Components Associated With Home Visiting Program Outcomes: A Meta-Analysis
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Components Associated With Home Visiting Program Outcomes: A Meta-Analysis

  • Published Date:

    Nov 2013

  • Source:
    Pediatrics. 132(0 2):S100-S109
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    Introduction Although several systematic reviews have concluded that home visiting has strong evidence of effectiveness, individual evaluations have produced inconsistent results across and within programs. We used a component-based, domain-specific approach to determine which program characteristics most strongly predict outcomes across a range of programs and models. Methods Medline and PsycINFO searches identified evaluations of universal and selected home visiting programs implemented in the United States. Coders trained to criterion coded characteristics of research design, program content, and service delivery. We conducted random-effects, inverse-variance-weighted linear regressions using program characteristics to predict effect sizes (ESs) on six outcome domains (birth outcomes, parenting behavior, maternal life course, child cognitive outcomes, child physical health, and child maltreatment). Results Aggregated to a single ES per study (k=51), the mean ES was 0.20 (95% CI = 0.14, 0.27), with a range of – 0.68 to 3.95. Mean ESs were significant and positive for three of the six outcome domains (maternal life course outcomes, child cognitive outcomes, and parent behaviors and skills), with marked heterogeneity of ESs in all six outcome domains. Research design characteristics generally did not predict ESs across the six outcome domains. No consistent pattern of effective components emerged across all outcome domains. Conclusions Home visiting programs evidenced small but significant overall effects, with wide variability in the size of domain-specific effects and in the components that significantly predicted domain-specific effects. Communities may need complementary or alternative strategies to home visiting programs to ensure widespread impact on these six important public health outcomes.
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