Not statistically significant, p ≥ 0.05 |
1124 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
|||
Received any early intervention services (%) |
15 months old |
High | 0.09 | Not statistically significant, p ≥ 0.05 |
1101 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
Reductions in juvenile delinquency, family violence, and crime
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Revised Conflict Tactics Scale (CTS2), maternal perpetration of physical violence |
15 months old |
High | 0.13 | Not statistically significant, p ≥ 0.05 |
1096 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
Revised Conflict Tactics Scale (CTS2), maternal experience with physical or sexual violence |
15 months old |
High | 0.47 | Not statistically significant, p ≥ 0.05 |
1095 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
Women's Experience with Battering (WEB) Scale |
15 months old |
High | 0.48 | Not statistically significant, p ≥ 0.05 |
1088 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
Received any domestic violence services |
15 months old |
High | 0.26 | Not statistically significant, p ≥ 0.05 |
1097 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
Received any services from a domestic violence shelter |
15 months old |
High | 0.49 | Not statistically significant, p ≥ 0.05 |
1096 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
Reductions in child maltreatment
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Any substantiated maltreatment report |
15 months old |
High | 0.19 | Not statistically significant, p ≥ 0.05 |
1406 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
Loss of custody |
15 months old |
High | 0.12 | Not statistically significant, p ≥ 0.05 |
1407 mothers | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
Child health
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Primary care provider for the child (%) |
15 months old |
High | 0.02 | Not statistically significant, p ≥ 0.05 |
1136 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
Number of Medicaid-paid immunizations |
15 months old |
High | Not statistically significant, p ≥ 0.05 |
1210 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
|||
Any Medicaid-paid nonbirth hospitalizations |
15 months old |
High | 0.03 | Not statistically significant, p ≥ 0.05 |
1375 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
Underweight (%) |
15 months old |
High | 0.16 | Not statistically significant, p ≥ 0.05 |
908 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
Normal weight (%) |
15 months old |
High | 0.06 | Not statistically significant, p ≥ 0.05 |
908 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
At risk of being overweight (%) |
15 months old |
High | 0.14 | Not statistically significant, p ≥ 0.05 |
908 children | HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
||
Duration of breastfeeding |
15 months old |
Moderate | Not statistically significant, p ≥ 0.05 |
579 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