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Healthy Families America (HFA)®

Meets DHHS criteria for an evidenced based model

Last Updated: April 2017

Effects Shown in Research & Outcome Measure Details for Reductions in Juvenile Delinquency, Family Violence, and Crime Outcomes

Impact Studies Rated High

Bair-Merritt, M. H., Jennings, J. M., Chen, R., Burrell, L., McFarlane, E., Fuddy, L., et al. (2010). Reducing maternal intimate partner violence after the birth of a child: A randomized controlled trial of the Hawaii Healthy Start home visitation program. Archives of Pediatrics and Adolescent Medicine, 164(1), 16–23.
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Outcome Effect Sample Timing of Follow-Up Sample Size Program Group Comparison Group Mean Difference or Odds Ratio
 Statistical Significance
 Effect Size
 Outcome Type
Maternal perpetration (CTS) Favorable Full sample, Hawaii trial Average across 3 years of program 640 mothers Mean = 5.08 Mean = 7.72 IRR = 0.83 Statistically significant,
p < 0.052 		Not available Secondary
Maternal perpetration (CTS) No Effect Full sample, Hawaii trial Average when child was 7-9 years old 640 mothers Mean = 2.45 Mean = 2.51 IRR = 0.98 Not statistically significant,
p > 0.05 		Not available Secondary
Maternal victimization (CTS) No Effect Full sample, Hawaii trial Average when child was 7-9 years old 640 mothers Mean = 3.35 Mean = 4.01 IRR = 0.95 Not statistically significant,
p > 0.05 		Not available Secondary
Maternal victimization (CTS) No Effect Full sample, Hawaii trial Average across 3 years of program 640 mothers Mean = 7.50 Mean = 9.55 IRR = 0.861 Not statistically significant,
p > 0.05 		Not available Secondary

1 Incidence rate ratio is calculated using imputed data and adjusted for baseline covariates.

2 Actual p-value was not reported by the authors.

Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
CTS: Maternal perpetration The CTS assesses victimization and perpetration related to intimate partner violence and maltreatment. The researchers used the 38-item CTS1 at baseline and the 78-item revised CTS2 at subsequent follow-ups. The CTS2 includes questions on verbal aggression/abuse, physical assault, sexual coercion/abuse, and injury. The researchers transformed the CTS’s categorical response categories into counts: never (0), once (1), twice (2), 3 to 5 times (4), 6 to 10 times (8), 11 to 20 times (15), and more than 20 times (25). Parent/caregiver report Cronbach’s α: verbal aggression and abuse (.79), physical assault (.86), sexual coercion and abuse (.87), and injury (.95), Secondary
CTS: Maternal victimization The CTS assesses victimization and perpetration related to intimate partner violence and maltreatment. The researchers used the 38-item CTS1 at baseline and the 78-item revised CTS2 at subsequent follow-ups. The CTS2 includes questions on verbal aggression/abuse, physical assault, sexual coercion/abuse, and injury. The researchers transformed the CTS’s categorical response categories into counts: never (0), once (1), twice (2), 3 to 5 times (4), 6 to 10 times (8), 11 to 20 times (15), and more than 20 times (25). Parent/caregiver report Cronbach’s α: verbal aggression and abuse (.79), physical assault (.86), sexual coercion and abuse (.87), and injury (.95), Secondary
Duggan, A., Fuddy, L., Burrell, L., Higman, S. M., McFarlane, E., Windham, A., et al. (2004). Randomized trial of a statewide home visiting program to prevent child abuse: Impact in reducing parental risk factors. Child Abuse & Neglect, 28(6), 623–643.
Show Study Effects Details
Outcome Effect Sample Timing of Follow-Up Sample Size Program Group Comparison Group Mean Difference or Odds Ratio
 Statistical Significance
 Effect Size
 Outcome Type
Partner incident resulting in injury (CTS) No Effect Full sample, Hawaii trial Year 2 556 mothers 14% 20% -6 Statistical significance not reported HomVEE = -0.26 Secondary
Partner incident resulting in injury (CTS) No Effect Full sample, Hawaii trial Year 3 548 mothers 17% 18% -1 Statistical significance not reported HomVEE = -0.04 Secondary
Partner incident resulting in injury (CTS) No Effect Full sample, Hawaii trial Years 1-3 564 mothers 24% 26% OR = 0.81 Not statistically significant,
p > 0.05 		Not available Secondary
Partner incident resulting in injury (CTS) No Effect Full sample, Hawaii trial Year 1 564 mothers 24% 26% -2 Statistical significance not reported HomVEE = -0.06 Secondary
Partner physical abuse (CTS) No Effect Full sample, Hawaii trial Year 1 564 mothers 37% 42% -5 Statistical significance not reported HomVEE = -0.13 Secondary
Partner physical abuse (CTS) No Effect Full sample, Hawaii trial Year 2 556 mothers 26% 32% -6 Statistical significance not reported HomVEE = -0.18 Secondary
Partner physical abuse (CTS) No Effect Full sample, Hawaii trial Years 1-3 564 mothers 37% 42% OR = 0.83 Not statistically significant,
p > 0.05 		Not available Secondary
Partner physical abuse (CTS) No Effect Full sample, Hawaii trial Year 3 548 mothers 29% 30% -1 Statistical significance not reported HomVEE = -0.03 Secondary
Partner psychological abuse (CTS) No Effect Full sample, Hawaii trial Year 3 548 mothers 42% 38% -4 Statistical significance not reported HomVEE = 0.10 Secondary
Partner psychological abuse (CTS) No Effect Full sample, Hawaii trial Years 1-3 564 mothers 49% 49% OR = 1.051 Not statistically significant,
p > 0.05 		Not available Secondary
Partner psychological abuse (CTS) No Effect Full sample, Hawaii trial Year 1 564 mothers 49% 49% 0 Statistical significance not reported HomVEE = 0.00 Secondary
Partner psychological abuse (CTS) No Effect Full sample, Hawaii trial Year 2 556 mothers 42% 42% 0 Statistical significance not reported HomVEE = 0.00 Secondary

