Legacy for Children™ Research Sites

University of Miami

The Miami site of Legacy for Children™ is a randomized, controlled, longitudinal research project designed to examine the potential for improvement in child developmental outcomes. The intervention program began at birth and continued until children in the project were 5 years of age. A total of 180 families were enrolled in the intervention group, and 120 were enrolled in the control group. Follow up assessments of the families are continuing.

Goals

The goals for the project at University of Miami were consistent with the five overall Legacy goals. The goals for the project at University of Miami were consistent with the five overall Legacy goals. The goals were used to guide the interventions for the target population at this site.

Target Population

The target population for the Miami project were mothers who were experiencing poverty (identified by their eligibility for Medicaid), were at least 18 years of age, and lived within 50 minutes of one of the community intervention sites. To be able to participate in the group interventions, only mothers who were comfortable speaking and understanding conversational English were eligible. The project focused on mothers of children without existing disabilities or major medical risks and did not include mothers who reported mental illness or substance abuse issues. Mothers were recruited in the hospital at the time of delivery or within one week after discharge.

The Intervention

There were three primary components of the intervention: (1) parenting group sessions, (2) one-on-one visits with group leaders, and (3) activities to build a sense of community.

Parenting groups met weekly for approximately 1.5 hours, year round, with only a few breaks for holidays. Each session consisted of parent–child time during which mothers tried out parenting skills with guidance from the group leaders, a component focused on building a sense of community, and a focused topic discussion with activities. Topics were repeated as children grew and included: basic care, health and safety, parent issues, behavioral guidance, social skills, play and toy making, language and literacy, and individual differences.

There were also one-on-one visits to follow up on the parenting sessions and to reinforce the curriculum. Originally these were to be conducted during home visits, but they were difficult to schedule and most mothers preferred to have the one-on-one visits in conjunction with group sessions.

In addition, there were two field trips per year to community sites. Celebrations and trips were planned with the mothers during the group sessions. The Miami project was planned to build a sense of community by promoting group cohesion among peers and encouraging parental involvement in the community.

 

University of California at Los Angeles

The University of California at Los Angeles (UCLA) site of Legacy for Children™ is a randomized, controlled, longitudinal research project designed to examine the potential for improvement in child developmental outcomes. The intervention program began prenatally and continued until the children in the project were 36 months of age. A total of 190 families were enrolled in the intervention group and 125 were enrolled in the control group. Follow up assessments are continuing.

Goals

The goals for the project at UCLA were consistent with the five overall Legacy goals. (link "overall Legacy goals" to the Legacy page, goals section) The goals were used to guide the interventions for the target population at this site.

Target Population

The target population for the UCLA project enrolled women who were experiencing poverty (identified by their eligibility for Medi-Cal), lived within 10 miles of UCLA, and were 18 years of age or older. The project focused on mothers of children without existing disabilities or major medical risks, and did not include mothers who reported mental illness or substance abuse issues. To be able to participate in the group interventions, only mothers who were comfortable speaking and understanding conversational English were eligible. Mothers who received their care from the prenatal and well-baby UCLA Medi-Cal Health Maintenance Organization were recruited prior to their last trimester of pregnancy (by 28 weeks).

The Intervention

There were three primary components of the intervention: (1) parenting group sessions, (2) visits to the home, and (3) activities to build a sense of community.

Parenting groups began with five prenatal weekly group sessions. Starting when the babies reached 2 months of age, intervention sessions were conducted in blocks of 10 weekly 2-hour meetings, separated by 4- to 6-week breaks. Topics covered during the group sessions included family health and safety, communication skills, behavioral regulation skills, emotional development, temperament, attachment and autonomy, how to play with a child, helping children learn, using praise and encouragement, limit setting, and problem solving. These topics were centered around significant changes in child development, or touch points. Children participated in every other group meeting; group meetings without children were followed by special sessions planned by the mothers to build a sense of community, such as field trips into the community and special celebrations.

A nurse also made two or three visits to the home during the prenatal period and early infancy. Between each block of group sessions, the intervention specialist conducted visits to the home to provide an expanded and individualized focus on the topics that were discussed during the previous group sessions.

 

Measurement

Outcome Data

Systematic developmental assessments were conducted starting with a baseline assessment, followed by a 6-month assessment, and continuing annually through the time the children were 5 years of age. Follow-up data will be collected when the children are in third grade, at approximately 8 years of age.

The assessments were designed to provide a comprehensive picture of each mother’s characteristics and child developmental outcomes that were key to the intervention. The following chart shows the constructs and when they were assessed.

 

	Age of Child
Areas of Measurement	Birth	6 Months	12 Months	24 Months	36 Months	48 Months	60 Months	3rd Grade
MOTHER1
Self-efficacy (a mother’s belief that she can parent her child well)	X	X	X	X	X	X	X	X
Commitment to and satisfaction with positive parenting		X	X	X	X	X	X	X
Emotional well-being	X	X	X	X	X	X	X	X
Sense of community, support, connectedness	X	X	X	X	X	X	X	X
Mother–child interaction		X	X		X	X	X	X
Parenting practices	X	X	X	X	X	X	X	X
CHILD
Social and emotional skills		X	X	X	X	X	X	X
Behavior				X	X	X	X	X
Language and communication skills				X		X	X	X
Thinking  and learning			X		X	X	X	X
1In addition to the areas of measurement displayed in the table, other aspects, such as demographics, family background, and environmental factors, were assessed.

Assessment methods included interviews, tests of skills and abilities, as well as videotaped observations.

Process Data

Extensive process data were collected throughout the intervention. This included qualitative and quantitative data collected from the group leaders as well as qualitative data based on observation of group sessions by ethnographers  and special focus groups and case studies.

Cost Data

Measurement also incorporated tracking the costs of each component of the study in order to perform cost–benefit and cost-effectiveness analyses. This included looking at intervention, assessment, and operational costs, as well as time and activity diaries for sample time periods.