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Koniak-Griffin, D., Anderson, N. L., Verzemnieks, I., & Brecht, M. L. (2000). A public health nursing early intervention program for adolescent mothers: Outcomes from pregnancy through 6 weeks postpartum. Nursing Research, 49(3), 130–138.

Manuscript screening details
Screening decision Screening conclusion HomVEE procedures and standards version
Passes screens Eligible for review Version 1
Study design details
Rating Design Attrition Baseline equivalence Compromised randomization Confounding factors Valid, reliable measure(s)
High Randomized controlled trial Low Not Applicable None None Not assessed in manuscripts reviewed before 2021
Notes:

footnote110

Submitted by user on Fri, 03/15/2019 - 14:29

High rating applies to 12 outcomes. Analyses of two outcomes—NCAST total score and NCAST mother’s score—receive a moderate rating because of high attrition.

Study characteristics
Study participants Participants were recruited via referrals to a county public health department and assigned randomly to either the intervention or the comparison group. Initially 144 mothers were randomly assigned, 75 to the treatment group and 69 to the comparison group (information obtained from authors). One hundred twenty-one young mothers and their children participated in the study. Most were poor, unmarried, and expecting their first child. Mothers ranged in age from 14 to 19 years old at intake (26 weeks or less gestation). Sixty-four percent of the mothers were Latina, 11 percent were African American, and 20 percent were white. Participants were followed from pregnancy through year six weeks postpartum. Note: This study contains the same samples as postpartum. Note: This study contains the same samples as is a follow-up to Koniak-Griffin et al. (1999).
Setting The study was conducted in San Bernardino County, California, a large, ethnically diverse county adjacent to Los Angeles.
Intervention services The intervention included a combination of home visits and motherhood preparation classes, both conducted by specially trained public health nurses. The intervention began in mid-pregnancy and continued through the first year of the infant’s life. Participants received approximately 17 home visits by a public health nurse. Each visit lasted between two and two and a half hours. In addition, participants attended four “Preparation for Motherhood” classes lasting six hours each. In addition, The intervention covered five main content areas: (1) health, (2) sexuality and family planning, (3) life skills, (4) maternal role, and (5) social support systems.
Comparison conditions Comparison group members received traditional public health nursing services, consisting of three home visits: one at intake, one for prenatal care, and one for postpartum/well-baby care information.
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).
Subgroups are not listed for manuscripts reviewed before 2021.
Staff characteristics and training The public health nurses in this study had a minimum education level of a bachelor’s degree in nursing. They received special training and used written protocols as guides in implementing the intervention and the traditional public health nursing services.
Funding sources National Institutes of Nursing Research, Grants R0-1 NR02325 and NR02325-S1, and the Office of Research on Women’s Health, Grant NR02325-S2.
Author affiliation The authors are developers of this model.
Peer reviewed

Findings details

Child health
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High Birth weight
FavorableUnfavorable or ambiguousNo Effect
San Bernardin o sample 6 weeks postpartum 121 mothers Mean = 3280430.00 Mean = 3206430.00 Mean difference = 74.00 HomeVEE calculated = 0.04 Statistical significance not reported
High Additional days of rehospitalization
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample 6 weeks postpartum 121 mothers Number of days = 23.00 Number of days = 36.00 Difference = -13.00 Not available Statistically significant, p = 0.046

footnote101

Submitted by user on Fri, 03/15/2019 - 14:29

Statistical significance is based on the results of the authors’ analysis using a chi-square test.

High Percentage premature
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample Intrapartum 121 mothers Percentage = 0.03 Mean % = 0.08 Mean difference = -0.05 HomeVEE calculated = -0.62 Statistical significance not reported
High Total number of days for birth-related infant hospitalization
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample 6 weeks postpartum 121 mothers Number of days = 91.00 Number of days = 110.00 Difference = -19.00 Not available Not statistically significant, p = 0.07

footnote101

Submitted by user on Fri, 03/15/2019 - 14:29

Statistical significance is based on the results of the authors’ analysis using a chi-square test.

