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Campbell, K. I., & Silva, P. A. (1997). Parents as first teachers pilot programme evaluation : Age three assessments. Final report to the ministry of education on the Dunedin and Gisborne/East coast areas. Wellington: Ministry of Education.

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 Not established on race/ethnicity, SES, or outcomes None None Not assessed in manuscripts reviewed before 2021
Notes:

In 2020, HomVEE updated this review in two ways. First, HomVEE removed five findings related to mother's partnership status/family structure from the Family Economic Self-Sufficiency domain because ACF determined that mother's partnership status is ineligible for review by HomVEE. Second, HomVEE removed two partner employment findings from the Family Economic Self-Sufficiency domain because partner SES is not eligible for review unless the same SES variable is measured for the mother, and the partner is coresident with the mother.

footnote170

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

This study receives a mixed rating. All outcomes from the Gisborne/East Coast areas had high attrition and receive a low rating. Many of the outcomes from the Dunedin sample had low attrition and receive a moderate rating. Some of the Dunedin outcomes had high attrition or lacked the sample size information necessary to calculate attrition and receive a low rating (low-rated outcomes are not reported).

footnote171

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

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, we had insufficient information to assess baseline equivalence on race/ethnicity, SES, or outcomes in order to determine if there were statistically significant differences for which the authors should have controlled in analyses.

Study characteristics
Study participants The Parents as First Teachers (PAFT) pilot project was initiated in 1992–1993 in four areas of New Zealand: Whangarei, South Auckland, Gisbome, and Dunedin. This study reports on the Dunedin and Gisborne regions. The PAFT pilot project aimed to provide first-time parents in each of the four geographical areas with a variety of services, from the birth of their first child until the child was 3 years of age. Participants were randomly assigned to the program or comparison group. In Dunedin, 133 program families and 134 comparison families took part in the evaluation. In Gisborne, 108 program families and 100 comparison families took part in the evaluation.
Setting This study took place in two areas within New Zealand: Dunedin and Gisborne.
Intervention services Trained parent educators provided monthly home visits, offering parenting education and guidance with the goal of increasing parents’ feelings of confidence and competence. The intervention included periodic child development screening and any necessary referrals, monthly group meetings, and access to resources at PAFT centers.
Comparison conditions Comparison group families had annual contact with program staff, via mailings, to maintain contact and update addresses. 
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 Parent educators had at least an undergraduate-level degree, had prior experience with children and parents, and were qualified in general or Plunket Society nursing or early childhood or primary teaching (or the equivalent). Initial training lasted two weeks and covered information on PAT, the home visits, conducting educationally focused parent meetings, empowering parents, encouraging parent-child interactions, sensory overload, avoiding dependency relationships, early language, record keeping, and children with special needs. Ongoing training was provided annually for one week. Parent educators received certification from the PAT National Center for fulfilling training requirements.
Funding sources New Zealand Ministry of Education
Author affiliation None of the study authors is a developer of this model.
Peer reviewed Peer reviewed status is not listed for manuscripts reviewed before 2021.

Findings details

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 Notes
Moderate Age in months when child first walked 6 steps unaided
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 206 mothers Unadjusted mean = 12.90 Unadjusted mean = 12.37 Mean difference = 0.53 HomeVEE calculated = 0.24 Not statistically significant, p ≥ 0.05
Moderate Behaviour Checklist
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Not available Not available Not reported Not available Not statistically significant, p ≥ 0.05
Moderate Denver II Assessment, Fine Motor Delay
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 206 mothers Not available Not available Not reported Not available Not statistically significant, p ≥ 0.05
Moderate Denver II Assessment, Gross Motor Delay
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 206 mothers Not available Not available Not reported Not available Not statistically significant, p ≥ 0.05
Moderate Denver II Assessment, Language Delay
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 206 mothers Not available Not available Not reported Not available Not statistically significant, p ≥ 0.05
Moderate Denver II Assessment, Personal Social Items
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 206 mothers Not available Not available Not reported Not available Not statistically significant, p ≥ 0.05
Moderate Kaufman Assessment Battery for Children, Mental Processing Composite
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 158 mothers Unadjusted mean = 59.44 Unadjusted mean = 60.34 Mean difference = -0.90 HomeVEE calculated = -0.09 Not statistically significant, p ≥ 0.05
Moderate Kaufman Assessment Battery for Children, Sequential Processing
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 158 mothers Unadjusted mean = 22.14 Unadjusted mean = 23.00 Mean difference = -0.86 HomeVEE calculated = -0.16 Not statistically significant, p ≥ 0.05
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 Incidence of ear infections
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Unadjusted % = 0.70 Unadjusted % = 0.79 Mean difference = -0.09 HomeVEE calculated = -0.29 Not statistically significant, p ≥ 0.05
Moderate Incidence of hearing problems
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Unadjusted % = 0.08 Unadjusted % = 0.07 Mean difference = 0.01 HomeVEE calculated = 0.09 Not statistically significant, p ≥ 0.05
Moderate Number of health problems children had experienced
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Unadjusted mean = 4.85 Unadjusted mean = 4.91 Mean difference = -0.06 HomeVEE calculated = -0.03 Not statistically significant, p ≥ 0.05

