Healthy Families America (HFA)® Meets HHS Criteria

Model effectiveness research report last updated: 2020

Effects shown in research & outcome measure details

Maternal health

Findings rated high

Healthy Families America (HFA)®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
Above threshold for depression (CES-D = 16)
FavorableUnfavorable or ambiguousNo Effect
Year 1 follow-up Full sample, San Diego trial 435 mothers % = 39.00 % = 42.00 = -3.00 HomeVEE calculated = -0.08 Not statistically significant, p ≥ 0.05
Above threshold for depression (CES-D = 16)
FavorableUnfavorable or ambiguousNo Effect
Year 3 follow-up Full sample, San Diego trial 412 mothers % = 33.00 % = 29.00 = 4.00 HomeVEE calculated = 0.11 Not statistically significant, p ≥ 0.05
Confidence in adult relationships
FavorableUnfavorable or ambiguousNo Effect
Year 1 follow-up Full sample, San Diego trial 435 mothers Mean = 33.40 Mean = 33.80 Mean difference = -0.40 HomeVEE calculated = -0.08 Not statistically significant, p ≥ 0.05
Confidence in adult relationships
FavorableUnfavorable or ambiguousNo Effect
Year 3 follow-up Full sample, San Diego trial 412 mothers Mean = 33.70 Mean = 33.80 Mean difference = -0.10 HomeVEE calculated = -0.02 Not statistically significant, p ≥ 0.05
Depressive symptoms (CES-D)
FavorableUnfavorable or ambiguousNo Effect
Year 1 follow-up Full sample, San Diego trial 435 mothers Mean = 14.50 Mean = 15.50 Mean difference = -1.00 HomeVEE calculated = -0.10 Not statistically significant, p ≥ 0.05
Depressive symptoms (CES-D)
FavorableUnfavorable or ambiguousNo Effect
Year 3 follow-up Full sample, San Diego trial 412 mothers Mean = 12.50 Mean = 12.90 Mean difference = -0.40 HomeVEE calculated = -0.04 Not statistically significant, p ≥ 0.05
Drinks per day
FavorableUnfavorable or ambiguousNo Effect
Year 1 follow-up Full sample, San Diego trial 435 mothers Mean = 2.50 Mean = 2.30 Mean difference = 0.20 HomeVEE calculated = 0.08 Not statistically significant, p ≥ 0.05
Drinks per day
FavorableUnfavorable or ambiguousNo Effect
Year 3 follow-up Full sample, San Diego trial 412 mothers Mean = 2.10 Mean = 2.40 Mean difference = -0.30 HomeVEE calculated = -0.15 Not statistically significant, p ≥ 0.05
Maternal social support (MHI)
FavorableUnfavorable or ambiguousNo Effect
Year 1 follow-up Full sample, San Diego trial 435 mothers Mean = 18.60 Mean = 19.10 Mean difference = -0.50 HomeVEE calculated = 0.00 Not statistically significant, p ≥ 0.05
Mental Health (MHI)
FavorableUnfavorable or ambiguousNo Effect
Year 1 follow-up Full sample, San Diego trial 435 mothers Mean = 22.90 Mean = 22.20 Mean difference = 0.70 HomeVEE calculated = 0.15 Not statistically significant, p ≥ 0.05
Mental Health (MHI)
FavorableUnfavorable or ambiguousNo Effect
Year 3 follow-up Full sample, San Diego trial 412 mothers Mean = 24.00 Mean = 24.10 Mean difference = -0.10 HomeVEE calculated = -0.02 Not statistically significant, p ≥ 0.05
Parenting Stress (PSI)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, San Diego trial 435 mothers Mean = 72.40 Mean = 71.22 Mean difference = 1.20 HomeVEE calculated = 0.06 Not statistically significant, p ≥ 0.05
Parenting Stress (PSI)
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, San Diego trial 412 mothers Mean = 71.20 Mean = 72.82 Mean difference = -1.60 HomeVEE calculated = -0.08 Not statistically significant, p ≥ 0.05
Problem substance use (CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE)
FavorableUnfavorable or ambiguousNo Effect
Year 1 follow-up Full sample, San Diego trial 435 mothers % = 21.00 % = 18.00 = 3.00 HomeVEE calculated = 0.54 Not statistically significant, p ≥ 0.05
Problem substance use (CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE)
FavorableUnfavorable or ambiguousNo Effect
Year 3 follow-up Full sample, San Diego trial 412 mothers % = 9.00 % = 10.00 = -1.00 HomeVEE calculated = -0.07 Not statistically significant, p ≥ 0.05
Repeat birth within 36 months of index birth
FavorableUnfavorable or ambiguousNo Effect
Year 3 follow-up Full sample, San Diego trial 412 mothers % = 27.00 % = 22.00 = 5.00 HomeVEE calculated = 0.16 Not statistically significant, p ≥ 0.05
Repeat pregnancy within 36 months of index birth
FavorableUnfavorable or ambiguousNo Effect
Year 3 follow-up Full sample, San Diego trial 412 mothers % = 43.00 % = 50.00 = -7.00 HomeVEE calculated = 0.15 Not statistically significant, p ≥ 0.05
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Outcome measure Outcome measure description Collection method Properties