High Total number of days for infant re-hospitalization during the first 6 weeks of life
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample 6 weeks postpartum 121 mothers Number of days = 114.00 Number of days = 146.00 Difference = -32.00 Not available Statistically significant, p = 0.01

footnote101

Submitted by user on Fri, 03/15/2019 - 14:29

Statistical significance is based on the results of the authors’ analysis using a chi-square test.

Family economic self-sufficiency
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High Positive education outcome
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample 6 weeks postpartum 121 mothers Not available Not available Not Reported Not available Statistically significant, p < 0.009

footnote101

Submitted by user on Fri, 03/15/2019 - 14:29

Statistical significance is based on the results of the authors’ analysis using a chi-square test.

High Positive education transitions
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample 6 weeks postpartum 121 mothers Not available Not available Not Reported Not available Statistically significant, p =0.02

footnote101

Submitted by user on Fri, 03/15/2019 - 14:29

Statistical significance is based on the results of the authors’ analysis using a chi-square test.

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 External social competence
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample 6 weeks postpartum 121 mothers Mean = 80.18 Mean = 77.11 Mean difference = 3.07 HomeVEE calculated = 0.40 Statistically significant, p =0.03

footnote106

Submitted by user on Fri, 03/15/2019 - 14:29

Information on outcomes was received through communication with the authors.

footnote107

Submitted by user on Fri, 03/15/2019 - 14:29

Although the treatment group has a higher mean, the authors report that the comparison group showed a significantly greater gain on this measure.

High Internal social competence
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample 6 weeks postpartum 121 mothers Mean = 70.68 Mean = 66.97 Mean difference = 3.71 HomeVEE calculated = 0.28 Not statistically significant, p > 0.05

footnote102

Submitted by user on Fri, 03/15/2019 - 14:29

Authors report whether the groups are significantly different or not, but do not report actual p-values.

footnote106

Submitted by user on Fri, 03/15/2019 - 14:29

Information on outcomes was received through communication with the authors.

High Number of prenatal health problems
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample 6 weeks postpartum 121 mothers Mean = 0.64 Mean = 0.72 Mean difference = -0.08 HomeVEE calculated = -0.03 Not statistically significant, p ≥ 0.05

footnote102

Submitted by user on Fri, 03/15/2019 - 14:29

Authors report whether the groups are significantly different or not, but do not report actual p-values.

High Substance use
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample 6 weeks postpartum 121 mothers Not available Not available Not Reported Not available Not statistically significant, p ≥ 0.05

footnote102

Submitted by user on Fri, 03/15/2019 - 14:29

Authors report whether the groups are significantly different or not, but do not report actual p-values.

High Total number of prenatal visits
FavorableUnfavorable or ambiguousNo Effect
San Bernardion sample 6 weeks postpartum 121 mothers Mean = 9.69 Mean = 9.34 Mean difference = 0.35 HomeVEE calculated = 0.03 Not statistically significant, p ≥ 0.05

footnote102

Submitted by user on Fri, 03/15/2019 - 14:29

Authors report whether the groups are significantly different or not, but do not report actual p-values.

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
Moderate NCAST mother’s score
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample, NCAST sample 6 weeks postpartum 97 mothers Not available Not available Not Reported Not available Not statistically significant, p ≥ 0.05

footnote102

Submitted by user on Fri, 03/15/2019 - 14:29

Authors report whether the groups are significantly different or not, but do not report actual p-values.

Moderate NCAST total score
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample, NCAST sample 6 weeks postpartum 97 mothers Mean = 39.31 Mean = 41.40 Mean difference = -2.09 HomeVEE calculated = -0.28 Not statistically significant, p ≥ 0.05

footnote102

Submitted by user on Fri, 03/15/2019 - 14:29

Authors report whether the groups are significantly different or not, but do not report actual p-values.

footnote106

Submitted by user on Fri, 03/15/2019 - 14:29

Information on outcomes was received through communication with the authors.

