Healthy Families America (HFA)® Meets HHS Criteria

Model effectiveness research report last updated: 2020

Effects shown in research

Child 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
Adequate well-child visits
FavorableUnfavorable or ambiguousNo Effect
Year 2 Children in custody of biological mother at interview, Alaska trial 249 children % (adjusted) = 4.00 Adjusted mean % = 8.00 OR = 0.96 HomVEE calculated = -0.45 Not statistically significant, p ≥ 0.05
Has primary care provider
FavorableUnfavorable or ambiguousNo Effect
Year 2 Children in custody of biological mother at interview, Alaska trial 249 children % (adjusted) = 74.00 Adjusted mean % = 78.00 OR = 0.76 HomVEE calculated = -0.13 Not statistically significant, p ≥ 0.05
Immunizations up-to-date
FavorableUnfavorable or ambiguousNo Effect
Year 2 Children in custody of biological mother at interview, Alaska trial 249 children % (adjusted) = 27.00 Adjusted mean % = 27.00 OR = 1.01 HomVEE calculated = 0.00 Not statistically significant, p ≥ 0.05
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
Hospitalizations for ambulatory care
FavorableUnfavorable or ambiguousNo Effect
Years 1-3 Full sample, Hawaii trial 573 children % = 12.00 % = 10.00 OR = 1.27 HomVEE calculated = 0.12 Not statistically significant, p ≥ 0.05
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
Child has regular health care site
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, San Diego trial 435 children % = 98.10 % = 97.70 = 0.40 HomVEE calculated = 0.12 Not statistically significant, p ≥ 0.05
Child has regular health care site
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, San Diego trial 412 children % = 98.00 % = 98.50 = -0.50 HomVEE calculated = -0.18 Not statistically significant, p ≥ 0.05
Child has specific health care provider
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, San Diego trial 435 children % = 74.00 % = 81.60 = -7.60 HomVEE calculated = -0.27 Not statistically significant, p ≥ 0.05
Child has specific health care provider
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, San Diego trial 412 children % = 63.60 % = 72.20 = -8.60 HomVEE calculated = -0.24 Not statistically significant, p ≥ 0.05
Compliance with recommended number of well-child visits
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, San Diego trial 435 children % = 58.60 % = 59.60 = -1.00 HomVEE calculated = -0.03 Not statistically significant, p ≥ 0.05
Compliance with recommended number of well-child visits
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, San Diego trial 412 children % = 85.80 % = 83.80 = 3.00 HomVEE calculated = 0.09 Not statistically significant, p ≥ 0.05
Immunizations up-to-date
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, San Diego trial 412 children % = 96.90 % = 95.90 = 1.00 HomVEE calculated = 0.18 Not statistically significant, p ≥ 0.05
Number of sick visits
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, San Diego trial 435 children Median = 3.00 Median = 3.00 Not reported Not available Not statistically significant, p ≥ 0.05
Number of sick visits
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, San Diego trial 412 children Median = 1.00 Median = 1.00 Not reported Not available Not statistically significant, p ≥ 0.05
Number of well-child visits
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, San Diego trial 435 children Mean = 7.00 Mean = 6.80 Mean difference = 0.20 HomVEE calculated = 0.05 Not statistically significant, p ≥ 0.05
Number of well-child visits
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, San Diego trial 412 children Mean = 2.40 Mean = 1.90 Mean difference = 0.50 HomVEE calculated = 0.22 Statistically significant,
p < 0.05
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

Immunizations

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 children Unadjusted mean = 13.70 Unadjusted mean = 13.70 Mean difference = 0.00 Study reported = 0.04

Not statistically significant, p= 0.79

Well-baby checks

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 children Unadjusted mean = 4.00 Unadjusted mean = 4.10 Mean difference = -0.10 Study reported = -0.06