footnote165

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

Authors report that significantly more program children experienced bronchitis attacks.

Moderate Number of hospital admissions
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Unadjusted % = 0.33 Unadjusted % = 0.30 Mean difference = 0.03 HomeVEE calculated = 0.08 Not statistically significant, p ≥ 0.05
Moderate Number of hospital visits
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Unadjusted % = 0.64 Unadjusted % = 0.72 Mean difference = -0.08 HomeVEE calculated = -0.22 Not statistically significant, p ≥ 0.05
Moderate Number of times children visited a hospital clinic
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Unadjusted % = 0.42 Unadjusted % = 0.51 Mean difference = -0.09 HomeVEE calculated = -0.22 Not statistically significant, p ≥ 0.05
Moderate Number of times children visited general practitioner
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Unadjusted % = 0.00 Unadjusted % = 0.00 Mean difference = 0.00 Not available Not statistically significant, p ≥ 0.05
Moderate Number of times children visited health specialist
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Unadjusted % = 0.54 Unadjusted % = 0.51 Mean difference = 0.03 HomeVEE calculated = 0.07 Not statistically significant, p ≥ 0.05
Moderate Number of times children visited other professional health service
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Unadjusted % = 0.18 Unadjusted % = 0.15 Mean difference = 0.03 HomeVEE calculated = 0.13 Not statistically significant, p ≥ 0.05
Moderate Total number of injuries
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Unadjusted % = 0.42 Unadjusted % = 0.38 Mean difference = 0.04 HomeVEE calculated = 0.10 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 Attained additional educational qualifications since birth of child
FavorableUnfavorable or ambiguousNo Effect
Dunedin 3 years 207 mothers Unadjusted % = 0.23 Unadjusted % = 0.30 Mean difference = -0.07 HomeVEE calculated = -0.22 Not statistically significant, p ≥ 0.05
Moderate Elley-Irving Socio-Economic Index
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Not available Not available Not reported Not available Not statistically significant, p ≥ 0.05
Moderate Family means of transport
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Not available Not available Not reported Not available Not statistically significant, p ≥ 0.05
Moderate Family owns car
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Unadjusted % = 0.88 Unadjusted % = 0.90 Mean difference = -0.02 HomeVEE calculated = -0.12 Not statistically significant, p ≥ 0.05
Moderate Family Strains Questionnaire, Sum of strains
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 206 mothers Unadjusted mean = 10.92 Unadjusted mean = 9.97 Mean difference = 0.95 HomeVEE calculated = 0.12 Not statistically significant, p ≥ 0.05

footnote169

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

Authors report that significantly more program group families reported experiencing increased strain on family money for medical expenses, clothes, food, etc., but, after applying the Bonferroni inequality, this difference was no longer significant.