Outcome measure summary

Child health
Outcome measure Description of measure Data collection method Properties of measure

Additional days of rehospitalization

The number of additional days an infant was hospitalized beyond birth related hospitalization. Reasons for infant rehospitalization included respiratory difficulties, fever, dehydration, and jaundice. Review of medical records

Not applicable

Additional days of rehospitalization

Additional days of newborn rehospitalization Review of medical records

Not applicable

Birth weight

The child’s recorded birth weight in grams Review of delivery room or nursery records

Not applicable

Birth weight

Weight of the infant at birth Review of medical records

Not applicable

Percentage premature

Percentage of children that were born at less than 36 weeks gestation Review of medical records

Not applicable

Percentage premature

Percentage of infants born earlier than 36 weeks gestation Review of medical records

Not applicable

Total number of days for birth-related infant hospitalization

Total number of days of birth-related newborn hospitalization Review of medical records

Not applicable

Total number of days for birth-related infant hospitalization

Total number of days an infant was hospitalization for birth–related issues. This does not include later re–hospitalizations Review of medical records

Not applicable

Total number of days for infant re-hospitalization during the first 6 weeks of life

Total number of days infants were re-hospitalized during their first six weeks of life Review of medical records

Not applicable

Total number of days for infant re-hospitalization during the first 6 weeks of life

Total number of days for birth–related infant hospitalization plus additional days of rehospitalization during the first six weeks of life Review of medical records

Not applicable

Family economic self-sufficiency
Outcome measure Description of measure Data collection method Properties of measure

Positive education outcome

Percentage of participants experiencing positive education outcomes such as attending high school or junior college or having successfully graduated from high school Parent/caregiver report

Not applicable

Positive education transitions

Four categories of education transitions from pregnancy (intake) to postpartum were examined for group differences: positive change, negative change, positive status quo, and negative status quo. Parent/caregiver report

Not applicable

Maternal health
Outcome measure Description of measure Data collection method Properties of measure

External social competence

Socialcompetence measureswerecomposites derivedfrom (1)the Rosenberg Self–Esteem Inventory,(2)Pearlin’sSenseofMastery Scale, (3)the Centerfor EpidemiologicalStudies DepressionScale,(4) thePerceived StressScale;(5)the Community Life SkillsScale(CLSS), and (6)the SocialSkills Inventory (SSI). Factor analysis was used to develop two conceptual factors representing Internal and external social competence. Composite measures were formed by first standardizing each measure to a 0–100 scale with higher numbers representing higher skills, then averaging the relevant translated scores. Parent/caregiver report

Not reported by author

Internal social competence

Socialcompetence measureswerecomposites derivedfrom (1)the Rosenberg Self–Esteem Inventory;(2)Pearlin’sSenseofMastery Scale, (3)the Centerfor EpidemiologicalStudies DepressionScale,(4) thePerceived StressScale,(5)the Community Life SkillsScale(CLSS), and (6)the SocialSkills Inventory (SSI). Factor analysis was used to develop two conceptual factors representing Internal and external social competence. Composite measures were formed by first standardizing each measure to a 0–100 scale with higher numbers representing higher skills, then averaging the relevant translated scores. Parent/caregiver report

Not reported by author

Number of prenatal health problems

Count of the number of prenatal health problems experienced by mothers Review of medical records

Not applicable

Substance use

This measure of parents’ substance use include frequency–of–use categories(e.g., 0, 1 or 2, 3 to 9, 10 to 19, or 20+ times) during the past 30 days, 12 months, and lifetime for tobacco, alcohol, marijuana, cocaine, hallucinogens, and heroin. Parent/caregiver report

Not applicable

Total number of prenatal visits

Count of the number of prenatal visits completed by EIP and TPHN home visitors Review of medical records

Not applicable

Positive parenting practices
Outcome measure Description of measure Data collection method Properties of measure

Nursing Child Assessment Teaching Scale (NCAST) mother’s score

The NCAST is a 73–item binary scale that measures maternal and child contributions to dyadic interactive quality.

Coding of videotaped parent-child interaction during structured play episodes

Cronbach’s α = 0.77

Nursing Child Assessment Teaching Scale (NCAST) total score

The NCAST is a 73–item binary scale that measures maternal and child contributions to dyadic interactive quality.

Coding of videotaped parent-child interaction during structured play episodes

Cronbach’s α = 0.80