Randomized Trial of the Early Start Program of Home Visitation

David M. Fergusson; Hildegard Grant; L. John Horwood; Elizabeth M. Ridder

doi:10.1542/peds.2005-0948

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TABLE 1.

Social and Demographic Characteristics at Baseline

Measure	Controls (N = 221)	Early Start (N = 206)	P
Maternal factors
Mean age of mother at enrollment	24.4	24.6	.67
% Māori	26.7	24.8	.65
% Lacked educational qualifications	69.9	70.6	.88
% Interparental conflict/assault during childhood	57.0	50.5	.18
% Child abuse during childhood	41.6	44.7	.53
% Ran away from home before age 16	49.8	42.7	.14
% Assaulted by current partner	25.6	35.0	.11
Paternal factors (biological father)
Mean age	26.6	27.3	.36
% Māori	25.4	30.7	.22
% Lacked educational qualifications	72.3	77.8	.23
Family factors
% Single parent family	63.8	64.6	.87
% Pregnancy unplanned	82.3	80.1	.57
% Welfare dependent	90.1	88.4	.57

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TABLE 2.

Rates of Participation in the Early Start Trial and the Early Start Service at Enrollment and at 6, 12, 24, and 36 Months After Enrollment.

Period	Research Participation				Service Participation
	Controls		Early Start		Active in Early Start
	N	%	N	%	N	%
Enrollment	223	100	220	100	220	100
Baseline	221	99.1	206	93.6	206	93.6
6 mo	216	96.9	196	89.1	174	79.1
12 mo	216	96.9	198	90.0	162	73.6
24 mo	211	94.6	187	85.0	143	65.0
36 mo	207	92.8	184	83.6	131	59.5

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TABLE 3.

Outcomes of the Trial

Measure	Controls (N = 207)	Early Start (N = 184)	P	Association * (95% CI)	Effect (d; 95% CI)
Child health
Mean no. of GP visits (0–36 mo)	20.7	23.4	<.05	0.11 (0.01–0.21)	0.24 (0.02–0.41)
% Up to date with immunizations (0–36 mo)	91.9	92.5	.83	1.09 (0.51–2.32)	0.02 (−0.19–0.22)
% Up to date with well-child checks (0–36 mo)	30.1	41.9	<.05	1.70 (1.11–2.59)	0.25 (0.06–0.46)
% Attended hospital for accident/injury or accidental poisoning (0–36 mo)	26.3	17.5	<.05	0.59 (0.36–0.98)	0.22 (0.02–0.41)
% Enrolled with dental nurse/dentist at 36 mo	62.8	72.3	<.05	1.54 (1.01–2.37)	0.20 (0.01–0.40)
Service utilization
Mean duration of early childhood education, mo (0–36 mo)	13.6	16.4	<.05	0.11 (0.01–0.21)	0.22 (0.02–0.42)
Mean no. of community service contacts (0–36 mo)	7.7	8.7	<.01	0.16 (0.06–0.26)	0.31 (0.13–0.51)
Maternal parenting attitudes†
Mean positive parenting attitudes (36 mo)	9.88	10.14	<.01	0.13 (0.03–0.23)	0.26 (0.06–0.47)
Mean nonpunitive attitudes (36 mo)	9.90	10.12	<.05	0.11 (0.01–0.21)	0.22 (0.02–0.42)
Mean parenting score (36 mo)	9.87	10.14	<.01	0.13 (0.03–0.23)	0.27 (0.07–0.47)
Child abuse and neglect
% Parental report of severe physical assault (0–36 mo)	11.7	4.4	<.01	0.35 (0.15–0.80)	0.26 (0.07–0.48)
% In contact with agencies for child abuse or neglect (0–36 mo)	21.3	19.6	.39	0.91 (0.55–1.48)	0.04 (−0.15–0.25)
Child behavioral adjustment†
Mean externalizing score (36 mo)	10.09	9.90	<.07	0.09 (−0.01–0.19)	0.19 (−0.01–0.39)
Mean internalizing score (36 mo)	10.12	9.86	<.01	0.13 (0.03–0.23)	0.26 (0.06–0.47)
Mean total behavior score (36 mo)	10.11	9.87	<.05	0.12 (0.02–0.22)	0.24 (0.04–0.44)

CI indicates confidence interval; GP, general practitioner.
↵* Association between treatment group and outcomes is described by the odds ratio for dichotomous measures and the correlation ratio for continuous measures.
↵† For ease of interpretation, all parenting and child behavior scores have been standardized to a mean of 10 and an SD of 1.