Moderate Family Stressors Questionnaire, Sum of stressors
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 206 mothers Unadjusted mean = 15.42 Unadjusted mean = 14.54 Mean difference = 0.88 HomeVEE calculated = 0.10 Not statistically significant, p ≥ 0.05
Moderate Held a community services card
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Unadjusted % = 0.39 Unadjusted % = 0.42 Mean difference = -0.03 HomeVEE calculated = -0.08 Not statistically significant, p ≥ 0.05
Moderate Language use in the home
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Not available Not available Not reported Not available Not statistically significant, p ≥ 0.05
Moderate Mother working in full-time position
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Unadjusted % = 0.35 Unadjusted % = 0.53 Mean difference = -0.18 HomeVEE calculated = -0.45 Statistically significant, p < 0.05
Moderate Mother working in paid employment
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Unadjusted % = 0.64 Unadjusted % = 0.56 Mean difference = 0.08 HomeVEE calculated = 0.20 Not statistically significant, p ≥ 0.05
Moderate Receiving government support
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Unadjusted % = 0.42 Unadjusted % = 0.39 Mean difference = 0.03 HomeVEE calculated = 0.08 Not statistically significant, p ≥ 0.05
Moderate Subjective perception of income level
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 207 mothers Not available Not available Not reported Not available Not statistically significant, p ≥ 0.05
Moderate Type of accomodation
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Not available Not available Not reported 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 Maternal Social Support Index (MSSI),Overall
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 207 mothers Not available Not available Not reported Not available Not statistically significant, p ≥ 0.05
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 Questionnaire, Overall
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 207 mothers Not available Not available Not reported Not available Not statistically significant, p ≥ 0.05
Moderate Parental Concerns, Disruption of plans
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Unadjusted % = 0.04 Unadjusted % = 0.04 Mean difference = 0.00 HomeVEE calculated = 0.00 Not statistically significant, p ≥ 0.05
Moderate Parental Concerns, Disruption of relationship with partner
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Unadjusted % = 0.10 Unadjusted % = 0.15 Mean difference = -0.05 HomeVEE calculated = -0.28 Not statistically significant, p ≥ 0.05
Moderate Parental Concerns, Significant Concern
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Unadjusted % = 0.18 Unadjusted % = 0.14 Mean difference = 0.04 HomeVEE calculated = 0.18 Not statistically significant, p ≥ 0.05
Moderate Parental Concerns, Social Concern
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Unadjusted % = 0.21 Unadjusted % = 0.25 Mean difference = -0.04 HomeVEE calculated = -0.14 Not statistically significant, p ≥ 0.05
Moderate Parents as Teachers Questionnaire, Overall
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Not available Not available Not reported Not available Not statistically significant, p ≥ 0.05

footnote167

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

Authors report that significantly more program parents respond yes to the following item: Looking around his/her surroundings takes up much of a baby's day during the first month of life.

Moderate Total number of activities
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Unadjusted mean = 27.64 Unadjusted mean = 27.27 Mean difference = 0.37 HomeVEE calculated = 0.17 Not statistically significant, p ≥ 0.05

footnote166

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

Authors report that significantly more program children play fantasy games.

Moderate Total number of experiences
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 208 mothers Unadjusted mean = 18.93 Unadjusted mean = 18.79 Mean difference = 0.14 HomeVEE calculated = 0.04 Not statistically significant, p ≥ 0.05
Moderate Video Session, Parent-Child Interaction
FavorableUnfavorable or ambiguousNo Effect
Dunedin sample 3 years 155 mothers Unadjusted mean = 26.78 Unadjusted mean = 30.97 Mean difference = -4.19 HomeVEE calculated = -0.21 Not statistically significant, p ≥ 0.05

footnote168

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

Authors report significant differences on several items: “Book chosen by,” “Motivation,” “Attention maintained,” “Attending to help,” and “Using information.”

Outcome measure summary

Child development and school readiness
Outcome measure Description of measure Data collection method Properties of measure

Age in months when child first walked 6 steps unaided

Mean age in months when child first walked 6 steps unaided

Parent/caregiver report

Not applicable

Behaviour Checklist

Number/percentage of parents who responded whether each of 14 listed behavior and emotional problems (e.g. poor appetite, difficulty sleeping at night, overactive, etc.) apply, somewhat apply, or do not apply to their children.

Parent/caregiver report

Not applicable

Denver II Assessment, Fine Motor Delay

Number/percentage of children whose performance on the Denver II Assessment of fine motor delay was categorized as advanced, delayed, or cautions. The Denver II Assessment was designed to detect potential developmental problems.

Child assessment

Not reported by authors

Denver II Assessment, Language Delay

Number/percentage of children whose performance on the Denver II Assessment of language delay was categorized as advanced, delayed, or cautions. The Denver II Assessment was designed to detect potential developmental problems.

Child assessment

Not reported by authors

Denver II Assessment, Personal Social Items

Number/percentage of children whose performance on the Denver II Assessment of personal social items was categorized as advanced, delayed, or cautions. The Denver II Assessment was designed to detect potential developmental problems.

Child assessment

Not reported by authors

Kaufman Assessment Battery for Children, Mental Processing Composite

Mean mental processing composite score on the Kaufman Assessment Battery for Children. The mental processing composite includes measures of sequential and simultaneous processing, designed to elicit problem-solving and information processing styles while minimizing the role of language and verbal skills.