CES-D: Above threshold for depression

The CES-D is a 20-item assessment of depressive symptoms. The researchers examined the total score and a binary measure indicating whether the total depression score was at or above a cutoff of 16. Parent/caregiver report

Not reported by author

CES-D: Depressive symptoms

The CES-D is a 20-item assessment of depressive symptoms. The researchers examined the total score and a binary measure indicating whether the total depression score was at or above a cutoff of 16. Parent/caregiver report

Not reported by author

MHI

The MHI assesses levels of anxiety and depressive symptoms. Parent/caregiver report

Not applicable

Confidence in adult relationships

No description provided by author Parent/caregiver report

Not reported by author

Drinks per day

Number of drinks the parent consumed per day on average Parent/caregiver report

Not applicable

Parenting Stress (PSI)

The PSI assesses stress in the parent-child relationship arising from child temperament, parental depression, and negatively reinforcing parent-child interactions. Parent/caregiver report

Not reported by author

Problem substance use (CAGE)

Percentage of parents with problem alcohol use, defined as a report of alcohol use in the year prior to pregnancy and a CAGE score greater than or equal to 2 Parent/caregiver report

Not reported by author

Repeat pregnancy within 36 months of index birth

Percentage of mothers who had a repeat birth within 36 months after the index birth Parent/caregiver report

Not applicable

Healthy Families America (HFA)®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes

Emotional loneliness

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 9.80 Unadjusted mean = 10.00 Mean difference = -0.20 Study reported = -0.03

Not statistically significant, p= 0.94

Hope

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 26.90 Unadjusted mean = 26.60 Mean difference = 0.30 Study reported = 0.15

Not statistically significant, p= 0.31

Subsequent pregnancy

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Cases = 1.00 Cases = 3.00 Not reported Not available

Not statistically significant, p ≥ 0.05

Authors describe reduced subsequent pregnancies as favorable to the intervention.

Substance abuse treatment

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted proportion = 0.01 Unadjusted proportion = 0.01 Mean difference = 0.00 HomeVEE calculated = 0.26

Not statistically significant, p = 0.07

,
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Outcome measure Outcome measure description Collection method Properties

Emotional loneliness

Social Loneliness subscale (DiTommaso and Spinner, 1993)

Parent/caregiver report

alpha=.86

Hope

Adult Hope Scale (Snyder et al., 1991)

Parent/caregiver report

alpha=.67

Subsequent pregnancy

Whether became pregnant by follow-up

Parent/caregiver report

Not reported by author

Substance abuse treatment

Whether treated for substance abuse by follow-up

Parent/caregiver report

Not reported by author

Healthy Families America (HFA)®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
Confidence in adult relations
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 mothers Mean = 34.30 Mean = 33.80 Mean difference = 0.50 Not available Not statistically significant, p ≥ 0.05
Confidence in adult relations
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 567 mothers Mean = 34.40 Mean = 33.70 Mean difference = 0.70 Not available Not statistically significant, p ≥ 0.05
Maternal life skills (CLSS)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 mothers Mean = 24.20 Mean = 24.30 Mean difference = -0.10 Not available Not statistically significant, p ≥ 0.05
Maternal life skills (CLSS)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 567 mothers Mean = 23.90 Mean = 23.90 Mean difference = 0.00 Not available Not statistically significant, p ≥ 0.05
Maternal social support (MSSI)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 mothers Mean = 21.50 Mean = 21.90 Mean difference = -0.40 Not available Not statistically significant, p ≥ 0.05
Maternal social support (MSSI)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 567 mothers Mean = 21.40 Mean = 21.70 Mean difference = -0.30 Not available Not statistically significant, p ≥ 0.05
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Outcome measure Outcome measure description Collection method Properties