1 Adjusted odds ratios are based on the average effect across all follow-up years.

Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
CTS:
  • Partner psychological abuse
  • Partner physical abuse
  • Partner incident resulting in injury
 		The CTS assesses victimization and perpetration related to intimate partner violence and maltreatment. The researchers examined the prevalence of psychological abuse, physical abuse, and an incident of injury. The father was considered to be physically violent if he had committed three or more incidents of physical violence toward the mother in the year prior to the baseline interview and was psychologically aggressive if he had committed acts of psychological aggression more than 35 times in the year prior to the interview. Parent/caregiver report Not reported by author Secondary
DuMont, K., Kirkland, K., Mitchell-Herzfeld, S., Ehrhard-Dietzel, S., Rodriguez, M. L., Lee, E., Layne, C., & Greene, R. (2010). “A randomized trial of Healthy Families New York (HFNY): Does home visiting prevent child maltreatment?” Rensselaer, NY: New York State Office of Children & Family Services and Albany, NY: The University of Albany, State University of New York, 2010.
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Outcome Effect Sample Timing of Follow-Up Sample Size Program Group Comparison Group Mean Difference or Odds Ratio
 Statistical Significance
 Effect Size
 Outcome Type
Aggressive behaviors (CBCL) No Effect New York sample 7 year 897 mothers Adjusted mean = 6.99 Adjusted mean = 6.72 MD = 0.27 Not statistically significant, p > 0.05 Study-reported = 0.04 Primary
Rule breaking behavior (CBCL) No Effect New York sample 7 year 897 mothers Adjusted mean = 2.74 Adjusted mean = 2.66 MD = 0.08 Not statistically significant, p > 0.05 Study-reported = 0.03 Primary
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Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
Aggressive behaviors (CBCL) The Child BehaviorChecklist for Ages6ndash;8(CBCL/6-18) assesses children’s emotional and behavioral problems. Researchers selected five subscales that aligned with constructs of interest: attention problems, rule breaking and aggressive behaviors, social problems, and the anxious-depressed and withdrawn-depressed syndrome scales. Parent/caregiver report Not reported by author Primary
Rule breaking behavior (CBCL) The Child BehaviorChecklist for Ages6ndash;8(CBCL/6-18) assesses children’s emotional and behavioral problems. Researchers selected five subscales that aligned with constructs of interest: attention problems, rule breaking and aggressive behaviors, social problems, and the anxious-depressed and withdrawn-depressed syndrome scales. Parent/caregiver report Not applicable Primary
Landsverk, J., Carrilio, T., Connelly, C. D., Ganger, W., Slymen, D., Newton, R., et al. (2002). Healthy Families San Diego clinical trial: Technical report. San Diego, CA: The Stuart Foundation, California Wellness Foundation, State of California Department of Social Services: Office of Child Abuse Prevention.
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Outcome Effect Sample Timing of Follow-Up Sample Size Program Group Comparison Group Mean Difference or Odds Ratio
 Statistical Significance
 Effect Size
 Outcome Type
Family court No Effect Full sample, San Diego trial Year 3 382 families 10% 7% 3 Not statistically significant,
p > 0.05 		HomVEE = 0.24 Secondary
Family court No Effect Full sample, San Diego trial Year 1 422 families 11% 10% 1 Not statistically significantNot statistically significant,
