Manuscript Detail | Home Visiting Evidence of Effectiveness

Schwarz, D. F., O’Sullivan, A. L., Guinn, J., Mautone, J. A., Carlson, E. C., Zhao, H., Zhang, X., Esposito, T. L., Askew, M., & Radcliffe, J. (2012). Promoting early intervention referral through a randomized controlled home-visiting program. Journal of Early Intervention, 34(1), 20–39

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

Notes:

footnote154

In order to receive a high rating, randomized controlled trials (RCTs) with low attrition must control for race/ethnicity, socioeconomic status (SES), and, if applicable, baseline outcomes if statistically significant differences exist between treatment and control groups. In this case, there were no significant differences in terms of race/ethnicity, but we had insufficient information to assess baseline equivalence on SES because the only SES measure collected at baseline was maternal education. HomVEE prefers to see equivalence on income, earnings, or poverty levels according to federal thresholds, but also considers other measures of SES (that is, maternal education, employment, and Aid to Families with Dependent Children/Temporary Assistance for Needy Families or food stamps receipt), if at least two such alternative measures of SES are provided.

Study characteristics
Study participants	Participating mothers were recruited from the postpartum unit of a hospital in Philadelphia and randomized into treatment and control groups. Of the 650 mothers who met eligibility criteria, 618 were invited to participate (32 were not invited, largely due to being discharged early from the hospital). The 302 mothers who consented to study participation were randomized to the treatment (n = 152) and control (n = 150) groups. All mothers lived in zip codes with high rates of poverty and each had just given birth to a singleton that weighed at least 2,500 grams and did not appear to have any genetic or developmental disorders. The study notes that most of the mothers were African American but does not provide statistics on the racial composition of the sample. The mothers had completed 12 years of schooling. No additional baseline data on socioeconomic status are specified. Participants were followed from birth until 33-months of age: telephone interviews were conducted with the mothers every four months, in-person assessments of children were completed at 18 and 33 months, and mothers were assessed and interviewed at 33 months.
Setting	The study was conducted in a high-poverty area of Philadelphia.
Intervention services	The intervention included, on average, eight 15-minute home visits that were scheduled to coincide with well-child pediatric appointments during the child’s first three years. During these visits, the home visitors informed each mother of the content of the upcoming well-child visit, asked the mother to identify any concerns about her child, informed the mother about the developmental milestones relevant to her child’s age, and asked if her child met each milestone. In addition, home visitors advised the mother to raise concerns about her child’s health during the visit to the health care provider and informed her about early education services that might be suitable for the child. At 18 months, home visitors conducted a more extensive visit. They described the developmental expectations for children from 18 to 24 months, paying particular attention to emerging language skills. They reinforced previous referrals to Early Head Start or early intervention services by asking about the referral process and/or providing the relevant contact information again. They discussed the importance of immunization and lead screening. They prepared the mother for the 18-month well-child visit by emphasizing to the mother the importance of checking whether the child was growing at the expected rate, reviewing any questions for the health provider, and discussing potential barriers for attending the next well-child visit and identifying potential solutions. The mother was reminded of the importance of the annual gynecological exam, provided with resources as necessary, and asked to confirm her contact information. Finally she was offered a developmental screen for her child using the Ages and Stages Questionnaire (ASQ).
Comparison conditions	The comparison group members received information booklets on child/family services on enrollment and details on transportation for the 33-month child evaluation. They also received follow-up telephone calls every four months to maintain up-to-date contact 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.
Funding sources	The William Penn Foundation (Grant 229-08)
Author affiliation	Not clear from the article.
Peer reviewed	Peer reviewed status is not listed for manuscripts reviewed before 2021.

Findings that rate moderate or high

Child development and school readiness
Rating	Outcome measure	Effect	Sample	Timing of follow-up	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
Moderate	Denver Developmental Screening Test-II (DDST-II)	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	16 months	287 mothers	Not available	Not available	Not reported	Not available	Not statistically significant, p ≥ 0.05
Moderate	Wechsler Preschool and Primary Scale of Intelligence-Third Edition (WPPSI-III), Full Scale IQ	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	271 mothers	Mean = 88.44	Mean = 89.53	Mean difference = -1.09	HomVEE calculated = -0.09	Not statistically significant, p ≥ 0.05
Moderate	Wechsler Preschool and Primary Scale of Intelligence-Third Edition (WPPSI-III), Language Score	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	271 mothers	Mean = 90.10	Mean = 90.36	Mean difference = -0.26	HomVEE calculated = -0.02	Not statistically significant, p ≥ 0.05
Moderate	Wechsler Preschool and Primary Scale of Intelligence-Third Edition (WPPSI-III), Performance Score	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	271 mothers	Mean = 89.38	Mean = 91.18	Mean difference = -1.80	HomVEE calculated = -0.15	Not statistically significant, p ≥ 0.05
Moderate	Wechsler Preschool and Primary Scale of Intelligence-Third Edition (WPPSI-III), Verbal Score	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	271 mothers	Mean = 90.33	Mean = 91.02	Mean difference = -0.69	HomVEE calculated = -0.06	Not statistically significant, p ≥ 0.05

