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Healthy Families America (Home Visiting for Prevention of Child Abuse and Neglect) (HFA)

Scientific Rating:
4
Evidence Fails to Demonstrate Effect
See scale of 1-5
Child Welfare Relevance Level:
Medium

See descriptions of 3 levels

Brief Description

The information in this program outline is provided by the program representative and edited by the CEBC staff. The Healthy Families America (Home Visiting for Prevention of Child Abuse and Neglect) (HFA) program has been rated by the CEBC in the area of: Home Visiting for Prevention of Child Abuse and Neglect.

  • Types of Maltreatment: Does not target any specific kind of maltreatment
  • Target Population: Overburdened families who are at risk for child abuse and neglect and other adverse childhood experiences. Families are determined eligible for services once they are screened and/or assessed for the presence of factors that could contribute to increased risk for child maltreatment or other poor childhood outcomes, (e.g., social isolation, substance abuse, mental illness, parental history of abuse in childhood, etc.). Home visiting services must be initiated either prenatally or within three months after the birth of the baby.

Healthy Families America (HFA) has been rated by the CEBC in both Home Visiting topic areas. Please click here to see the HFA entry and rating in the Home Visiting for Child Well-Being topic area.

HFA is a home visiting program model designed to work with overburdened families who are at risk for child abuse and neglect and other adverse childhood experiences. It is designed to work with families who may have histories of trauma, intimate partner violence, mental health issues, and/or substance abuse issues. HFA services are offered voluntarily, intensively, and over the long-term (3 to 5 years after the birth of the baby).

The HFA model is based upon 12 Critical Elements. These Critical Elements are operationalized through a series of standards that provide a solid structure for quality, yet offer programs the flexibility to design services specifically to meet the unique needs of families and communities.

HFA’s Vision: All children receive nurturing care from their family essential to leading a healthy and productive life.

HFA’s Mission: To promote child well-being and prevent the abuse and neglect of our nation’s children through home visiting services.

HFA Program Goals:

  • Build and sustain community partnerships to systematically engage overburdened families in home visiting services prenatally or at birth.
  • Cultivate and strengthen nurturing parent-child relationships.
  • Promote healthy childhood growth and development.
  • Enhance family functioning by reducing risk and building protective factors.

Essential Components

HFA’s 12 Critical Elements make up the essential components of the HFA Model. They can be broken into three broad areas: Service initiation, service content, and staff characteristics and supervision.

Service Initiation

  • Initiate services prenatally or at birth.
    • The screening and assessment should occur within two weeks after the birth of the baby.
    • The first home visit should occur within three months after the birth of the baby – preferably prenatally.
  • Administer a standardized (i.e., in a consistent way for all families) assessment
    • The Parent Survey (formerly the Kempe Family Stress Checklist) is conducted to identify the family strengths as well as family history and/or issues related to higher risk of child maltreatment and/or poor childhood outcomes.
    • HFA staff must be well-trained in how to administer and score the assessment.
  • Offer services voluntarily and use positive outreach efforts to build family trust.
    • Services must be voluntary.
    • Program staff must identify positive ways to establish a relationship with a family and keep families interested and connected over time because many participants are often reluctant to engage in services and may have difficulty building trusting relationships.

Service Content

  • Offer services intensively with well-defined criteria for increasing or decreasing frequency of service and over the long-term.
    • Services should be offered AT LEAST WEEKLY during the 1st six months after the birth of the baby.
    • The family’s progress is used for determining service intensity – as the family’s confidence and self-sufficiency increases, the frequency of visits decrease.
    • HFA offers services for a minimum of three years and up to five years after the birth of the baby.
  • Provide services that are culturally sensitive.
    • Ethnic, racial, language, demographic, and other cultural characteristics identified by the program must be taken into account in overseeing staff-family interactions.
    • Staff receives training designed to increase understanding and sensitivity of the unique characteristics of the service population.
    • The program analyzes the extent to which all aspects of its service delivery system (assessment, home visitation, and supervision) are culturally sensitive.
  • Provide services that focus on supporting the parent as well as supporting parent-child interaction and child development.
    • Home visiting staff discuss and review, in supervision and with families, issues identified in the initial assessment during the course of home visiting services.
    • Program services to families are guided by the Individual Family Support Plan (IFSP).
    • The program promotes positive parent-child interaction, child development skills, and health and safety practices with families through the use of curriculum or other educational materials.
    • The program monitors the development of participating infants and children with a standardized developmental screening, tracks children who are suspected of having a developmental delay, and follows through with appropriate referrals and follow-up.
  • Link all families to a medical provider to assure optimal health and development (e.g., timely immunizations, well-child care, etc.) Depending on the family's needs, they may also be linked to additional services such as financial, food, and housing assistance programs, school readiness programs, child care, job training programs, family support centers, substance abuse treatment programs, and domestic violence shelters.
    • Participating Target Children are linked to a medical/health care provider
    • The program ensures immunizations are up-to-date for target children and provides information, referrals, and linkages to available health care resources for all participating family members.
    • Families are connected to additional services in the community.
  • Limit staff caseloads
    • No more than 15 families who are currently being seen weekly
    • No more than 25 families per caseload

