MIHOW Works!

Study Staff (L-R): Joselyn Hernandez, Sulma Lazo de Paz, Carolina Abrigo, Anais Riggs,and Tonya Elkins Thank you to Catholic Charities staff for providing high quality services in accordance with the MIHOW model.

How was the study set up? – The Logistics

Vanderbilt University partnered with Catholic Charities of Middle Tennessee to conduct a randomized control trial to find out how well the MIHOW model works with Hispanic families. Study recruitment began in summer of 2015 and the last family finished services in September 2016. Study staff recruited 188 Hispanic pregnant women in the Nashville area to participate. They were assigned to either receive
(1) only educational packets or (2) educational packets and the MIHOW intervention (home visits and group opportunities).

The study tracked families through pregnancy and until the child turned 6 months old. Data was collected at 5 time points: enrollment, prenatally (35 weeks) and then 2 weeks, 2 months, and 6 months postpartum. The data collector did not know which families were receiving the MIHOW intervention.

Where do we excel? – The Findings

Overall, the results provide strong evidence of the effectiveness of MIHOW on improving health outcomes in this sample of Hispanic mothers and their children.

  1. Women in the MIHOW group reported more breastfeeding exclusivity at six months postpartum and longer duration of exclusive breastfeeding.  Breastfeeding self-efficacy scores were higher in the MIHOW group compared to the comparison group at all postpartum time points.
  2. Women assigned to the MIHOW group reported more safe sleep practices than those in the comparison group. More babies of MIHOW mothers were placed on their backs at all time points than mothers in the comparison group. There was much less cosleeping in MIHOW families than those in the comparison group.
  3. Mothers in the MIHOW group had fewer depressive symptoms and less parenting stress than mothers in the compairson group. Depressive symptoms were lower in mothers who received MIHOW at all postpartum time points than mothers who only received the educational packets.  Relative to the comparison group, levels of parenting stress were lower in mothers in the MIHOW group at all postpartum time points. MIHOW mothers reported more social and emotional help relative to comparison group mothers at all postpartum time points, find more information here.
  4. Receipt of and follow through with referrals was greater in mothers who received MIHOW services.  Mothers in the MIHOW group received more referrals for additional services, connected with the resources and received more new services than mothers in the comparison group.
  5. At all postpartum time points, data collectors observed a higher level of quality and quantity of stimulation and support available to the child in the home environment.  Mothers in the MIHOW group reported a greater frequency of singing songs, telling stories and reading books to their child than mothers in the comparison group.

What does the future hold for MIHOW? – Next Steps

MIHOW has submitted a full report of the findings to be reviewed by the federal Home Visiting Evidence of Effectiveness (HomVEE) project. We will not know until Fall 2017 what further evidence they need to add MIHOW to the list of evidence-based models. In the meantime, we will be publishing the results in a peer-reviewed journal and we will be supporting West Virginia in their efforts to complete another research study to test MIHOW’s effectiveness in a rural population.


Many thanks to Melanie Lutenbacher and Mary Deitrich at Vanderbilt School of Nursing for serving as the research team on the project. Dr. Dietrich completed the data analysis and Dr. Lutenbacher served as Principal Investigator.


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