Not statistically significant, p= 0.70

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
Low birth weight
FavorableUnfavorable or ambiguousNo Effect
At birth Full sample Adjusted proportion = 0.05 Adjusted proportion = 0.10 OR = 0.43 HomVEE calculated = -0.51 Statistically significant, p = 0.02
Submitted by user on
Negative value is favorable to the intervention.
Preterm birth
FavorableUnfavorable or ambiguousNo Effect
At birth Full sample Not reported Not reported Not reported Not available Not statistically significant, p ≥ 0.05
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
Ever hospitalized for any reason
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 children % = 17.00 % = 18.00 = -1.00 HomVEE calculated = -0.04 Not statistically significant, p ≥ 0.05
Ever hospitalized for any reason
FavorableUnfavorable or ambiguousNo Effect
Years 1 and 2 Full sample, Hawaii trial 534 children % = 19.00 % = 22.00 = 3.00 HomVEE calculated = -0.11 Not statistically significant, p ≥ 0.05
Ever used emergency department
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 children % = 40.00 % = 44.00 = -4.00 HomVEE calculated = -0.10 Not statistically significant, p ≥ 0.05
Ever used emergency department
FavorableUnfavorable or ambiguousNo Effect
Years 1 and 2 Full sample, Hawaii trial 534 children % = 58.00 % = 60.00 = -2.00 HomVEE calculated = -0.05 Not statistically significant, p ≥ 0.05
Has a PCP who handles most health care needs
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 children % = 93.00 % = 90.00 = 3.00 HomVEE calculated = 0.24 Not statistically significant, p ≥ 0.05
Has a PCP who handles most health care needs
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 567 children % = 89.00 % = 84.00 = 5.00 HomVEE calculated = 0.26 Not statistically significant, p ≥ 0.05
Has a PCP who knows all aspects of child’s care
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 children % = 84.00 % = 79.00 = 5.00 HomVEE calculated = 0.20 Not statistically significant, p ≥ 0.05
Has a PCP who knows all aspects of child’s care
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 567 children % = 80.00 % = 75.00 = 5.00 HomVEE calculated = 0.17 Not statistically significant, p ≥ 0.05
Has a PCP who knows family’s concerns about child
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 children % = 45.00 % = 48.00 = 3.00 HomVEE calculated = -0.07 Not statistically significant, p ≥ 0.05
Has a PCP who knows family’s concerns about child
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 567 children % = 50.00 % = 39.00 = 11.00 HomVEE calculated = 0.27 Statistically significant,
p < 0.05
Has a primary care provider (PCP)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 children % = 94.00 % = 90.00 = 4.00 HomVEE calculated = 0.34 Not statistically significant, p ≥ 0.05
Has a primary care provider (PCP)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 567 children % = 91.00 % = 86.00 = 5.00 HomVEE calculated = 0.30 Not statistically significant, p ≥ 0.05
Immunizations up-to-date
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 children % = 82.00 % = 82.00 = 0.00 HomVEE calculated = 0.00 Not statistically significant, p ≥ 0.05
Immunizations up-to-date
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 567 children % = 87.00 % = 85.00 = 2.00 HomVEE calculated = 0.10 Not statistically significant, p ≥ 0.05
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
Child hospitalized for ambulatory care sensitive conditions (ACSC)
FavorableUnfavorable or ambiguousNo Effect
Years 1 and 2 Families with complete medical record data, Alaska trial 268 families % (adjusted) = 9.00 Adjusted mean % = 9.00 OR = 1.09 HomVEE calculated = 0.00 Not statistically significant, p ≥ 0.05
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Ambulatory care sensitive conditions include: asthma, pneumonia, other upper airway conditions, gastroenteritis, dehydration, cellulitis, and seizures.
Child seen in emergency department for ACSC
FavorableUnfavorable or ambiguousNo Effect
Years 1 and 2 Families with complete medical record data, Alaska trial 268 families % (adjusted) = 81.00 Adjusted mean % = 78.00 OR = 1.23 HomVEE calculated = 0.11 Not statistically significant, p ≥ 0.05
Number of times hospitalized for ACSC
FavorableUnfavorable or ambiguousNo Effect
Years 1 and 2 Families with complete medical record data, Alaska trial 268 families Adjusted mean = 0.11 Adjusted mean = 0.12 Mean difference = -0.01 Not available Not statistically significant, p ≥ 0.05
Number of times seen in emergency department for ACSC
FavorableUnfavorable or ambiguousNo Effect
Years 1 and 2 Families with complete medical record data, Alaska trial 268 families Adjusted mean = 3.13 Adjusted mean = 4.09 Mean difference = -0.96 Not available Not statistically significant, p ≥ 0.05

Findings rated moderate

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
Number of pediatric emergency department visits
FavorableUnfavorable or ambiguousNo Effect
36 months Program group children not affected by substance abuse,
NY Best Beginnings trial
271 children Not available Not available Beta = 0.12 Not available Statistically significant,
p < 0.05
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

Asthma (diagnosed past year)

FavorableUnfavorable or ambiguousNo Effect

8 years

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

384 children Adjusted proportion = 0.07 Adjusted proportion = 0.14 Odds ratio = 0.46 HomVEE calculated = -0.47

Statistically significant, p <.05

Submitted by user on

Negative effect is favorable to the intervention.