CLSS: Maternal life skills

The CLSS assesses a person’s transportation, budgeting, support service, support-involvement, interests-hobbies, regularity/organization routines, practices, and resources. Parent/caregiver report

Not reported by author

MSSI: Maternal social support

The MSSI assesses caregiver social support with regard to the division of household tasks and responsibilities for child rearing, access to transportation, interaction with other adults, and community involvement. Parent/caregiver report

Not reported by author

Confidence in adult relations

No description provided by author Parent/caregiver report

Not reported by author

Healthy Families America (HFA)®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
Alcohol or drug use
FavorableUnfavorable or ambiguousNo Effect
Year 2 Biological mothers with custody of index child at interview, Alaska trial 249 mothers % = 28.00 % = 33.00 OR = 0.80 HomeVEE calculated = -0.14 Not statistically significant, p ≥ 0.05
Any illicit drug use
FavorableUnfavorable or ambiguousNo Effect
Year 2 Biological mothers with custody of index child at interview, Alaska trial 249 mothers % = 21.00 % = 18.00 OR = 1.23 HomeVEE calculated = 0.12 Not statistically significant, p ≥ 0.05
Problem alcohol use
FavorableUnfavorable or ambiguousNo Effect
Year 2 Biological mothers with custody of index child at interview, Alaska trial 249 mothers % = 13.00 % = 22.00 OR = 0.52 HomeVEE calculated = -0.39 Not statistically significant, p ≥ 0.05
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Outcome measure Outcome measure description Collection method Properties

Alcohol or drug use

Percentage of parents with a positive CAGE score and who drank in the past year or who had any illicit drug use in 2 years prior to baseline interview Parent/caregiver report

Not applicable

Any illicit drug use

Percentage of parents who engaged in illicit drug use, defined as a report of any illegal drug use in the past 2 years Parent/caregiver report

Not applicable

Problem alcohol use

Percentage of parents with problem alcohol use, defined as a report of alcohol use in the year prior to pregnancy and a CAGE score greater than or equal to 2 Parent/caregiver report

Not reported by author

Healthy Families America (HFA)®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Illicit drug use
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 mothers % = 9.00 % = 9.00 = 0.00 HomeVEE calculated = 0.00 Not statistically significant, p ≥ 0.05
Illicit drug use
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 556 mothers % = 10.00 % = 11.00 = -1.00 HomeVEE calculated = -0.06 Not statistically significant, p ≥ 0.05
Illicit drug use
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, Hawaii trial 548 mothers % = 11.00 % = 9.00 = 2.00 HomeVEE calculated = 0.14 Not statistically significant, p ≥ 0.05
Illicit drug use
FavorableUnfavorable or ambiguousNo Effect
Years 1-3 Full sample, Hawaii trial 564 mothers Not available Not available OR = 1.06 Not available Not statistically significant, p ≥ 0.05
Mothers with depressive symptoms (CES-D)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 mothers % = 23.00 % = 23.00 = 0.00 HomeVEE calculated = 0.00 Not statistically significant, p ≥ 0.05
Mothers with depressive symptoms (CES-D)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 556 mothers % = 16.00 % = 18.00 = -2.00 HomeVEE calculated = -0.09 Not statistically significant, p ≥ 0.05
Mothers with depressive symptoms (CES-D)
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, Hawaii trial 548 mothers % = 16.00 % = 16.00 = 0.00 HomeVEE calculated = 0.00 Not statistically significant, p ≥ 0.05
Mothers with depressive symptoms (CES-D)
FavorableUnfavorable or ambiguousNo Effect
Years 1-3 Full sample, Hawaii trial 564 mothers Not available Not available OR = 0.97 Not available Not statistically significant, p ≥ 0.05

