Development & Psychopathology published an RCT of home visiting and doula visits for low-income women starting in pregnancy. Quick take: Despite study claims of positive results, it found no discernible impact on child outcomes and little impact on parent practices, at age 30 months.
Program:
The program provided home visits from both a paraprofessional and a doula to young, low-income women starting in pregnancy. A doula is a health educator from the community often with similar background to the women, who provides support in pregnancy, childbirth and postpartum.
Study Design:
The study randomly assigned 312 women to treatment (home visits) vs. control (usual care, consisting of light-touch case management). Based on careful review, this was a high-quality RCT (e.g., baseline balance, attrition within WWC standards, blinded assessors).
Findings:
At the longest-term follow-up (child age 30 months), the study found no discernible impact on any child social-emotional or behavioral outcome - see chart below (note similar outcomes scores for treatment ("HV") vs control ("CM")).
The study also found a statistically significant impact on only 1 of 9 measured parenting practices and attitudes at 30 months (the 1 could be a chance finding resulting from measurement of many outcomes). Modest parenting impacts in earlier study follow-ups had mostly faded by 30 months.
Comment:
Unfortunately, the study abstract (below) doesn't mention the null 30 month findings and instead portrays the results as positive based on post-hoc (vs. prespecified) subgroup analyses that aren't reliable under established standards (FDA, IES) as they could easily be due to chance.
Such unbalanced reporting in the study abstract (which busy readers often rely on for the main take-aways) could easily lead policy officials to consider and/or adopt this program in the mistaken belief it's been found effective.