p > 0.05 		HomVEE = 0.06 Secondary
Incident of physical assault, frequency (CTS) No Effect Full sample, San Diego trial Year 1 422 families Mean = 2
SD = 4.7 		Mean = 2.2
SD = 4.7 		MD = -0.2 Not statistically significant,
p > 0.05 		HomVEE = -0.04 Secondary
Incident of physical assault, frequency (CTS) No Effect Full sample, San Diego trial Year 3 382 families Mean = 0.93
SD = 3 		Mean = 0.87
SD = 2.9 		MD = 0.06 Not statistically significant,
p > 0.05 		HomVEE = 0.02 Secondary
Incident of physical assault, prevalence (CTS) No Effect Full sample, San Diego trial Year 1 422 families 36% 39% -3 Not statistically significant,
p > 0.05 		HomVEE = -0.08 Secondary
Incident of physical assault, prevalence (CTS) No Effect Full sample, San Diego trial Year 3 382 families 18% 17% 1 Not statistically significant,
p > 0.05 		HomVEE = 0.04 Secondary
Partner violence resulting in injury (CTS) No Effect Full sample, San Diego trial Year 3 382 families 8% 6% 2 Not statistically significant,
p > 0.05 		HomVEE = 0.19 Secondary
Partner violence resulting in injury (CTS) No Effect Full sample, San Diego trial Year 1 422 families 15% 15% 1 Not statistically significant,
p > 0.05 		HomVEE = 0.00 Secondary
Restraining order No Effect Full sample, San Diego trial Year 1 422 families 7% 7% 0 Not statistically significant,
p > 0.05 		HomVEE = 0.00 Secondary
Restraining order No Effect Full sample, San Diego trial Year 3 382 families 6% 4% 2 Not statistically significant,
p > 0.05 		HomVEE = 0.26 Secondary
Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
CTS:
  • Partner violence resulting in injury
  • Incident of physical assault, prevalence
 		The CTS assesses victimization and perpetration related to intimate partner violence and maltreatment. The researchers examined the prevalence and the frequency of physical assault and partner violence that resulted in injury. Parent/caregiver report Not reported by author Secondary
Family court Percentage of program participants who had been connected to resources that helped them enter family court Parent/caregiver report Not applicable Secondary
Restraining order Percentage of program participants who had been connected to resources that helped them obtain a restraining order Parent/caregiver report Not applicable Secondary
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Impact Studies Rated Moderate

LeCroy, C. W., & Krysik, J. (2011). Randomized trial of the Healthy Families Arizona home visiting program. Children and Youth Services Review, 33(10), 1761–1766. †
Show Study Effects Details
Outcome Effect Sample Timing of Follow-Up Sample Size Program Group Comparison Group Mean Difference or Odds Ratio
 Statistical Significance
 Effect Size
 Outcome Type
Family violence No Effect Arizona sample 6 months 180 mothers Mean = 0.51(SD = 0.08) Mean = 0.43(SD = 0.08) MD = 0.08 Not statistically significant, p =0.15 HomVEE = 1.87 Secondary
Family violence No Effect Arizona sample 12 months 168 mothers Mean = 0.43(SD = 0.08) Mean = 0.52(SD = 0.08) MD = -0.09 Not statistically significant, p =0.37 HomVEE = -1.12 Secondary
Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
Family violence The authors used common indicators of violence to create a family violence index similar to the Conflict Tactics Scale. The index included items that describe violent behaviors in the home such as pushing and shoving, slapping, and throwing objects. Parent/caregiver report Not reported by author Secondary
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