footnote51

Submitted by user on Fri, 03/15/2019 - 14:29

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

Poor general mental health (MHI < 67)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 mothers % = 36.00 % = 46.00 = -10.00 HomeVEE calculated = -0.25 Statistically significant, p < 0.05
Poor general mental health (MHI < 67)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 556 mothers % = 35.00 % = 38.00 = -3.00 HomeVEE calculated = -0.20 Statistically significant, p < 0.05
Poor general mental health (MHI < 67)
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, Hawaii trial 548 mothers % = 29.00 % = 32.00 = -3.00 HomeVEE calculated = -0.09 Not statistically significant, p ≥ 0.05
Problem alcohol use (CAGE)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 mothers % = 8.00 % = 10.00 = -2.00 HomeVEE calculated = -0.15 Not statistically significant, p ≥ 0.05
Problem alcohol use (CAGE)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 556 mothers % = 8.00 % = 9.00 = -1.00 HomeVEE calculated = -0.08 Not statistically significant, p ≥ 0.05
Problem alcohol use (CAGE)
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, Hawaii trial 548 mothers % = 7.00 % = 10.00 = -3.00 HomeVEE calculated = -0.24 Statistically significant, p < 0.05
Problem alcohol use (CAGE)
FavorableUnfavorable or ambiguousNo Effect
Years 1-3 Full sample, Hawaii trial 564 mothers Not available Not available OR = 0.76 Not available Not statistically significant, p ≥ 0.05
Severe parenting stress (PSI)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 mothers % = 11.00 % = 10.00 = 1.00 HomeVEE calculated = 0.06 Not statistically significant, p ≥ 0.05
Severe parenting stress (PSI)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 556 mothers % = 8.00 % = 9.00 = -1.00 HomeVEE calculated = -0.08 Not statistically significant, p ≥ 0.05
Severe parenting stress (PSI)
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, Hawaii trial 548 mothers % = 8.00 % = 8.00 = 0.00 HomeVEE calculated = 0.00 Not statistically significant, p ≥ 0.05
Severe parenting stress (PSI)
FavorableUnfavorable or ambiguousNo Effect
Years 1-3 Full sample, Hawaii trial 564 mothers Not available Not available OR = 1.04 Not available Not statistically significant, p ≥ 0.05
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Outcome measure Outcome measure description Collection method Properties

CES-D: Depressive symptoms

The CES-D is a 20-item assessment of depressive symptoms. A binary variable was formed from the total score where parents with scores greater than or equal to 24 were said to have probable cases of depression. Parent/caregiver report

Not reported by author

MHI: Poor general mental health

The MHI assesses levels of anxiety and depressive symptoms. The researchers created a binary variable where those with MHI scores less than 67 were considered to have poor mental health. Parent/caregiver report

Not reported by author

PSI: Severe parenting stress

The PSI assesses stress in the parent-child relationship arising from child temperament, parental depression, and negatively reinforcing parent-child interactions. A mother was considered positive for severe parenting stress if she scored positive for personal adjustment problems, child abuse potential, or high child abuse potential as defined by Abidin. Parent/caregiver report

Not reported by author

Illicit drug use

Percentage of parents who engaged in illicit drug use, defined as a report of any illegal drug use in the past year Parent/caregiver report

Not reported by author

Problem alcohol use (CAGE)

Percentage of parents with problem alcohol use, defined as a report of alcohol use in the year prior to pregnancy and a CAGE score greater than or equal to 2 Parent/caregiver report

Not reported by author

Healthy Families America (HFA)®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Did not use birth control after index child’s birth
FavorableUnfavorable or ambiguousNo Effect
One year postpartum Full sample, Hawaii trial 564 mothers % (adjusted) = 18.00 Adjusted mean % = 20.00 OR = 0.85 HomeVEE calculated = -0.08 Not statistically significant, p ≥ 0.05
Maternal desire for RRB
FavorableUnfavorable or ambiguousNo Effect
One year postpartum Full sample, Hawaii trial 564 mothers % (adjusted) = 9.00 Adjusted mean % = 11.00 OR = 0.80 HomeVEE calculated = -0.14 Not statistically significant, p ≥ 0.05
No family planning site
FavorableUnfavorable or ambiguousNo Effect
One year postpartum Full sample, Hawaii trial 564 mothers % (adjusted) = 15.00 Adjusted mean % = 14.00 OR = 1.06 HomeVEE calculated = 0.05 Not statistically significant, p ≥ 0.05
Rapidrepeat birth (RRB)
FavorableUnfavorable or ambiguousNo Effect
One year postpartum Full sample, Hawaii trial 564 mothers % (adjusted) = 21.00 Adjusted mean % = 20.00 OR = 1.05 HomeVEE calculated = 0.04 Not statistically significant, p ≥ 0.05

