Manuscript Details

Paradis, H. A., Sandler, M., Manly, J. T., & Valentine, L. (2013). Building Healthy Children: Evidence-based home visitation integrated with pediatric medical homes. Pediatrics, 132(Suppl. 2), S174–179. https://doi.org/10.1542/peds.2013-1021R

Peer Reviewed

Model(s): Building Healthy Children (BHC)
Study Registration: ClinicalTrials.gov
High rating
This manuscript received a rating of high because it is a randomized-controlled trial with low-attrition.

Study reviewed under: Handbook of Procedures and Standards, Version 2.3
Child Health
Outcome Measure Timing of Follow-Up Rating Direction of Effect Effect Size (Absolute Value) Stastical Significance Sample Size Sample Description
Number of emergency department visits for any reason 24 months old High
0.03 Not statistically significant, p ≥ 0.05 215 children Building Healthy Children vs. referrals to community resources RCT, Rochester, NY, 2012, full sample
Up-to-date immunizations (%) 24 months old High
0.51 Not statistically significant, p ≥ 0.05 215 children Building Healthy Children vs. referrals to community resources RCT, Rochester, NY, 2012, full sample
Up-to-date well-child visits (%) 24 months old High
1.15 Statistically significant, p < 0.006 215 children Building Healthy Children vs. referrals to community resources RCT, Rochester, NY, 2012, full sample
Effect rating key
Favorable finding / Statistically significant
Unfavorable finding / Statistically significant
Ambiguous finding / Statistically significant
No effect / Not statistically significant
Reductions In Child Maltreatment
Outcome Measure Timing of Follow-Up Rating Direction of Effect Effect Size (Absolute Value) Stastical Significance Sample Size Sample Description
Absence of emergency department visits for injury (%) 24 months old High
0.21 Not statistically significant, p ≥ 0.05 215 children Building Healthy Children vs. referrals to community resources RCT, Rochester, NY, 2012, full sample
Substantiated reports of child maltreatment (%) 24 months old High
0.57 Not statistically significant, p ≥ 0.05 497 families Building Healthy Children vs. referrals to community resources RCT, Rochester, NY, 2012, full sample
Effect rating key
Favorable finding / Statistically significant
Unfavorable finding / Statistically significant
Ambiguous finding / Statistically significant
No effect / Not statistically significant

Note: Tables do not include findings that HomVEE rated low or indeterminate, or found to be ineligible for review.

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
68%
Hispanic or Latino
19%
White
20%
Two or more races
11%

Maternal Education

Less than a high school diploma
61%
High school diploma or GED
39%

Other Characteristics

Data not available

This study included participants from the following locations:

  • New York
Study Participants
  • Families were recruited through three primary care practices and were eligible for the study if they had a low income, no previous involvement with the child welfare system, and if the mother had given birth to her first child before the age of 21.
  • A total of 497 families were randomly assigned to either the Building Healthy Children (BHC) intervention group (270 families) or the comparison condition (227 families).
  • Outcomes were measured when the children were 24 months old.
  • At enrollment, 22 percent of mothers had depressive symptoms, 37 percent had experienced abuse or neglect as a child, and 59 percent had a history of domestic violence in their family. Mothers were 19 years old on average at enrollment, and families had an average income of $10,900 at enrollment. On average, children were 6 months old at enrollment, and 48 percent of children were female.
Setting

The study took place in Rochester, New York.

Intervention condition
Building Healthy Children (BHC)

Note: Navigate to the model page for more information about the home visiting model. See the source manuscript for more information about how the model was implemented in this study.

Comparison Conditions
  • Families assigned to the comparison condition were not eligible to receive intervention services through BHC.
  • Families received referrals to clinical staff members who could provide additional referrals to community services.
Author Affiliation

Three of the authors are affiliated with the University of Rochester, which sponsors BHC. The fourth author was from the Society for Protection and Care of Children.

Funding Sources

This research was supported by the United Way of Greater Rochester and the Monroe County Department of Human Services.

Study design characteristics contributing to rating
Design Random assignment compromised? Attrition Baseline equivalence Confounding factors? Valid, reliable measures?
Randomized controlled trial No Low

Not assessed for randomized controlled trials with low attrition

No

Yes
Notes from the review of this manuscript

Information on sample attrition was obtained through correspondence with one of the manuscript's authors.