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Study Detail

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.

Program(s) Reviewed: Healthy Families America (HFA)®

Study Screening Details

Screening DecisionScreening Conclusion
Study Passes ScreensEligible for Review

Study Design Details

RatingDesignSampleAttritionBaseline EquivalenceReassignmentConfounding Factors
HighRandomized controlled trialOther SamplesLowEstablished on race/ethnicity and SES.NoneNone
Notes:

High rating applies to year 1 and year 3 outcomes. Insurance outcomes receive a moderate rating because of baseline differences on health insurance at birth.

Study Characteristics

Study Participants Using computerized hospital records, the records of all births were screened for eligibility criteria including (1) residence in the target area, (2) being a non-military family, and (3) speaking English or Spanish. Families meeting these criteria were screened for risk factors for child abuse and neglect. Mothers who screened positive for risk or for whom there was not sufficient information to screen them out, were screened further using the Kempe Family Stress Checklist (FSC). Families in which either parent received a score of 25 or greater on the FSC were randomly assigned to the treatment or control group using a deck of cards. 515 families agreed to participate in the study and were randomly assigned (255 to the control group and 260 to the treatment group). Participant enrollment took place between February 1, 1996, and March 31, 1997. 247 program group families and 241 comparison group families completed a baseline interview. At baseline, 32.8% of all mothers were under age 20. 26.8% of participating mothers were Hispanic (English-speaking), 19.3% were Hispanic (Spanish-speaking), 24.2% were Caucasian, 19.5% were African American, and 10.2% were Asian or of another race/ethnicity. 53.4% of participants did not have a high school diploma, 52.3% were receiving food stamps, 55.7% were receiving TANF, and 52.3% were unemployed. This study reports results from three years of follow-up of the Healthy Families San Diego clinical trial. The analytic samples for the control group were 214, 207, and 207 for years 1, 2, and 3, respectively. For the program group, the corresponding analytic samples were 221, 196, and 205 for years 1, 2, and 3 .
Setting San Diego County, a primarily urban county that includes suburban and rural regions.
Home Visiting Services Home visitors were randomly assigned to families and attempted to visit them at the hospital following the birth of the child. Initial assessments were conducted in a home visit to gauge family needs and develop an Individualized Family Service Plan. In addition to home visits, families were encouraged to attend group meetings for parents and/or children. Visits continued until children reached age 3.
Comparison Condition Families in the comparison group were given a list of community resources at the time of the baseline interview.
Staff Characteristics and Training Healthy Families San Diego home visitor staff were required to have some relevant college coursework (Bachelor’s degree preferred) or a minimum of four years of experience related to working with at-risk families. Home visitors were also expected to be knowledgeable about child abuse, have an ability to engage the program clientele, and demonstrate other desirable personal characteristics, such as maturity and cultural competence. Staff received a 40-hour training in their first week of work. New home visitors also shadowed existing staff. All staff attended monthly in-service trainings on a variety of topics.
Funding Source The Stuart Foundation; California Wellness Foundation; State of California Department of Social Services: Office of Child Abuse Prevention
Author Affiliation None of the study authors are developers of this program model.

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