footnote52

Submitted by user on Fri, 03/15/2019 - 14:29

Rapid repeat birth is defined as a birth occurring within 24 months after a previous birth or a repeat birth while still a teen for adolescent mothers (El-Kamary et al., 2004).

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Outcome measure Outcome measure description Collection method Properties

Did not use birth control after index child’s birth

Percentage of mothers who were not using birth control at the time of the interview and who did not use any birth control since the index birth Parent/caregiver report

Not applicable

Maternal desire for RRB

Percentage of mothers who desired to have another child within 2 years after the index birth Parent/caregiver report

Not applicable

No family-planning site

Percentage of mothers who lacked access to a family-planning site Parent/caregiver report

Not applicable

Rapidrepeat birth (RRB)

Percentage of mothers who had a repeat birth within 24 months after the index birth or, for teenagers, had a repeat birth at any time through the age of 19 years Parent/caregiver report

Not applicable

Healthy Families America (HFA)®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
Alcohol use
FavorableUnfavorable or ambiguousNo Effect
12 months Arizona sample 171 mothers Mean % = 12.00 Mean % = 20.50 Mean difference = -8.50 HomeVEE calculated = -0.40 Statistically significant, p = 0.04
Alcohol use
FavorableUnfavorable or ambiguousNo Effect
6 months Arizona sample 180 mothers Mean % = 16.50 Mean % = 35.20 Mean difference = -18.70 HomeVEE calculated = -0.59 Not available
Using birth control
FavorableUnfavorable or ambiguousNo Effect
12 months Arizona sample 171 mothers Mean % = Mean % = 72.20 Not reported Not available Not statistically significant, p = 0.54
Using birth control
FavorableUnfavorable or ambiguousNo Effect
6 months Arizona sample 180 mothers Mean % = 65.80 Mean % = 65.10 Mean difference = 0.70 HomeVEE calculated = 0.03 Not statistically significant, p = 0.061
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Outcome measure Outcome measure description Collection method Properties

Alcohol use

Alcohol use was measured by a series of questions that included: Do you drink beer or alcohol? To which the mother could answer yes or no. If the mother answered yes, then another question was asked: In the past two weeks how many times did you drink beer or alcohol? Parent/caregiver report

Not applicable

Using birth control

A measure of consistent use of birth control since last birth Parent/caregiver report

Not applicable

Findings rated moderate

Healthy Families America (HFA)®
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Healthy Families America (HFA)®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes

Parenting Stress Index - difficult child

FavorableUnfavorable or ambiguousNo Effect

8 years

HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample

380 mothers Unadjusted mean = 24.14 Unadjusted mean = 25.97 Mean difference = -1.83 HomeVEE calculated = -0.24

Not statistically significant, p ≥ 0.05

Parenting Stress Index - parental child-dysfunctional interaction

FavorableUnfavorable or ambiguousNo Effect

8 years

HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample

380 mothers Unadjusted mean = 18.38 Unadjusted mean = 19.71 Mean difference = -1.33 HomeVEE calculated = -0.22

Not statistically significant, p ≥ 0.05

Parenting Stress Index - parental distress

FavorableUnfavorable or ambiguousNo Effect

8 years

HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample

379 mothers Unadjusted mean = 24.41 Unadjusted mean = 26.32 Mean difference = -1.91 HomeVEE calculated = -0.22

Not statistically significant, p ≥ 0.05

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Outcome measure Outcome measure description Collection method Properties

