Randomized controlled trial of the parents as teacher home visiting program: Outcomes of the intervention on families at six month follow-up

Family support programs are considered central to improving the health and development of children, and home visitation remains one of the most frequently used early intervention strategies. This study utilized a randomized controlled trial (RCT) design to test the effectiveness of the Parents as Teachers (PAT) home visiting program intervention on child and caregiver outcomes, measured at six months post enrollment, with families randomized to study groups. Four PAT affiliates selected for the study are "blue ribbon" programs that meet certain quality standards. A total of 461 families (a 69 % retention rate) completed both baseline and 6-month data collection, including n = 295 for intervention and n = 166 for control. Differential attrition was 3.7 %. Baseline equivalency tests confirmed that the random assignment was effective and the groups were equivalent. Significant differences were observed between intervention and control groups, favoring the PAT intervention group, in 3 of the 4 domains assessed: child development, including Vineland-II Listening and Understanding and Talking and frequency of reading to the child; parenting practices, including improved sense of parenting efficacy and hopefulness; and family health and safety, including improved safety practices at home and reduced risk scores that capture depression and parenting stress. Estimated effect sizes for significant measures ranged from 0.12 to 0.28 and thus were in the range of what would be considered to have meaningful impact when compared with similar studies. Our findings contribute significantly to the understanding of home visitation program outcomes and adds to existing research by showing gains in child development that can be attributed to the PAT program. The RCT provides valuable evidence supporting the PAT program's role in enhancing child development, improving parenting practices, and ensuring family health and safety. However, the lack of difference in service utilization between groups and the challenges faced during the study highlight the need for consideration of external factors, such as the impact of the COVID-19 pandemic on service availability and utilization. This study contributes to the broader understanding of early childhood interventions and their efficacy in real-world, community settings.