Staff Characteristics

  • Select service providers based on their personal characteristics (i.e., non-judgmental, compassionate, ability to establish a trusting relationship, etc.), their willingness to work in or their experience working with culturally diverse communities, and their skills to do the job. Service providers have a framework, based on education or experience, for handling the variety of situations they may encounter when working with at-risk families.
  • Provide basic training for service providers in areas such as cultural competency, substance abuse, reporting child abuse, domestic violence, drug-exposed infants, and services in their community.
    • All staff must receive Orientation training prior to working with families.
    • All staff must receive training in Wraparound topics within 6 months and 12 months of hire (distance learning modules and/or in person).
  • Provide intensive training to Service providers specific to their role.
    • All staff must receive in-person Core Training in either Parent Survey (Assessment) or Integrated Strategies (Home Visitors) within six months of hire.
    • Supervisors also receive in-person training based on the track (assessment or home visiting) they supervise and administrative, clinical, and reflective practice training within six months of hire.
  • Provide ongoing, effective, accountable, clinical, and reflective supervision to all service providers.
    • Direct service providers must receive weekly, individualized supervision.
    • Full-time supervisors are to have 6 or fewer direct services staff.
    • Direct service staff must receive skill development and professional support and be held accountable for the quality of their work.
    • Supervisors and Program Managers are also held accountable for the quality of their work and provided with skill development and professional support.

Additionally, it is very important that materials be presented in a lower grade level of reading, typically 5th grade or lower.

Child Component

Healthy Families America (Home Visiting for Prevention of Child Abuse and Neglect) (HFA) was not designed with a child component.

Parent / Caregiver Component

Healthy Families America (Home Visiting for Prevention of Child Abuse and Neglect) (HFA) was designed with a parent/caregiver component that addresses the following presenting problems and symptoms:

  • Expectant or new parents screened and/or assessed as moderate to high risk for child maltreatment and/or poor early childhood outcomes (e.g., mental health issues, domestic violence, substance abuse, poverty, housing, lack of education, lack of social support, etc.).
Treatment Involves Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Children develop within the context of a relationship.  Relationship-based early intervention focuses on strengthening the parent (or caregiver)-child relationship. HFA takes advantage of teachable moments in order to encourage the healthy parent-child relationship.  There are three key aspects in building a relationship that must be present to grow a mentally and emotionally healthy child.  Parents or caregivers must touch the child, have eye contact, and give quality time to the child. Children must experience, regulate and express emotions, to form close and secure interpersonal relationships, and to explore his or her environment and learn. The end result is a strong attachment to the parent or caregiver. It is critical that early caregivers know how to promote healthy social and emotional well-being through nurturing and consistent relationships.

Group Format

Healthy Families America (Home Visiting for Prevention of Child Abuse and Neglect) (HFA) was not designed to be conducted in a group setting, and has not been tested for use in a group setting.

Delivery Setting

This program is typically conducted in a(n):

  • Birth Family Home

Homework

This program does not include a homework component.

Languages

Healthy Families America (Home Visiting for Prevention of Child Abuse and Neglect) (HFA) has materials available in languages other than English:

Chinese, Japanese, Spanish

For information on which materials are available in these languages, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

  • A host agency or a collaboration of host agencies that provide office space with confidentiality related to participant files/records
  • Computer and email
  • Data or tracking system
  • Cell phones
  • Program Manager
  • 1 FTE Supervisor per 5-6 FTE home visitors
  • 1 FTE Supervisor per 5-6 FTE assessment staff
  • Travel expense reimbursement (mileage) for home visitors
  • A community advisory board
  • Diversified, and sustainable funding.