Parenting Stress Index - difficult child

Parenting Stress Index - Difficult Child subscale

Self-report questionnaire

Not reported

Parenting Stress Index - parental child-dysfunctional interaction

Parenting Stress Index - Parental-Child Dysfunctional Interaction subscale

Self-report questionnaire

Not reported

Parenting Stress Index - parental distress

Parenting Stress Index - Parental Distress subscale

Self-report questionnaire

Not reported

Healthy Families America (HFA)®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
CDC Pregnancy Risk Assessment Monitoring System (PRAMS) measure of maternal depression- full sample
FavorableUnfavorable or ambiguousNo Effect
Child's 1st birthday HF Oregon 2010-2012 764 mothers Adjusted mean = 2.17 Adjusted mean = 2.22 Mean difference = -0.05 HomeVEE calculated = -0.06 Not statistically significant, p ≥ 0.05

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

Parenting Stress Index - Short Form (PSI) - General Distress subscale score - full sample
FavorableUnfavorable or ambiguousNo Effect
Child's 1st birthday HF Oregon 2010-2012 764 mothers Adjusted mean = 1.78 Adjusted mean = 1.86 Mean difference = -0.08 HomeVEE calculated = -0.11 Not statistically significant, p ≥ 0.05

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

Parenting Stress Index - Short Form (PSI) - Parenting Stress subscale score - full sample
FavorableUnfavorable or ambiguousNo Effect
Child's 1st birthday HF Oregon 2010-2012 764 mothers Adjusted mean = 2.02 Adjusted mean = 2.14 Mean difference = -0.12 HomeVEE calculated = -0.14 Not statistically significant, p = 0.07

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

Parenting Stress Index - Short Form (PSI) Total Score
FavorableUnfavorable or ambiguousNo Effect
Child's 1st birthday HF Oregon 2010-2012 764 mothers Adjusted mean = 1.90 Adjusted mean = 2.00 Mean difference = -0.10 HomeVEE calculated = -0.14 Not statistically significant, p = 0.06

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

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Outcome measure Outcome measure description Collection method Properties

CDC Pregnancy Risk Assessment Monitoring System (PRAMS) measure of maternal depression- full sample

CDC Pregnancy Risk Assessment Monitoring System (PRAMS) is a 3-item measure of maternal depression. Parent/caregiver report

Not reported by author

Parenting Stress Index - Short Form (PSI) - General Distress subscale score - full sample

The Parenting Stress Index-Short Form General Distress subscale. Parent/caregiver report

Crohnbach's alpha = .715

Parenting Stress Index - Short Form (PSI) - Parenting Stress subscale score - full sample

The Parenting Stress Index-Short Form Parental Distress subscale measures the level of distress parents feel in their role because of personal factors. Parent/caregiver report

Crohnbach's alpha = .638

Parenting Stress Index - Short Form (PSI) Total Score

The Parenting Stress Index-Short Form assesses stress in the parent-child relationship arising from child temperament, parental depression, and negatively reinforcing parent-child interactions. Parent/caregiver report

Crohnbach's alpha = .794

Healthy Families America (HFA)®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes

Contraception use

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted proportion = 0.76 Unadjusted proportion = 0.66 Mean difference = 0.10 Study reported = 0.21

Not statistically significant, p= 0.14

Mental health index

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 19.00 Unadjusted mean = 24.70 Mean difference = -5.70 Study reported = 0.35

Statistically significant, p= 0.02

Subsequent pregnancy

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 mothers Unadjusted mean = 0.05 Unadjusted mean = 0.12 Mean difference = -0.07 Study reported = 0.25

Not statistically significant, p=0.10

Authors describe reduced subsequent pregnancies as favorable to the intervention.

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Outcome measure Outcome measure description Collection method Properties

Contraception use

Whether or not used contraceptives

Parent/caregiver report

Not reported by author

Mental health index

Rand Mental Health Inventory Mental Health Index (negative effect is favorable)

