Manuscript Detail | Home Visiting Evidence of Effectiveness

Chapman, D. J., Damio, G., Young, S., & Perez-Escamilla, R. (2004). Effectiveness of breastfeeding peer counseling in a low-income, predominantly Latina population: A randomized controlled trial. Archives of Pediatrics & Adolescent Medicine, 158(9), 897-902. https://doi.org/10.1001/archpedi.158.9.897

Manuscript screening details
Screening decision	Screening conclusion	HomVEE procedures and standards version
Passes screens	Eligible for review	Version 2

Study design details
Rating	Design	Attrition	Baseline equivalence	Compromised randomization	Confounding factors	Valid, reliable measure(s)
High	Randomized controlled trial	Low	Not assessed for randomized controlled trials with low attrition	No	No	Yes

Study characteristics
Study participants	Pregnant women were recruited at prenatal clinics. To be eligible, the mother had to be age 18 or older, up to 26 weeks pregnant, and have low income (that is, participating in the Supplemental Nutrition Program for Women, Infants, and Children or in the Supplemental Nutrition Assistance Program, or with a household income below 180 percent of the federal poverty level). At the time of birth, mother-child dyads were screened a final time and eligible for the study if the newborn was born healthy at full term, had no congenital anomalies and no maternal history of human immunodeficiency virus, and was not admitted to the neonatal intensive care unit. Among eligible mothers, 90 were randomly assigned to the Breastfeeding: Heritage and Pride™ (BHP) home visiting group and 75 to the comparison group. Outcomes were measured at birth and at one month, three months, and six months postpartum. Eighty percent of mothers were Hispanic, nine percent were African American, four percent were White, and eight percent reported they were another race.
Setting	The study took place in Hartford, Connecticut.
Intervention services	The Breastfeeding: Heritage and Pride™ (BHP) intervention consisted of at least one prenatal home visit, daily in-hospital visits during postpartum hospitalization, and three postpartum home visits. These visits were conducted by peer counselors, one of whom was assigned to each mother-child dyad. During the prenatal home visit, the peer counselor provided education on a range of topics including the benefits of breastfeeding, common breastfeeding myths, behaviors that impede early initiation and successful breastfeeding, infant feeding cues, and proper latch-on technique or positioning. During the postpartum period, mothers received the first home visit within 24 hours of discharge from the hospital. The peer counselor provided hands-on breastfeeding support and counseling based on the mother’s needs. Free mini-electric breast pumps were provided to mothers who needed one.
Comparison conditions	Mothers assigned to the comparison group received routine breastfeeding education. This included written materials on breastfeeding and individualized breastfeeding information in response to questions at prenatal visits. During postpartum hospitalization, mothers received hands-on assistance and education from staff nurses, and had access to a certified lactation consultant for serious breastfeeding problems. During the postpartum period, mothers could also call the hospital to speak with a registered nurse who could answer questions about breastfeeding.
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). There were no subgroups reported in this manuscript.
Funding sources	This research was supported by the Centers for Disease Control and Prevention through a subcontract with the Association of Teachers of Preventative Medicine; Connecticut Family Nutrition Program for Infants, Toddlers, and Children; and the Hartford Hospital Research Foundation.
Author affiliation	The authors are affiliated with the University of Connecticut, the Hispanic Health Council, and Hartford Hospital. One of the authors is affiliated with the Hispanic Health Council, which sponsors the Breastfeeding: Heritage and Pride™ home visiting model.
Peer reviewed	Yes

Study Registration:

Clinicaltrials.gov Identifier: None found. SocialScienceRegistry.org Identifier: None found. Registry of Efficacy and Effectiveness Studies Identifier: None found. Study registration was assessed by HomVEE for Clinicaltrials.gov beginning with the 2014 review, and for other registries beginning with the 2021 review.

Findings that rate moderate or high

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	Exclusive breastfeeding	FavorableUnfavorable or ambiguousNo Effect	BHP and conventional breastfeeding support vs. conventional breastfeeding support RCT, Connecticut, 2000-2003, full sample	1 month old	157 mother/child dyads	Not reported	Not reported	Not reported	Study reported = 1.07	Not statistically significant, p ≥ 0.05	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention. The reported effect size is the relative risk, which is expressed as a positive value.
High	No initiation or cessation of breastfeeding	FavorableUnfavorable or ambiguousNo Effect	BHP and conventional breastfeeding support vs. conventional breastfeeding support RCT, Connecticut, 2000-2003, full sample	6 months old	144 mother/child dyads	Not reported	Not reported	Not reported	Study reported = 0.94	Not statistically significant, p ≥ 0.05	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention. The reported effect size is the relative risk, which is expressed as a positive value.
High	No initiation or cessation of breastfeeding	FavorableUnfavorable or ambiguousNo Effect	BHP and conventional breastfeeding support vs. conventional breastfeeding support RCT, Connecticut, 2000-2003, full sample	birth	165 mother/child dyads	Unadjusted proportion = 0.09	Unadjusted proportion = 0.23	Mean difference = -0.14	Study reported = 0.39	Statistically significant, p <0.05	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention. The reported effect size is the relative risk, which is expressed as a positive value.
High	No initiation or cessation of breastfeeding	FavorableUnfavorable or ambiguousNo Effect	BHP and conventional breastfeeding support vs. conventional breastfeeding support RCT, Connecticut, 2000-2003, full sample	1 month old	157 mother/child dyads	Unadjusted proportion = 0.36	Unadjusted proportion = 0.49	Mean difference = -0.14	Study reported = 0.72	Not statistically significant, p ≥ 0.05	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention. The reported effect size is the relative risk, which is expressed as a positive value.
High	No initiation or cessation of breastfeeding	FavorableUnfavorable or ambiguousNo Effect	BHP and conventional breastfeeding support vs. conventional breastfeeding support RCT, Connecticut, 2000-2003, full sample	3 months old	153 mother/child dyads	Unadjusted proportion = 0.56	Unadjusted proportion = 0.71	Mean difference = -0.15	Study reported = 0.78	Not statistically significant, p ≥ 0.05	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention. The reported effect size is the relative risk, which is expressed as a positive value.