Randomized Trial of the Early Start Program of Home Visitation: Parent and Family Outcomes

Abstract

OBJECTIVE. To examine the extent to which the Early Start program of home visitation had beneficial consequences in the areas of maternal health, family functioning, family economic circumstances, and exposure to stress and adversity. METHODS. The study used a randomized, controlled trial design in which 220 families receiving the Early Start program were contrasted with a control series of 223 families not receiving the program. Families were enrolled in the program after population screening conducted by community health nurses. Families were enrolled in the program for up to 36 months. Outcomes were assessed at 6, 12, 24, and 36 months after trial entry. RESULTS. There was a consistent lack of association between maternal and family outcomes and group membership. There were no significant differences between the Early Start and control series in any comparisons. CONCLUSIONS. This evaluation suggested that the Early Start program failed to lead to parent- and family-related benefits. This absence of benefit for parent/family outcomes is contrasted with the benefits found previously for child-related outcomes, including child health, preschool education, child abuse and neglect, parenting, and behavioral adjustment. This comparison suggests that home visitation programs may provide benefits for child-related outcomes in the absence of parent- or family-related outcomes.