Minimum Provider Qualifications

Program staff is selected because of a combination of personal characteristics, experiential, and educational qualifications.

Direct Service Staff should have qualifications including, but not limited to:

  • Experience in working with or providing services to children and families.
  • An ability to establish trusting relationships.
  • Acceptance of individual differences.
  • Experience and willingness to work with the culturally diverse populations that are present among the program’s target population.
  • Knowledge of infant and child development.

Supervisors should have qualifications including, but not limited to:

  • A solid understanding of and experience in supervising and motivating staff, as well as providing support to staff in stressful work environments.
  • Knowledge of infant and child development and parent-child attachment.
  • Experience with family services that embrace the concepts of family-centered and strength-based service provision.
  • Knowledge of maternal-infant health and dynamics of child abuse and neglect.
  • Experience in providing services to culturally diverse communities/families.
  • Experience in home visitation with a strong background in prevention services to the 0-3 age population.
  • Bachelor’s degree in human services or related field required (Master’s degree preferred).

Program managers should have qualifications including, but not limited to:

  • A solid understanding of and experience in managing staff.
  • Administrative experience in human service or related program(s), including experience in quality assurance/improvement and program development.
  • A bachelor’s degree in human services administration or related field required (Master’s degree preferred).

Education and Training Resources

There is a manual that describes how to implement this program, and there is training available for this program.

Training Contact:
Training is obtained:

Training is provided in person either in state or regionally

Number of days/hours:

4 full days for direct service staff, 5 days for supervisors. Two tracks: Parent Survey (assessment) and Integrated Strategies (home visiting). Three day advanced clinical and reflective practice training for Supervisors.

Relevant Published, Peer-Reviewed Research

This program is rated a "4 - Evidence Fails to Demonstrate Effect" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least two or more randomized controlled trials (RCTs) that have found the practice has not resulted in improved outcomes, when compared to usual care. If multiple outcome studies have been conducted, the overall weight of evidence does not support the benefit of the practice. The overall weight of evidence is based on the preponderance of published, peer-reviewed studies, and not a systematic review or meta-analysis. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Child/Family Well-Being

Show relevant research...

Note: Healthy Families America is rated a "1 - Well-Supported by Research Evidence" on the Scientific Rating Scale in the Home Visiting for Child Well-Being topic area, based on the published, peer-reviewed research available for child well-being outcomes.

Duggan, A., Fuddy, L., Burrell, L., Higman, S., McFarlane, E., Windham, A., & Sia, C. (2004). Randomized trial of a statewide home visiting program: Impact in reducing parental risk factors. Child Abuse & Neglect, 28, 623-643.

Type of Study: Randomized controlled trial
Number of Participants: 643

Population:

  • Age range — Mothers with children aged from birth to 9 years
  • Race/Ethnicity — 34% Native Hawaiian/Pacific Islander, 28% Asian/Filipino, 12% Caucasian, and 27% Other
  • Gender — Females
  • Status — Participants were families at risk for child maltreatment.

Location / Institution: Three regional community agencies on Oahu, Hawaii.

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study assessed the impact of the Healthy Start Program (HSP) (a former version of Healthy Families America) in reducing malleable parental risk factors for child abuse in families of newborns identified, through population-based screening, as at-risk of child abuse. Measures used included the Center for Epidemiological Studies Depression Scale (CES-D), Parenting Stress Index (PSI), Conflict Tactics Scale (CTS), and CAGE questions (which ask about alcohol use). Results indicated that malleable parental risks for child abuse were common at baseline. There was no significant overall program effect on any risk or on at-risk mothers’ desire for and use of community services to address risks. There was a significant reduction in one measure of poor mental health at one agency and a significant reduction in maternal problem alcohol use and repeated incidents of physical partner violence for families receiving ≥75% of visits called for in the model. Limitations included home visitors often failed to recognize parental risks and seldom linked families with community resources, and HSP training programs were under-developed in preparing staff to address risks and to link families with community resources. Overall, the home visiting program did not reduce major risk factors for child abuse that made families eligible for service.

Length of post-intervention follow-up: 3 years.

Duggan, A., McFarlane, E., Fuddy, L., Burrell, L., Higman, S. M., Windham, A., & Sia, C. (2004). Randomized trial of a statewide home visiting program: Impact in preventing child abuse and neglect. Child Abuse and Neglect, 28, 597-622.

