title: Components associated with home visiting program outcomes: a meta-analysis.
abstract: BACKGROUND
  Although several systematic reviews have concluded that home visiting has strong evidence of effectiveness, individual evaluations have produced inconsistent results. We used a component-based, domain-specific approach to determine which characteristics most strongly predict outcomes.
  
  
  METHODS
  Medline and PsycINFO searches were used to identify evaluations of universal and selective home visiting programs implemented in the United States. Coders trained to the study criterion coded characteristics of research design, program content, and service delivery. We conducted random-effects, inverse-variance-weighted linear regressions by using program characteristics to predict effect sizes on 6 outcome domains (birth outcomes, parenting behavior and skills, maternal life course, child cognitive outcomes, child physical health, and child maltreatment).
  
  
  RESULTS
  Aggregated to a single effect size per study (k = 51), the mean effect size was 0.20 (95% confidence interval: 0.14 to 0.27), with a range of -0.68 to 3.95. Mean effect sizes were significant and positive for 3 of the 6 outcome domains (maternal life course outcomes, child cognitive outcomes, and parent behaviors and skills), with heterogeneity of effect sizes in all 6 outcome domains. Research design characteristics generally did not predict effect sizes. No consistent pattern of effective components emerged across all outcome domains.
  
  
  CONCLUSIONS
  Home visiting programs demonstrated 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 6 important public health outcomes.
authors.affiliation: James Bell Associates, 3033 Wilson Blvd, Suite 650, Arlington, VA 22201. filene@jbassoc.com.
authors.forename: Jill H
authors.initials: JH
authors.lastname: Filene
authors.forename: Jennifer W
authors.initials: JW
authors.lastname: Kaminski
authors.forename: Linda Anne
authors.initials: LA
authors.lastname: Valle
authors.forename: Patrice
authors.initials: P
authors.lastname: Cachat
mesh_terms: D006699:Home Care Services / Q000592:standards; D006792:House Calls; D006801:Humans; D015397:Program Evaluation / Q000379:methods* / Q000592:standards; D016896:Treatment Outcome; D014481:United States
keywords: birth outcomes; child cognitive development; child maltreatment; child physical health; early childhood; effectiveness; home visiting; infancy; maternal life course; meta-analysis; parenting behavior