Healthy Families America (HFA)®
Model effectiveness research report last updated: 2020
Effects shown in research
Child health
Findings rated high
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Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance |
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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 |
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Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance |
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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 |
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Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance |
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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 |
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Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance |
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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 |
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Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
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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 | Negative value is favorable to the intervention.
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Preterm birth | FavorableUnfavorable or ambiguousNo Effect |
At birth | Full sample | Not reported | Not reported | Not reported | Not available | Not statistically significant, p ≥ 0.05 |
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Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance |
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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 |
Show findings details
Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
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Child hospitalized for ambulatory care sensitive conditions ( |
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 | Ambulatory care sensitive conditions include: asthma, pneumonia, other upper airway conditions, gastroenteritis, dehydration, cellulitis, and seizures.
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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
Show findings details
Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance |
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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 |
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Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
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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 |
Negative effect is favorable to the intervention. 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 |
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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 |
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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 |
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 |
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 |
Show findings details
Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
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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 | Negative value is favorable to the intervention.
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Show findings details
Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance |
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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 |
Show findings details
Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance |
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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 |