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Koniak-Griffin, D., Anderson, N. L., Brecht, M. L., Verzemnieks, I., Lesser, J., & Kim, S. (2002). Public health nursing care for adolescent mothers: Impact on infant health and selected maternal outcomes at 1 year postbirth. Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 30(1), 44–54.

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)
Moderate Randomized controlled trial High Established on race/ethnicity, SES, and baseline outcomes. None None Not assessed in manuscripts reviewed before 2021
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. Sixty-two were assigned to the intervention group, and 59 were assigned to the comparison group. At the one-year follow-up 102 adolescent mothers participated in the study, 55 in the intervention group and 47 in the comparison group. 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 19 percent were white. Participants were followed from pregnancy through six weeks postpartum. Note: This study contains the same sample as Koniak-Griffin et al. (1999, 2000).
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
Moderate Number of episodes of hospitalizations
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample One year postpartum 102 mothers Number of episodes = 14.00 Number of episodes = 24.00 Difference = -10.00 Not available Statistically significant, p =0.03

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.

Moderate Number of infant ER visits
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample One year postpartum 102 mothers Number of visits = 90.00 Number of visits = 80.00 Difference = 10.00 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 Percentage of children adequately immunized
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample One year postpartum 102 mothers Percentage = 0.96 Mean % = 0.86 Mean difference = 0.10 HomeVEE calculated = 0.83 Statistically significant, p < 0.05

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.

Moderate Percentage of children hospitalized
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample One year postpartum 102 mothers Percentage = 0.22 Mean % = 0.28 Mean difference = -0.06 HomeVEE calculated = -0.19 Statistical significance not reported
Moderate Total number of days of nonbirth-related infant hospitalization
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample One year postpartum 102 mothers Number of days = 74.00 Number of days = 154.00 Difference = -80.00 Not available Statistically significant, p < 0.001

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
Moderate CES-D (depression)
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample One year postpartum 102 mothers Mean = 14.53 Mean = 15.33 Mean difference = -0.80 HomeVEE calculated = -0.09 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 PSS (perceived stress)
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample One year postpartum 102 mothers Mean = 24.40 Mean = 23.55 Mean difference = 0.85 HomeVEE calculated = 0.13 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 RSEI (self-esteem)
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample One year postpartum 102 mothers Mean = 32.73 Mean = 31.07 Mean difference = 1.66 HomeVEE calculated = 0.37 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 Repeat pregnancy rate
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample One year postpartum 102 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.

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 child’s score
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample, NCAST sample One year postpartum 93 mothers Mean = 19.33 Mean = 19.16 Mean difference = 0.17 HomeVEE calculated = 0.09 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 mother’s score
FavorableUnfavorable or ambiguousNo Effect
San Bernardino sample, NCAST sample One year postpartum 93 mothers Mean = 34.04 Mean = 33.05 Mean difference = 0.00 HomeVEE calculated = 0.25 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 One year postpartum 93 mothers Mean = 53.36 Mean = 52.20 Mean difference = 1.16 HomeVEE calculated = 0.25 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.

Outcome measure summary

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

Number of episodes of hospitalizations

The total number of child hospitalization episodes during the first year of life. Parent/caregiver report confirmed by review of medical records for 87% of hospitalizations and 68% of ER episodes.

Not applicable

Number of infant ER visits

The total number of child ER visits during the first year of life. Common reasons for ER visits included illnesses, injuries, or accidents Parent/caregiver report confirmed by review of medical records for 87% of hospitalizations and 68% of ER episodes.

Not applicable

Percentage of children adequately immunized

Percentage of children that received three doses of diptheriatetanus–pertussis vaccine and two doses of oral polio vaccine by 12 months of age as recommended by the Centers for Disease Control and Prevention Review of immunization cards

Not applicable

Percentage of children hospitalized

Percentage of children that were hospitalized during the first year of life Parent/caregiver report confirmed by review of medical records for 87% of hospitalizations and 68% of ER episodes.

Not applicable

Total number of days of nonbirth-related infant hospitalization

Count of the total number of days of nonbirth–related infant hospitalization during the first year of life. Common reasons for hospitalization included respiratory problems, gastrointestinal problems, and fever. Parent/caregiver report confirmed by review of medical records for 87% of hospitalizations and 68% of ER episodes.

Not applicable

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

CES-D (depression)

The Center for Epidemiological Studies Depression Scale (CES–D) is a 20–item assessment designed to measure depressive symptoms. The scale contains items related to feelings and conditions such as powerlessness, guilt, helplessness, sadness, anorexia, and sleep disturbances. Parent/caregiver report

Cronbach’s α = 0.84 at intake and 0.83 at 12 months postpartum

PSS (perceived stress)

The Perceived Stress Scale (PSSmeasures global perceived stress during the past month through 14 items on a 5–point Likert scale (0 to 4). Scores on the PSS may range from 0 to 56. Parent/caregiver report

Cronbach’s α = 0.65 at intake and 0.69 at 12 months postpartum

RSEI (self-esteem)

Rosenberg Self–Esteem Inventory (RSEI) is a10–item instrument whose total score reflects the degree of positive self–esteem. Possible scores range from 10 to 40, with higher scores indicating higher self–esteem. Parent/caregiver report

Cronbach’s α = 0.84 at intake and 0.85 at 12 months postpartum

Repeat pregnancy rate

Percentage of mothers that experienced a repeat pregnancy Parent/caregiver report

Not applicable

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

NCAST child’s score

The Nursing Child Assessment Teaching Scale (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 = 0.71

NCAST mother’s score

The Nursing Child Assessment Teaching Scale (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

NCAST total score

The Nursing Child Assessment Teaching Scale (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