Submitted by barbara on

HomVEE calculated the effect size based on the study-reported odds ratio.

Child had dental visit (past year)

FavorableUnfavorable or ambiguousNo Effect

8 years

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

379 children Unadjusted proportion = 0.95 Unadjusted proportion = 0.98 Mean difference = -0.03 HomVEE calculated = -0.60

Not statistically significant, p ≥ 0.05

Child had well visit (past year)

FavorableUnfavorable or ambiguousNo Effect

8 years

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

383 children Unadjusted proportion = 0.99 Unadjusted proportion = 0.99 Mean difference = 0.00 HomVEE calculated = 0.00

Not statistically significant, p ≥ 0.05

Child visited emergency room (past year)

FavorableUnfavorable or ambiguousNo Effect

8 years

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

383 children Unadjusted proportion = 0.27 Unadjusted proportion = 0.24 Mean difference = 0.03 HomVEE calculated = 0.11

Not statistically significant, p ≥ 0.05

Submitted by user on

Negative effect is favorable to the intervention.

Obesity/overweight (past year)

FavorableUnfavorable or ambiguousNo Effect

8 years

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

384 children Unadjusted proportion = 0.05 Unadjusted proportion = 0.05 Mean difference = 0.01 HomVEE calculated = 0.08

Not statistically significant, p ≥ 0.05

Submitted by user on

Negative effect is favorable to the intervention.

Pediatric Quality of Life Inventory - physical functioning

FavorableUnfavorable or ambiguousNo Effect

8 years

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

381 children Adjusted mean = 93.91 Adjusted mean = 91.91 Mean difference = 2.00 Study reported = 0.20

Statistically significant, p <.05

Effect size is the Cohen's d

Pediatric Quality of Life Inventory - school functioning

FavorableUnfavorable or ambiguousNo Effect

8 years

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

383 children Unadjusted mean = 78.24 Unadjusted mean = 78.06 Mean difference = 0.18 HomVEE calculated = 0.01

Not statistically significant, p ≥ 0.05

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
Baby received developmental screening in first year of life
FavorableUnfavorable or ambiguousNo Effect
Child's 1st birthday HF Oregon 2010-2012 762 mothers Adjusted proportion = 0.94 Adjusted proportion = 0.87 OR = 0.41 Not available Statistically significant, p = 0.00
Child ever breastfed - full sample
FavorableUnfavorable or ambiguousNo Effect
Child's 1st birthday HF Oregon 2010-2012 752 mothers Adjusted proportion = 0.91 Adjusted proportion = 0.91 OR = 0.91 Not available Not statistically significant, p ≥ 0.05
Parent ever told that child was not on track developmentally - full sample
FavorableUnfavorable or ambiguousNo Effect
Child's 1st birthday HF Oregon 2010-2012 762 mothers Adjusted proportion = 0.05 Adjusted proportion = 0.09 OR = 1.46 Not available Not statistically significant, p = 0.08
Submitted by user on
Negative value is favorable to the intervention.
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

Breastfeeding

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted proportion = 0.89 Unadjusted proportion = 0.79 Mean difference = 0.10 Study reported = 0.29

Statistically significant, p= 0.04

Immunizations

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 children Unadjusted mean = 19.00 Unadjusted mean = 19.80 Mean difference = -0.80 Study reported = -0.02

Not statistically significant, p= 0.23

Well-baby checks

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 children Unadjusted mean = 0.98 Unadjusted mean = 1.00 Mean difference = -0.02 Study reported = -0.15

Not statistically significant, p= 0.15

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
Child ever without needed medical care
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY Trial 1061 children % = 2.20 % = 1.40 Not reported HomVEE calculated = 0.28 Not statistically significant, p ≥ 0.05
Child has primary care provider
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY Trial 1061 children % = 98.40 % = 98.60 = -0.20 HomVEE calculated = -0.08 Not statistically significant, p ≥ 0.05
Mother breastfed baby
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY Trial 1060 mothers % = 45.90 % = 44.70 = 1.20 Not available Not statistically significant, p ≥ 0.05
Number of months breastfed
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY Trial 1060 mothers Adjusted mean = 1.01 Adjusted mean = 1.04 Mean difference = -0.03 Not available Not statistically significant, p ≥ 0.05
Number of well-baby visits
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY Trial 1061 children Adjusted mean = 4.54 Adjusted mean = 4.61 Mean difference = -0.07 Not available Not statistically significant, p ≥ 0.05
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