Guide to Effective Programs
for Children and Youth

PROJECT CARE

OVERVIEW

Project CARE is a longitudinal, early childhood intervention study of the Frank Porter Graham Child Development Center at the University of North Carolina. Project CARE included a combination of educational daycare, provided by the Child Development Center, as well as a home-based, family education component. Families were selected to participate in the program if they had infants who were considered to be at risk for delayed development. The families were randomly assigned to one of three groups: Child Development Center Plus Family Education, Family Education only, or a Control group. Project CARE revealed that, although quality daycare had a positive impact on children's cognitive development, the family education component did not. An evaluation of Project CARE revealed that the combination of the Child Development Center and a family education component significantly increased children's cognitive development when compared to either family education alone or to the control group.

DESCRIPTION OF PROGRAM

 

Target population: Families with newborn infants considered to be at an elevated risk for developmental delays due to the disadvantaged educational and social circumstances of the parents were the focus.

Project CARE consisted of two major interventions. One component included an educational daycare program provided by the Child Development Center. Home visitors provided the other component of Project CARE which involved family education. The entire intervention was intended to last throughout the preschool years.

The educational daycare component was organized according to a systematic developmental curriculum and emphasized intellectual and social development. The daycare center maintained low child/teacher ratios and employed staff with an average of seven years experience in early childcare. 

The family education component was intended to help parents foster both the cognitive and social development of their child. Home visitors provided families with various supports, information, advice and referrals. They emphasized problem-solving methods as well as components of the same basic child curriculum used by the daycare center. Home visitors were traditionally teachers, social workers and nurses.

EVALUATION(S) OF PROGRAM

Wasik, B., Ramey, C., Bryant, D., & Sparling, J. (1990). A longitudinal study of two early intervention strategies: Project CARE. Child Development, 61, 1682-1696.

Evaluated population:  Of the 65 families that were ultimately selected to participate in Project CARE, only one elected not to participate. All families had been identified because at birth, their infant was considered to be at-risk for developmental delays. The average age of the parents was 22 for women and 25 for men. On average, parents had completed 10.5-11.4 years of education.

Approach: Over a period of 18 months, a home visitor at one local hospital reviewed all births and then selected families based on conditions of the target population. Families underwent a basic screening process, which consisted of an interview and a psychological assessment. Once families were considered eligible and accepted the conditions of the study, they were randomly assigned to one of three conditions. The first group, Child Development Center Plus Family Education, consisted of 16 families and received both educational daycare and the family education component. The second group, Family Education, included 25 families that received only the family education component. The control group received neither treatment and consisted of 23 families. Although the control group did not receive any systematic education or daycare from Project CARE, families in both the control group and the family education group received free iron-fortified formula as well as a monthly supply of diapers. Many of them also chose to send their children to other community daycares. Social workers were available for all groups.

The intervention began one month after birth with home visits. Only two families entered the program late. At six months, one family in the combined group moved away and one infant in the family education group had died. These developments brought the total sample size to 62 families. The control group did not lose any families. The overall retention rate of Project CARE at 54 months was 91 percent.

Both the combined group and the family education group were assigned to receive weekly home visits during the first 3 years of the program. Home visits during the fourth and fifth years depended on parents' preferences.

Home visits were not completed as often as the intended weekly amount. On average, the family education group reported 2.5 visits per month and the combined Child Development Center Plus Family Education group reported 2.7 visits per month. During the 4th and 5th years when visits were arranged according to parents' needs, the average frequency of visits for the parent education group and the combined group was 1.4 per month and 1.1 per month, respectively. Overall, 92 percent of the home visits were conducted with the mother. 60 percent of the visits lasted 30-60 minutes, however 20 percent lasted over an hour. Parents in both the family education and combined groups had the option of attending monthly parents' information/support meetings as well.

The evaluation assessed the cognitive development of the infant, the home environment, and childrearing attitudes of the parents. Evaluators used a variety of standardized tests, such as the Stanford-Binet Test of Intelligence, to assess cognitive development. All tests were administered in the same child development laboratory by research assistants not affiliated with Project CARE. To assess the home environment, evaluators used the infant/toddler and preschool versions of the Home Observation for Measurement of the Environment (HOME). Childrearing attitudes were assessed using maternal report.

Results: In general, the largest impacts in cognitive development were reported for the Child Development Center Plus Family Education group. The family education component, whether combined with the educational daycare or alone, did not appear to have a significant impact on any of the measured outcomes. Intellectual performance, measured through standardized intelligence tests, became significant after twelve months. At the 12, 18, 24 and 36 month tests, the combined group differed significantly from the other two groups on cognitive development outcomes. At the 30 and 42 month tests, however, the combined group differed significantly from the family education group but not from the control group. It is important to note that after the 24th month test, there was a general increase in scores for both the family education and control groups. Evaluators believe that this may be due to attendance in other daycare programs. The HOME inventory and an assessment of childrearing attitudes found no significant differences in outcomes between the groups.

 

SOURCES FOR MORE INFORMATION

 

References

Wasik, B., Ramey, C., Bryant, D., & Sparling, J. (1990). A longitudinal study of two early intervention strategies: Project CARE. Child Development, 61, 1682-1696.

Website: http://www.projectcare.org/index.asp 

 

Program categorized in this guide according to the following:

Evaluated participant ages: Birth through preschool years / Program age ranges in the Guide: 0-5

Program components: child care/early childhood education; clinic-based, provider-based, or miscellaneous; home visiting; parent or family component

Measured outcomes: education and cognitive development; social and emotional health and development

 

Program information last updated 3/16/07

   © Child Trends 2004