Parent/caregiver report

alpha=.91

Healthy Families America (HFA)®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
Above alcohol abuse cutoff (AUDIT)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY Trial 1061 mothers % (adjusted) = 2.00 Adjusted mean % = 3.80 = -1.80 Not available Not statistically significant, p ≥ 0.05
Above depression threshold (CES-D)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY Trial 1061 mothers % (adjusted) = 29.00 Adjusted mean % = 31.20 = -2.20 Not available Not statistically significant, p ≥ 0.05
Alcohol abuse (AUDIT)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY Trial 1061 mothers Adjusted mean = 1.14 Adjusted mean = 1.28 Mean difference = -0.14 Not available Not statistically significant, p ≥ 0.05
Depressive symptoms (CES-D)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY Trial 1061 mothers Adjusted mean = 11.45 Adjusted mean = 11.61 Mean difference = -0.16 Not available Not statistically significant, p ≥ 0.05
Drug use
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY Trial 1061 mothers % (adjusted) = 9.80 Adjusted mean % = 10.60 = -0.80 Not available Not statistically significant, p ≥ 0.05
Mother has primary care physician
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY Trial 1061 mothers % (adjusted) = 86.90 Adjusted mean % = 85.00 = 1.90 Not available Not statistically significant, p ≥ 0.05
Sense of personal mastery (PSM)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY Trial 1061 mothers Adjusted mean = 23.80 Adjusted mean = 23.55 Mean difference = 0.25 Not available Not statistically significant, p ≥ 0.05
Smoking
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY Trial 1061 mothers % (adjusted) = 41.30 Adjusted mean % = 43.80 = -2.50 Not available Not statistically significant, p ≥ 0.05
Smoking frequency
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY Trial 1061 mothers Adjusted mean = 3.42 Adjusted mean = 3.93 Mean difference = -0.51 Not available Not statistically significant, p ≥ 0.05
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Outcome measure Outcome measure description Collection method Properties

AUDIT: Alcohol abuse

The AUDIT assesses the degree to which a person’s alcohol use is harmful. Respondents reported the frequency with which they experienced eight, different symptoms of alcohol abuse, with possible scores ranging from 0 to 32. A score of 8 or more indicated a strong likelihood of alcohol abuse. The researchers examined the total score and a binary variable representing whether a respondent was above or below the cutoff of 8. Parent/caregiver report

Not reported by author

DAST: Drug use

The DAST assesses the degree to which a person’s use of illegal or legal drugs is harmful. The researchers used the instrument to examine the percentage of parents who reported using illegal drugs. Parent/caregiver report

Not reported by author

CES-D: Depressive symptoms CES-D: Above depression threshold

The CES-D is a 20-item assessment of depressive symptoms. The researchers examined the total score (range 0–60) and a binary measure indicating whether the total depression score was at or above a cutoff of 16, which defined cases of probable depression. Parent/caregiver report

Not reported by author

Mastery ofPsychological CopingResources Scale(PSM): Sense of personal mastery

The PSM assesses the extent to which respondents believe that their life chances are under their own control. The assessment measures the degree of agreement with eight statements related to the respondents’ capacity to affect events and circumstances in their lives. Parent/caregiver report

Not reported by author

Mother has primary care physician

Percentage of mothers who had a primary care physician Parent/caregiver report

Not applicable

Smoking

Percentage of parents who reported smoking cigarettes Parent/caregiver report

Not applicable

Smoking frequency

Average number of cigarettes smoked per day Parent/caregiver report

Not applicable

Healthy Families America (HFA)®
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
Perceived social support (MSSI)
FavorableUnfavorable or ambiguousNo Effect
12 months Program group members not affected by substance abuse,
NY Best Beginnings trial
325 mothers Mean = 6.50 Mean = 6.60 Mean difference = -0.10 HomeVEE calculated = -0.03 Statistical significance not reported
Perceived social support (MSSI)
FavorableUnfavorable or ambiguousNo Effect
24 months Program group members not affected by substance abuse,
NY Best Beginnings trial
274 mothers Mean = 6.20 Mean = 6.60 Mean difference = -0.40 HomeVEE calculated = -0.12 Statistical significance not reported
Perceived social support (MSSI)
FavorableUnfavorable or ambiguousNo Effect
6 months Program group members not affected by substance abuse,
NY Best Beginnings trial
354 mothers Mean = 6.20 Mean = 7.20 Mean difference = -1.00 HomeVEE calculated = -0.31 Statistical significance not reported
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Outcome measure Outcome measure description Collection method Properties

MSSI: Perceived Social Support

The MSSI assesses caregiver social support with regard to the division of household tasks and responsibilities for child rearing, access to transportation, interaction with other adults, and community involvement. The researchers analyzed the 3-item Perceived Social Support subscale, with possible scores ranging from 0 to 13. Parent/caregiver report

