Manuscript Details

McCombs-Thornton, K., Wang, Y., & Sturmfels, N. (2023). Parents as Teachers Family Outcomes: New Insights from the Mother and Infant Home Visiting Program Evaluation (MIHOPE). Parents as Teachers National Center. https://parentsasteachers.org/wp-content/uploads/2024/10/PAT-Family-Out…

Study Registration: ClinicalTrials.gov
Moderate rating
This manuscript received a rating of moderate because it is a non-experimental comparison group design study that satisfies the baseline equivalence requirement.

Study reviewed under: Handbook of Procedures and Standards, Version 2.3
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-month follow-up Moderate
0.10 Not statistically significant, p ≥ 0.05 440 families PAT (at least 3 months of home visits) vs. matched comparison group, MIHOPE, 2012-2015, United States, full sample
Effect rating key
Favorable finding / Statistically significant
Unfavorable finding / Statistically significant
Ambiguous finding / Statistically significant
No effect / Not statistically significant

This study included participants with the following characteristics at enrollment:

Race/Ethnicity

The race and ethnicity categories may sum to more than 100 percent if Hispanic ethnicity was reported separately or respondents could select two or more race or ethnicity categories.

Black or African American
21%
Hispanic or Latino
37%
White
37%
Unknown
5%

Maternal Education

Less than a high school diploma
42%
Unknown
58%

Other Characteristics

Enrollment in means-tested programs
4%

This study included participants from the following locations:

  • California
  • Georgia
  • Illinois
  • Iowa
  • Kansas
  • Michigan
  • Nevada
  • New Jersey
  • Pennsylvania
  • South Carolina
  • Washington
  • Wisconsin
Study Participants
  • Participants were eligible for the Mother and Infant Home Visiting Program Evaluation (MIHOPE) evaluation if they were age 15 or older at enrollment, were pregnant or had a young child, and spoke English or Spanish proficiently.
  • The intervention group included participants that received Parents as Teachers (PAT) home visits for at least three months (215 participants), and the comparison group was matched participants (225 participants).
  • Outcomes were measured when children were about 15 months old.
  • More than one-third of the mothers (37 percent) were Hispanic or Latino, 37 percent were White, and 21 percent were Black. Forty-two percent had less education than a high school diploma at study entry. Forty-four percent were pregnant at the time of enrollment. At study entry, children were two months old on average.
Setting

Researchers recruited families from 21 local Parents as Teachers programs in 12 U.S. states: California, Georgia, Illinois, Iowa, Kansas, Michigan, Nevada, New Jersey, Pennsylvania, South Carolina, Washington, and Wisconsin. The programs mainly operated in metropolitan areas.

Intervention condition
Comparison Conditions

Women assigned to the comparison group were not eligible to receive PAT services. They received information about other services in their local community.

Subgroups examined
  • Race/ethnicity (African American/Black, Hispanic/Latina, White, or Multiracial/Another race)
  • Pregnancy status at study entry (pregnant or not)
  • First-time mother (first birth or not)
  • Maternal education (less than high school, or high school or more)
  • Experience of intimate partner violence (experienced intimate partner violence in the year prior to the study or not)
  • Maternal emotional functioning (low, moderate, or high based on composite measure of depression, relationship anxiety, and relationship avoidance at study entry)
  • Maternal psychological resources (at or below the median score, or above the median score based on composite measure of mothers’ mental health including depressive symptoms and anxiety, mastery, and verbal abstract reasoning at study entry)
  • Other adults in the home (biological father or other adult relative lives in the home, or not at study entry)
  • Demographic risk (low, moderate, or high risk based on composite measure at study entry of mother receiving public assistance or Medicaid, mother being 20 years old or younger, child’s biological father not living in the home, and mother not being enrolled in school if younger than 19 years old or not having received a high school degree if at least 19 years old) 
Author Affiliation

Authors are affiliated with James Bell Associates. The authors were contracted by the home visiting model developers to evaluate the Parents as Teachers home visiting program.

Funding Sources

This research was supported by the Parents as Teachers National Center, Inc.

Study design characteristics contributing to rating
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 from the review of this manuscript

The Mother and Infant Home Visiting Program Evaluation (MIHOPE) was a national evaluation of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program. MIHOPE included four evidence-based home visiting models. This review focuses on Parents as Teachers (PAT) and the findings in McCombs-Thornton et al. (2023), which were secondary analyses of the MIHOPE data. HomVEE has reviewed additional analyses from the MIHOPE evaluation under Knox & Michalopoulos (2023) and Michalopoulos et al. (2019). 

Most findings in the manuscript (a total of 60, across various domains) received an indeterminate rating because HomVEE was unable to determine whether the intervention and comparison groups were equivalent on race or ethnicity and socioeconomic status in the analyzed sample at baseline. Two measures rated low because they did not satisfy HomVEE reliability requirements: the Brief Infant Toddler Social and Emotional Assessment (BITSEA), Total competence score; and the Infant-Toddler Home Observation for Measurement of the Environment (HOME), Parental lack of hostility scale. The analysis of one measure (mother receiving education or training) imputed missing pre-intervention measures of the outcome using an indicator approach, which is not an acceptable missing data approach for a non-experimental comparison group design under HomVEE standards.