Development & Psychopathology published an RCT of home visiting + 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 & little impact on parent practices, at age 30 months.

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Program:

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• The program provided home visits from both a paraprofessional & 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 & postpartum.

Study Design:

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• 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:

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• 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 & attitudes at 30 months (the 1 could well 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:

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• Unfortunately, the study abstract (below) doesn't mention the null 30 month findings & 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 &/or adopt this program in the mistaken belief it's been found effective.