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Kemp, L., Harris, E., McMahon, C., Matthey, S., Vimpani, G., Anderson, T., Schmied, V., Aslam, H., & Zapart, S. (2011). Child and family outcomes of a long-term nurse home visitation programme: A randomised controlled trial. Archives of Disease in Childhood, 96, 533-540.

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 Low Equivalent on SES, information on race/ethnicity not available None None Not assessed in manuscripts reviewed before 2021
Notes:

footnote139

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

Moderate rating applies to outcomes (birthweight and preterm birth) measured at the one-month post partum follow-up, which had low attrition. Outcomes measured after one month postpartum had high attrition. Because of missing data on race and ethnicity, baseline equivalence could not be established and all other outcomes receive a low rating.

Study characteristics
Study participants Pregnant women were eligible to participate if they did not require the use of an interpreter and reported at least one risk factor for poor maternal or child outcomes during routine psychosocial and domestic violence screenings conducted by midwives in a local hospital. After consenting to participate in the study, 208 eligible mothers were randomly assigned to the program (MECSH) or comparison group before baseline data were collected, assigning 111 to MECSH and 97 to the comparison group. There were no significant differences between the two groups on age, marital status, educational attainment, source of income, or number of risk factors. The study did not report baseline information on race or ethnicity, so equivalence could not be established on this factor. Participants were followed for 24 months.
Setting The study was conducted in a socioeconomically disadvantaged suburb of Sydney, Australia.
Intervention services Women in the intervention group received an average of 16.3 visits (range 0–52), each of 60 to 90 minutes duration, by a child health nurse. Visits began, on average, at 26 weeks gestation and continued up to the child’s second birthday. Home visits included information and activities to encourage child development and linkages to community activities (such as parenting groups).
Comparison conditions Women in both study conditions received usual antenatal midwifery, obstetric, and birthing services. Comparison group women were expected to receive a home visit by a child health nurse within two weeks of giving birth, in accordance with standard practice in New South Wales.
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.
Funding sources The trial was funded by the Australian Research Council (LP0560285), Sydney South West Area Health Service, the New South Wales (NSW) Department of Community Services, and the NSW Department of Health.
Author affiliation Lynn Kemp, a study author, is a developer of this model.
Peer reviewed Peer reviewed status is not listed for manuscripts reviewed before 2021.

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 Breastfeeding duration (weeks)
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 12 months 139 children Mean = 16.12 Mean = 8.24 Mean difference = 7.88 HomeVEE calculated = 0.52 Statistically significant, p = 0.002
Moderate Gastroenteritis
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 24 months 166 children % = 58.00 % = 60.00 OR = 1.10 HomeVEE calculated = -0.05 Not Statistically significant, p = 0.76
Moderate Immunization up to date
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 24 months 166 children % = 100.00 % = 100.00 Not reported Not available Not statistically significant, p ≥ 0.05
Moderate Low birth weight (< 2500 g)
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 1 month 201 mothers % = 7.00 % = 2.00 OR = 3.22 HomeVEE calculated = 0.79 Not Statistically significant, p = 0.15
Moderate Preterm (< 37 weeks)
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 1 month 203 mothers % = 10.00 % = 6.00 OR = 1.69 HomeVEE calculated = 0.33 Not Statistically significant, p = 0.32
Moderate Respiratory infection
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 24 months 166 children % = 33.00 % = 31.00 OR = 0.90 HomeVEE calculated = 0.06 Not Statistically significant, p = 0.76
Moderate Transition to solids (weeks)
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 12 months 162 children Mean = 21.74 Mean = 23.06 Mean difference = -1.32 Not available Not statistically significant, p ≥ 0.05
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 Family functioning
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 24 months 208 mothers Mean = 1.83 Mean = 1.77 Mean difference = 0.06 Not available Not Statistically significant, p = 0.21
Moderate Maternal depression
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 24 months 208 mothers Mean = 7.34 Mean = 7.07 Mean difference = 0.30 Not available Not Statistically significant, p = 0.55
Moderate Maternal experience of being a mother
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 12 months 138 mothers Mean = 30.05 Mean = 29.83 Mean difference = 0.22 Not available Not statistically significant, p ≥ 0.05
Moderate Maternal general health
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 24 months 208 mothers Mean = 2.42 Mean = 2.50 Mean difference = -0.08 Not available Not Statistically significant, p = 0.33
Moderate Maternal mental health
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 24 months 208 mothers Mean = 51.60 Mean = 51.33 Mean difference = 0.28 Not available Not Statistically significant, p = 0.69
Moderate Maternal physical health
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 24 months 208 mothers Mean = 48.34 Mean = 48.23 Mean difference = 0.11 Not available Not Statistically significant, p = 0.84
Moderate Maternal social support
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 24 months 208 mothers Mean = 20.11 Mean = 20.45 Mean difference = -0.34 Not available Not Statistically significant, p = 0.26
Moderate Mother never smoked
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 24 months 208 mothers % = 62.00 % = 68.00 OR = 1.30 HomeVEE calculated = 0.00 Not Statistically significant, p = 0.38
Moderate Stressful life events
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 24 months 208 mothers Mean = 3.07 Mean = 3.06 Mean difference = 0.01 Not available Not Statistically significant, p = 0.98
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 HOME avoidance of restriction and punishment
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 24 months 174 mothers Mean = 5.75 Mean = 5.50 Mean difference = 0.25 Not available Not Statistically significant, p = 0.18
Moderate HOME maternal involvement with child
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 24 months 174 mothers Mean = 3.24 Mean = 3.19 Mean difference = 0.05 Not available Not Statistically significant, p = 0.76
Moderate HOME organization of environment
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 24 months 174 mothers Mean = 4.92 Mean = 4.84 Mean difference = 0.09 Not available Not Statistically significant, p = 0.43
Moderate HOME provision of appropriate play materials
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 24 months 174 mothers Mean = 6.90 Mean = 6.68 Mean difference = 0.23 Not available Not Statistically significant, p = 0.21
Moderate HOME responsivity
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 24 months 174 mothers Mean = 9.35 Mean = 8.88 Mean difference = 0.47 Study reported = 0.26 Statistically significant, p = 0.02
Moderate HOME variety in daily stimulation
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 24 months 174 mothers Mean = 3.75 Mean = 3.67 Mean difference = 0.08 Not available Not Statistically significant, p = 0.49
Moderate Household always smoke free
FavorableUnfavorable or ambiguousNo Effect
Sydney sample 24 months 208 mothers % = 35.00 % = 35.00 OR = 1.00 HomeVEE calculated = 0.00 Not Statistically significant, p = 0.99