Type of Study: Randomized controlled trial
Number of Participants: 643

Population:

  • Age range — Families with children aged birth to 3 years
  • Race/Ethnicity — 32% Native Hawaiian, 23% Asian, 20% Other Pacific Islander, 7% Caucasian, and 18% Other
  • Gender — Not Specified
  • Status — Participants were families at risk for child maltreatment.

Location / Institution: Three regional community agencies on Oahu, Hawaii.

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Families were randomly assigned to the Healthy Start Program (HSP) (a former version of Healthy Families America) or to a control group. Measures used included the Parent-Child Conflict Tactics Scale (CTS-PC) and the Home Observation for Measurement of the Environment (HOME) Inventory. Hospitalizations, substantiated child protective services reports, and mother’s relinquishment of care were also tracked. Results indicated that the treatment and control groups did not differ on most measures of maltreatment. HSP mothers were less likely to use common methods of corporal/verbal punishment, but this effect was traced to only one agency. HSP mothers reported less neglectful behavior, related to decreased preoccupation with problems and improved access to medical care at one agency studied.

Length of post-intervention follow-up: 3 years.

Duggan, A., Fuddy, L., McFarlane, E., Burrell, L, Windham, A., Higman, S., & Sia, C. (2004). Evaluating a statewide home visiting program to prevent child abuse in at risk families of newborns: Fathers’ participation and outcomes. Child Maltreatment, 9(1), 3-17.

Type of Study: Randomized controlled trial
Number of Participants: 643

Population:

  • Age range — Families with children aged birth to 3 years
  • Race/Ethnicity — 32% Native Hawaiian, 23% Asian, 20% Other Pacific Islander, 7% Caucasian, 18% Other
  • Gender — Not Specified
  • Status — Participants were families at risk for child maltreatment.

Location / Institution: Three regional community agencies on Oahu, Hawaii.

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: This study used the same sample as Duggan, McFarlane et al. (2004) above. Families were randomly assigned to either the Healthy Start Program (HSP) (same as Healthy Families America) or the control group. Data were collected through interviews with mothers, HSP record reviews, and surveys of home visitors. Data concerning fathers included fathers’ participation in home visits and factors influencing their participation, role in parenting as identified by maternal reports, accessibility, responsibility, and engagement. Analysis showed no program effects on accessibility, engagement in parenting activities, or sharing responsibility for the child’s welfare. HSP fathers who were non-violent and living with the child’s mothers showed increased parenting involvement, as did HSP fathers who were violent and had little contact at baseline.

Length of post-intervention follow-up: 3 years.

Duggan, A., Caldera, D., Rodriguez, K., Burrell, L., Rohde, C., & Crown, S. S. (2007). Impact of a statewide home visiting program to prevent child abuse. Child Abuse & Neglect, 31, 801-827.

Type of Study: Randomized controlled trial
Number of Participants: 325

Population:

  • Age range — Families with children aged birth to 2 years
  • Race/Ethnicity — 22% Alaska Native, 55% Caucasian, 8% Multiracial, and 15% Other
  • Gender — Not Specified
  • Status — Participants were families at risk for child maltreatment.

Location / Institution: Healthy Families Alaska (HFAK)

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Families were randomly assigned to the Healthy Families program or to a control group who were referred to other services. Families were measured at baseline on maternal mental health, substance abuse, and partner violence by interview. Measures used included the Center for Epidemiological Studies Depression Scale (CES-D), Mental Health Index (MHI-5), CAGE scores (which ask about alcohol use), Revised Conflict Tactics Scale (CTS), and the Home Observation of the Environment (HOME) Inventory. Mother-child interactions were also observed. At follow up, maternal depression and partner violence were reassessed and parenting attitudes were measured with the Adult-Adolescent Parenting Index. Results indicated no program effects on maltreatment reports and most measures of potential maltreatment. Mothers who received home visits reported using mild forms of discipline less often. There was no program impact on parental risks and home visitors often failed to address caregiver risks and link to community resources.

Length of post-intervention follow-up: 2 years.

DuMont, K., Mitchell-Herzfeld, S., Greene, R., Lee, E., Lowenfels, A., Rodriguez, M., & Dorabawila, V. (2008). Healthy Families New York (HFNY) randomized trial: Effects on early child abuse and neglect. Child Abuse & Neglect, 32, 295-315.

Type of Study: Randomized controlled trial
Number of Participants: 1173

Population:

  • Age range — Families with children aged birth to 2 years
  • Race/Ethnicity — 35% Caucasian, 46% African American, and 19% Hispanic
  • Gender — Not Specified
  • Status — Participants were families at risk for child maltreatment.