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
Moderate	Maternal level of education	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	271 mothers	Mean = 12.20	Mean = 12.30	Mean difference = -0.10	HomVEE calculated = -0.05	Not statistically significant, p ≥ 0.05
Moderate	Monthly income > 2500	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	271 mothers	Percentage = 0.07	Mean % = 0.07	Percentage difference = 0.00	HomVEE calculated = 0.00	Not statistically significant, p ≥ 0.05	footnote173 Submitted by user on Fri, 03/15/2019 - 14:29 Author calculated p-value for overall difference across income categories = 0.70
Moderate	Monthly income: 1000	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	271 mothers	Percentage = 0.21	Mean % = 0.19	Percentage difference = 0.02	HomVEE calculated = 0.08	Not statistically significant, p ≥ 0.05	footnote173 Submitted by user on Fri, 03/15/2019 - 14:29 Author calculated p-value for overall difference across income categories = 0.70
Moderate	Monthly income: 1500	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	271 mothers	Percentage = 0.21	Mean % = 0.17	Percentage difference = 0.04	HomVEE calculated = 0.14	Not statistically significant, p ≥ 0.05	footnote173 Submitted by user on Fri, 03/15/2019 - 14:29 Author calculated p-value for overall difference across income categories = 0.70
Moderate	Monthly income: 2000	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	271 mothers	Percentage = 0.07	Mean % = 0.11	Percentage difference = 0.04	HomVEE calculated = 0.27	Not statistically significant, p ≥ 0.05	footnote173 Submitted by user on Fri, 03/15/2019 - 14:29 Author calculated p-value for overall difference across income categories = 0.70
Moderate	Monthly income: 250	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	271 mothers	Percentage = 0.18	Mean % = 0.13	Percentage difference = 0.05	HomVEE calculated = 0.24	Not statistically significant, p ≥ 0.05	footnote173 Submitted by user on Fri, 03/15/2019 - 14:29 Author calculated p-value for overall difference across income categories = 0.70
Moderate	Monthly income: 2500	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	271 mothers	Percentage = 0.04	Mean % = 0.05	Percentage difference = 0.01	HomVEE calculated = 0.11	Not statistically significant, p ≥ 0.05	footnote173 Submitted by user on Fri, 03/15/2019 - 14:29 Author calculated p-value for overall difference across income categories = 0.70
Moderate	Monthly income: 500	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	271 mothers	Percentage = 0.23	Mean % = 0.29	Percentage difference = 0.06	HomVEE calculated = 0.19	Not statistically significant, p ≥ 0.05	footnote173 Submitted by user on Fri, 03/15/2019 - 14:29 Author calculated p-value for overall difference across income categories = 0.70
Moderate	Number of months in school in past year	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	271 mothers	Mean = 2.00	Mean = 1.40	Mean difference = 0.60	HomVEE calculated = 0.19	Not statistically significant, p ≥ 0.05
Moderate	Number of months worked in past year	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	271 mothers	Mean = 6.80	Mean = 7.10	Mean difference = -0.30	HomVEE calculated = -0.06	Not statistically significant, p ≥ 0.05
Moderate	Number of moves in past 33 months	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	271 mothers	Mean = 1.10	Mean = 1.10	Mean difference = 0.00	HomVEE calculated = 0.00	Not statistically significant, p ≥ 0.05
Moderate	Receipt of public assistance	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	271 mothers	Percentage = 0.56	Mean % = 0.55	Percentage difference = 0.01	HomVEE calculated = 0.03	Not statistically significant, p ≥ 0.05
Moderate	Use of homeless services	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	271 mothers	Percentage = 0.10	Mean % = 0.06	Percentage difference = 0.04	HomVEE calculated = 0.32	Not statistically significant, p ≥ 0.05	footnote163 Submitted by user on Fri, 03/15/2019 - 14:29 Positive value is favorable to the comparison group. footnote174 Submitted by user on Fri, 03/15/2019 - 14:29 HomVEE-calculated p-value

Linkages and referrals
Rating	Outcome measure	Effect	Sample	Timing of follow-up	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
Moderate	Receipt of early intervention (EI) services	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	287 mothers	Percentage = 0.15	Mean % = 0.04	Percentage difference = 0.11	HomVEE calculated = 0.87	Statistically significant, p < 0.05
Moderate	Referral to early intervention (EI)	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	287 mothers	Percentage = 0.20	Mean % = 0.15	Percentage difference = 0.06	HomVEE calculated = 0.23	Statistically significant, p < 0.05
Moderate	Time to first receipt of early intervention (EI) services	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	287 mothers	Not available	Not available	Not reported	Not available	Statistically significant, p < 0.05
Moderate	Time to first referral for early intervention (EI) services	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	287 mothers	Not available	Not available	Not reported	Not available	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
Moderate	BDI-II total scale	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	269 mothers	Mean = 12.20	Mean = 11.00	Mean difference = 1.20	HomVEE calculated = 0.13	Not statistically significant, p ≥ 0.05
Moderate	Number of other children	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	271 mothers	Mean = 0.30	Mean = 0.30	Mean difference = 0.00	HomVEE calculated = 0.00	Not statistically significant, p ≥ 0.05
Moderate	Number of other children	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	271 mothers	Mean = 1.40	Mean = 1.40	Mean difference = 0.00	HomVEE calculated = 0.00	Not statistically significant, p ≥ 0.05
Moderate	Number of subsequent pregnancies	FavorableUnfavorable or ambiguousNo Effect	Philadelphia sample	33 months	271 mothers	Mean = 0.61	Mean = 0.60	Mean difference = 0.01	HomVEE calculated = 0.01	Not statistically significant, p ≥ 0.05