Child assessment

Not reported by authors

Kaufman Assessment Battery for Children, Sequential Processing

Mean sequential processing score on the Kaufman Assessment Battery for Children

Child assessment

Not reported by authors

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

Incidence of ear infections

Number/percentage of children who experienced an ear infection

Parent/caregiver report

Not applicable

Incidence of hearing problems

Number/percentage of children who experienced a hearing problem

Parent/caregiver report

Not applicable

Number of health problems children had experienced

Mean number of health problems children experienced

Parent/caregiver report

Not applicable

Number of hospital admissions

Number of hospital admissions children experienced

Parent/caregiver report

Not applicable

Number of hospital visits

Number of hospital visits children experienced

Parent/caregiver report

Not applicable

Number of times children visited a hospital clinic

Number of times children visited a hospital clinic

Parent/caregiver report

Not applicable

Number of times children visited general practitioner

Number of times children visited a general practitioner

Parent/caregiver report

Not applicable

Number of times children visited health specialist

Number of times children visited a health specialist

Parent/caregiver report

Not applicable

Number of times children visited other professional health service

Number of times children visited another professional health service

Parent/caregiver report

Not applicable

Total number of injuries

Total number of injuries children experienced

Parent/caregiver report

Not applicable

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

Attained additional educational qualifications since birth of child

Number/percentage of mothers who attained additional educational qualifications since birth of their child

Parent/caregiver report

Not applicable

Elley-Irving Socio-Economic Index

Distribution of socio-economic status (Level 1 & 2, Level 3 & 4, Level 5 or 6, Other), as defined by the Elley-Irving Socio-Economic Index.

Parent/caregiver report

Not reported by authors

Family means of transport

Distribution of families' means of transport

Parent/caregiver report

Not applicable

Family owns car

Number/percentage of families that owned a car

Parent/caregiver report

Not applicable

Family Strains Questionnaire, Sum of strains

Mean sum of strains parents experienced

Parent/caregiver report

Not reported by authors

Family Stressors Questionnaire, Sum of stressors

Mean sum of stressors parents experienced

Parent/caregiver report

Not reported by authors

Held a community services card

Number/percentage of families that held a Community Services Card

Parent/caregiver report

Not applicable

Language use in the home

Distribution of languages families spoke at home

Parent/caregiver report

Not applicable

Mother working in full-time position

Number/percentage of mothers working in full-time positions

Parent/caregiver report

Not applicable

Mother working in paid employment

Number/percentage of mothers working in paid employment

Parent/caregiver report

Not applicable

Receiving government support

Number/percentage of families receiving government support

Parent/caregiver report

Not applicable

Subjective perception of income level

Distribution of mothers' perception of their income levels, categorized as top or second to top, middle to average, or lower

Parent/caregiver report

Not applicable

Type of accomodation

Distribution of families' housing type

Parent/caregiver report

Not applicable

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

Maternal Social Support Index (MSSI),Overall

Mean overall results on the Maternal Social Support Index

Parent/caregiver report

Not reported by authors

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

HOME Questionnaire, Overall

The Home Observation forMeasurement of theEnvironment (HOME)Questionnaire was designed to rate family interaction/reactionary behaviors and non-interactive behaviors, especially between the main caregiver and the child.

Observational Assessment

Not reported by authors

Parental Concerns, Disruption of plans

Number/percentage of parents who reported caring for their child had disrupted their personal plans

Parent/caregiver report

Not applicable

Parental Concerns, Disruption of relationship with partner

Number/percentage of parents who reported caring for their child had disrupted their relationship with their partner

Parent/caregiver report

Not applicable

Parental Concerns, Significant Concern

Number/percentage of parents who had a significant concern about caring for their child

Parent/caregiver report

Not applicable

Parental Concerns, Social Concern

Number/percentage of parents who had a social concern about caring for their child

Parent/caregiver report

Not applicable

Parents as Teachers Questionnaire, Overall

The Parents as Teachers Questionnaire was designed to assess parental knowledge of child health and development.

Parent/caregiver report

Not reported by authors

Total number of activities

Mean total number of activities children experienced at home within six months prior to the parental interview

Parent/caregiver report

Not applicable

Total number of experiences

Mean total number of children's experiences out of the home

Parent/caregiver report

Not applicable

Video Session, Parent-Child Interaction

Parent-child interactions were video recorded and scored by researchers.

Videotaped observation

Not reported by authors