Location / Institution: Healthy Families New York (HFNY)

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated the effects of a home visiting program modeled after Healthy Families America on parenting behaviors in the first 2 years of life. Families were randomly assigned to receive the Healthy Families NY program or standard services. Participants were interviewed at baseline, 1 and 2 years follow-up. Mothers reported on parenting behaviors using the Parent-Child Conflict Tactics Scale (CTS-PC) and official CPS report data was also examined for the intervention period. At one-year follow-up, mothers in the Healthy Families NY program reported fewer acts of very serious abuse, minor physical aggression, and psychological aggression in the past year, as well as fewer acts of harsh parenting in the last week. At year 2, Healthy Families NY mothers reported significantly fewer acts of serious physical abuse. There was trend toward lower levels of neglect at both times for Healthy Families NY program mothers, as well, although it did not reach significance. No group differences were found for substantiated CPS reports.

Length of post-intervention follow-up: None.

Gessner, B. D. (2008). The effect of Alaska’s home visitation program for high-risk families on trends in abuse and neglect. Child Abuse & Neglect, 32, 317-333.

Type of Study: Retrospective cohort design
Number of Participants: 985

Population:

  • Age range — Families with children aged birth to 2 years
  • Race/Ethnicity — Not Specified
  • Gender — Not Specified
  • Status — Participants were families at risk for     child maltreatment with Alaska CPS reports for abuse and neglect.

Location / Institution: Healthy Families Alaska

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated the effectiveness of the Healthy Families Alaska home visitation program with families at risk for child maltreatment. Measures used included the Kempe Family Stress Checklist (KHSC) and Alaska CPS report data. Results indicated that compared to the two not enrolled high-risk groups, Healthy Families Alaska-enrolled children had a lower rate of experiencing abuse and neglect outcomes during the first month of life. Thereafter, rates were similar among all three groups or higher among enrolled children such that by age 2 years, the final proportions that had experienced an abuse or neglect outcome were nearly identical. Little evidence exists that Alaska’s home visitation program had a measurable impact on child maltreatment outcomes.

Length of post-intervention follow-up: None.

Cullen, J. P., Ownbey, J. B., & Ownbey, M. A. (2010). The effects of the Healthy Families America Home Visitation Program on parenting attitudes and practices and child social and emotional competence. Child & Adolescent Social Work Journal, 27, 335-354.

Type of Study: One group pretest-posttest design
Number of Participants: 64

Population:

  • Age range — Families with children aged birth to 5 years
  • Race/Ethnicity — 78% Caucasian, 17% African American, 2% Hispanic, and 3% Other
  • Gender — Parents: 14% Male, 86% Female
  • Status — Participants were under-resourced    families at risk for child maltreatment who were referred from human service organizations.

Location / Institution: Healthy Families in rural Western North Carolina

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated the effectiveness of the Healthy Families America program in a rural setting for families at risk for maltreatment. Intervention length ranged from 2.5 to 5 years for families. Measures used included the Kempe Family Stress Inventory (KFSI), Adult-Adolescent Parenting Inventory-Revised (AAPI-R, AAPI-2), and the Ages and Stages Questionnaire Social-Emotional (ASQ-SE) completed by the parent every 1 to 3 weeks. Results indicated that highly significant positive changes were noted between pre- and postintervention assessments on all attitudinal and behavioral factors, parental attitudes, and children’s social and emotional competence. Limitations included lack of a control group or random assignment. While the intervention length was extensive, the study did not provide an actual follow-up.

Length of post-intervention follow-up: None.

Rodriguez, M. L., Dumont, K., Mitchell-Herzfeld, S. D., Walden, N. J., & Greene, R. (2010). Effects of Healthy Families New York on the promotion of maternal parenting competencies and the prevention of harsh parenting. Child Abuse & Neglect, 34, 711-723.

Type of Study: Randomized controlled trial
Number of Participants: 522

Population:

  • Age range — Mothers with children aged 2.9 to 3.9 years
  • Race/Ethnicity — 42% Caucasian, 39% African American, 16% Hispanic, and 3% Other
  • Gender — Females
  • Status — Participants were mothers at risk for child maltreatment.