Not reported by author

Healthy Families America (HFA)®
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Repeat pregnancy (self report), time 3
FavorableUnfavorable or ambiguousNo Effect
2 years post enrollment MA sample 612 mothers Not reported Not reported OR = 0.94 HomeVEE calculated = -0.04 Not statistically significant, p = 0.72

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

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Outcome measure Outcome measure description Collection method Properties

Repeat pregnancy (self report), time 3

Interview question on whether the mother had become pregnant again since the birth of the target child Mother self-report

Not reported

Healthy Families America (HFA)®
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Repeated birth
FavorableUnfavorable or ambiguousNo Effect
2 years post enrollment MA sample 612 mothers Not reported Not reported OR = 0.73 HomeVEE calculated = -0.19 Not statistically significant, p = 0.161

footnote244

Submitted by user on Fri, 03/15/2019 - 14:29

The <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated p-value of the effect size is statistically significant (p=0.02)

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Outcome measure Outcome measure description Collection method Properties

Repeated birth

Percentage of mothers who gave birth subsequent to the target child Mother self-report

Not reported

Healthy Families America (HFA)®
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Rapid repeat birth
FavorableUnfavorable or ambiguousNo Effect
Child age 2 Full sample, Alaska trial 325 mothers % = 16.00 % = 17.00 OR = 0.96 HomeVEE calculated = -0.04 Not statistically significant, p ≥ 0.05

footnote52

Submitted by user on Fri, 03/15/2019 - 14:29

Rapid repeat birth is defined as a birth occurring within 24 months after a previous birth or a repeat birth while still a teen for adolescent mothers (El-Kamary et al., 2004).

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Outcome measure Outcome measure description Collection method Properties

Rapid repeat birth

Percentage of mothers who had a repeat birth within 24 months after the index birth Parent/caregiver report

Not reported by author

Healthy Families America (HFA)®
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
Emotional loneliness
FavorableUnfavorable or ambiguousNo Effect
6 months Arizona sample 180 mothers Mean = 1.75 Mean = 1.74 Mean difference = 0.01 HomeVEE calculated = 0.01 Not statistically significant, p = 0.34
Pathways to goal
FavorableUnfavorable or ambiguousNo Effect
12 months Arizona sample 171 mothers Mean = 12.96 Mean = 12.69 Mean difference = 0.27 HomeVEE calculated = 1.69 Not statistically significant, p =0.87
Pathways to goal
FavorableUnfavorable or ambiguousNo Effect
6 months Arizona sample 180 mothers Mean = 13.00 Mean = 13.17 Mean difference = -0.17 HomeVEE calculated = -0.89 Not statistically significant, p =0.12
Use of resources
FavorableUnfavorable or ambiguousNo Effect
12 months Arizona sample 171 mothers Mean = 2.53 Mean = 1.95 Mean difference = 0.58 HomeVEE calculated = 1.58 Statistically significant, p =0.001
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Outcome measure Outcome measure description Collection method Properties

Emotional loneliness

The Emotional/Social Loneliness Inventory was used to examine coping and the sense of isolation. Parent/caregiver report

Not reported by author

Pathways to goal

The authors used the Adult Hope Scale subscale that measures the ability to plan for personal goal achievement and referred to it as pathway to goals. Parent/caregiver report

Not reported by author

Use of resources

A scale representing the number of resources the family reported using such as mental health counseling, financial counseling, center-based family assistance, and so forth Parent/caregiver report

Not applicable

Healthy Families America (HFA)®
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Frequency of prenatal care visits during third trimester
FavorableUnfavorable or ambiguousNo Effect
At birth Full sample Not reported Not reported Not reported Not available Statistically significant, p<0.051
Mother has primary care provider
FavorableUnfavorable or ambiguousNo Effect
At birth Full sample Unadjusted proportion = 0.94 Unadjusted proportion = 0.88 Not reported Not available Statistically significant, p<0.05

footnote250

Submitted by user on Fri, 03/15/2019 - 14:29

<abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr> reported p value.

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Outcome measure Outcome measure description Collection method Properties

Frequency of prenatal care visits during third trimester

Mother was asked about the frequency of prenatal care visits during third trimester. Maternal interview

Not reported

Mother has primary care provider

Mother was asked if had primary care provider. Maternal interview

Not reported

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