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Early intervention and child health: Evidence from a Dublin-based randomized controlled trial

Author

Listed:
  • Orla Doyle

    (UCD School of Economics and UCD Geary Institute for Public Policy, University College Dublin)

  • Nick Fitzpatrick

    (UCD Geary Institute for Public Policy, University College Dublin)

  • Judy Lovett

    (UCD Geary Institute for Public Policy, University College Dublin)

  • Caroline Rawdon

    (UCD School of Psychology, University College Dublin)

Abstract

This article investigates the impact of an early intervention program, which experimentally modifies the parenting and home environment of disadvantaged families, on child health in the first 3 years of life. We recruited and randomized 233 (115 intervention, 118 control) pregnant women from a socioeconomically disadvantaged community in Dublin, Ireland into an intervention or control group. The treatment includes regular home visits commencing antenatally and an additional parenting course commencing at 2 years. Maternal reports of child health are assessed at 6, 12, 18, 24, and 36 months. Treatment effects are estimated using permutation testing to account for small sample size, inverse probability weighting to account for differential attrition, and the stepdown procedure to account for multiple hypothesis testing. Following adjustment for multiple testing and attrition, we observe a positive and statistically significant main treatment effect for wheezing/asthma. The intervention group are 15.5 percentage points (pp) less likely to require medical attention for wheezing/asthma compared to the control group. Statistically significant individual main effects which do not survive multiple testing and IPW-adjustment are found for general health (10.0 pp), hospitalizations (8.2 pp), immunizations (8.6 pp), chest infections (12.2 pp) and the number of health problems (d = 0.34). Subgroup analysis reveals more statistically significant adjusted treatment effects for boys than girls regarding fewer health problems (d = 0.63), accidents (23.9 pp), and chest infections (22.8 – 37.9 pp). Our results suggest that a community-based home visiting program may have favorable impacts on early health conditions. As child ill health is costly to society due to an increased demand on health resources and long-term productivity losses, identifying effective interventions to counteract inequalities in health is important from a policy perspective.

Suggested Citation

  • Orla Doyle & Nick Fitzpatrick & Judy Lovett & Caroline Rawdon, 2015. "Early intervention and child health: Evidence from a Dublin-based randomized controlled trial," Working Papers 201505, Geary Institute, University College Dublin.
  • Handle: RePEc:ucd:wpaper:201505
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    References listed on IDEAS

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    Full references (including those not matched with items on IDEAS)

    Citations

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    Cited by:

    1. Lucia Schiavon, 2020. "Maternal Postpartum Depression Effects on Child's Health," CHILD Working Papers Series 83 JEL Classification: I1, Centre for Household, Income, Labour and Demographic Economics (CHILD) - CCA.
    2. Deirdre Coy & Orla Doyle, 2020. "Should Early Health Investments Work? Evidence from an RCT of a Home Visiting Programme," Working Papers 202006, Geary Institute, University College Dublin.
    3. Hirani, Jonas Lau-Jensen & Sievertsen, Hans Henrik & Wüst, Miriam, 2020. "Missing a Nurse Visit," IZA Discussion Papers 13485, Institute of Labor Economics (IZA).
      • Miriam Wüst & Jonas Lau-Jensen Hirani & Hans Henrik Sievertsen, 2021. "Missing a Nurse Visit," CEBI working paper series 20-09, University of Copenhagen. Department of Economics. The Center for Economic Behavior and Inequality (CEBI).
    4. Jonas Lau-Jensen Hirani & Hans Henrik Sievertsen & Miriam Wüst & Johannes Wohlfart, 2020. "Missing a Nurse Visit," Discussion Papers 20-09, University of Copenhagen. Department of Economics.
    5. Sandner, Malte & Cornelissen, Thomas & Jungmann, Tanja & Herrmann, Peggy, 2018. "Evaluating the effects of a targeted home visiting program on maternal and child health outcomes," Journal of Health Economics, Elsevier, vol. 58(C), pages 269-283.
    6. Orla Doyle, 2017. "The First 2,000 Days and Child Skills: Evidence from a Randomized Experiment of Home Visiting," Working Papers 201715, School of Economics, University College Dublin.
    7. Orla Doyle, 2020. "Can Early Intervention have a Sustained Effect on Human Capital?," Working Papers 202008, School of Economics, University College Dublin.
    8. Pasqualini, M. & Lanari, D. & Minelli, L. & Pieroni, L. & Salmasi, L., 2017. "Health and income inequalities in Europe: What is the role of circumstances?," Economics & Human Biology, Elsevier, vol. 26(C), pages 164-173.
    9. Hirani, Jonas Cuzulan & Wüst, Miriam, 2022. "Nurses and infant vaccination coverage," Journal of Economic Behavior & Organization, Elsevier, vol. 196(C), pages 402-428.
    10. Kim, Jun Hyung & Schulz, Wolfgang & Zimmermann, Tanja & Hahlweg, Kurt, 2018. "Parent–child interactions and child outcomes: Evidence from randomized intervention," Labour Economics, Elsevier, vol. 54(C), pages 152-171.
    11. Jonas Lau-Jensen Hirani & Hans Henrik Sievertsen & Miriam Wust, 2020. "The Timing of Early Interventions and Child and Maternal Health," Bristol Economics Discussion Papers 20/720, School of Economics, University of Bristol, UK.

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    More about this item

    Keywords

    Randomized controlled trial; home visiting; child health; early intervention;
    All these keywords.

    JEL classification:

    • C12 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Hypothesis Testing: General
    • C93 - Mathematical and Quantitative Methods - - Design of Experiments - - - Field Experiments
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

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