Location / Institution: Healthy Families New York sites

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated the effectiveness of the Healthy Families New York home visiting program in promoting parenting confidence and preventing maladaptive parenting behaviors in mothers at risk for child maltreatment. The study used microlevel observational assessments of mother-child interactions in the third wave of a randomized controlled trial (DuMont et al. 2008). Participants were randomly assigned during pregnancy or shortly after the birth of the target child to an intervention group that was offered home visiting services or a control group that was given referrals to other services. Results indicated that Healthy Families was effective in fostering positive parenting, such as maternal responsivity and cognitive engagement. With respect to negative parenting, Healthy Families mothers in the High Prevention Opportunity subgroup were less likely than their counterparts in the control group to use harsh parenting, while no differences were detected for the Limited Prevention Opportunity subgroup. The major study limitation was lack of follow-up.

Length of post-intervention follow-up: None.

Falconer, M. K., Clark, M. H., & Parris, D. (2011). Validity in an evaluation of Healthy Families Florida – A program to prevent child abuse and neglect. Children and Youth Services Review, 33, 66-77.

Type of Study: Multiple group, posttest-only, quasi-experimental design
Number of Participants: Not Specified

Population:

  • Age range — Not Specified
  • Race/Ethnicity — Not Specified
  • Gender — Not Specified
  • Status — Families with a cumulative score of 13 or higher on the Healthy Families Florida Assessment Tool (HFFAT) prenatally, at time of birth or postnatally in the targeted counties.

Location / Institution: 40 counties in Florida

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated the effectiveness of the Healthy Families Florida program for families at risk for child maltreatment. The study analyzed data retrospectively from multiple groups: 1) families that completed the intervention, 2) families that received a high dose of services, 3) families that received a low dose of services, and 4) families that were eligible to enroll but did not due to program capacity issues. Measures included the Healthy Families Florida Assessment Tool (HFFAT) and Florida state CPS records on child abuse and neglect. Outcomes favored the home visiting program and increased after accounting for covariates that contributed to child abuse and neglect. Limitations included the lack of randomization.

Length of post-intervention follow-up: Varied depending on the group being examined.

LeCroy, C. W., & Krysik, J. (2011). Randomized trial of the Healthy Families Arizona home visiting program. Children and Youth Services Review. Advance online publication. doi:10.1016/j.childyouth.2011.04.036

Type of Study: Randomized controlled trial
Number of Participants: 195

Population:

  • Age range — Mean age 24 years
  • Race/Ethnicity — 60% Hispanic, 21% Caucasian, and 19% Not specified
  • Gender — Females
  • Status — Participants were mothers with children at risk for child maltreatment at an Arizona program site.

Location / Institution: Arizona

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated the effectiveness of the Healthy Families Arizona home visitation program for families at risk for child maltreatment. Participants were randomly assigned to a treatment or to Child Development control group. Mothers were assessed at intake, 6 and 12-month follow-ups using the Kempe Family Checklist, Revised Parent-Child Conflict Tactics Scale, Adult-Adolescent Parenting Inventory-2 (AAPI), and the Emotional/Social Loneliness Inventory. Results indicated that significant results favoring the experimental group in contrast to the control group were found on some measures in each of five domains including violent parenting behavior; parenting attitudes and practices; parenting support; mental health and coping; and maternal outcomes. Looking specifically at abusive parenting behaviors, the program found results on two of nine behaviors: shouted, yelled, or screamed at child; and slapped child's hand.  Limitations included significant differences between the experimental and control groups at baseline and the limited follow-up time period.  In addition, the control group received access to services which may have limited differences between treatment conditions.

Length of post-intervention follow-up: Not Specified

References

Daro, D., & Harding, K. A. (1999). Healthy Families America: Using research to enhance practice. The Future of Children, 9(1), 152-176.

Galano, J., Credle, W., & Perry, D. (2001). Developing and sustaining a successful community prevention initiative: The Hampton Healthy Families Partnership. Journal of Primary Prevention, 21(4), 495-509.

Harding, K., Galano, J., Martin, J, Huntington, L., & Schellenbach, C. J. (2007). Healthy Families America effectiveness: A comprehensive review of outcomes. Journal of Prevention and Intervention in the Community, 34(1/2), 149-179.

Contact Information

Name: Cydney M. Wessel, MSW
Agency/Affiliation: Healthy Families America at Prevent Child Abuse America
Website: www.healthyfamiliesamerica.org
Email:
Phone: (312) 218-7414

Date Reviewed: June 2011 (originally reviewed in June 2009)