title: Early intervention and child physical health: Evidence from a Dublin-based randomized controlled trial.
abstract: This article investigates the impact of an early intervention program, which experimentally modifies the parenting and home environment of disadvantaged families, on child physical health in the first 3 years of life. We recruited and randomized 233 (115 intervention, 118 control) pregnant women from a socioeconomically disadvantaged community in Dublin, Ireland into an intervention or control group. The treatment includes regular home visits commencing antenatally and an additional parenting course commencing at 2 years. Maternal reports of child health are assessed at 6, 12, 18, 24, and 36 months. Treatment effects are estimated using permutation testing to account for small sample size, inverse probability weighting to account for differential attrition, and both the stepdown procedure and an indices approach to account for multiple hypothesis testing. Following adjustment for multiple testing and attrition, we observe a positive and statistically significant main treatment effect for wheezing/asthma. The intervention group are 15.5 percentage points (pp) less likely to require medical attention for wheezing/asthma compared to the control group. Subgroup analysis reveals more statistically significant adjusted treatment effects for boys than girls regarding fewer health problems (d=0.63), accidents (23.9pp), and chest infections (22.8-37.9pp). Our results suggest that a community-based home visiting program may have favorable impacts on early health conditions.
authors.affiliation: UCD School of Economics, Dublin, Ireland; UCD Geary Institute for Public Policy, University College Dublin, Dublin, Ireland. Electronic address: orla.doyle@ucd.ie.
authors.forename: Orla
authors.initials: O
authors.lastname: Doyle
authors.affiliation: UCD Geary Institute for Public Policy, University College Dublin, Dublin, Ireland. Electronic address: nick.fitzpatrick@ucd.ie.
authors.forename: Nick
authors.initials: N
authors.lastname: Fitzpatrick
authors.affiliation: UCD Geary Institute for Public Policy, University College Dublin, Dublin, Ireland. Electronic address: judy.lovett@ucd.ie.
authors.forename: Judy
authors.initials: J
authors.lastname: Lovett
authors.affiliation: UCD School of Psychology, University College Dublin, Dublin, Ireland. Electronic address: caroline.rawdon@ucd.ie.
authors.forename: Caroline
authors.initials: C
authors.lastname: Rawdon
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000453:epidemiology / Q000517:prevention & control; D000067576:Child Health / Q000706:statistics & numerical data*; D002675:Child, Preschool; D005260:Female; D006304:Health Status; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data; D007223:Infant; D007231:Infant, Newborn; D007494:Ireland; D008297:Male; D009035:Mothers / Q000193:education*; D011203:Poverty; D011247:Pregnancy; D012135:Respiratory Sounds; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000517:prevention & control; D055815:Young Adult
keywords: Child physical health; Early intervention; Home visiting; Randomized controlled trial