Healthy Families America (HFA)® Meets HHS Criteria

Model effectiveness research report last updated: 2020

Effects shown in research

Positive parenting practices

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 Notes
Child Response Score NCAST
FavorableUnfavorable or ambiguousNo Effect
Age 2 Children in custody of biological mother at year 2 follow-up interview, Alaska trial 249 children Adjusted mean = 18.40 Adjusted mean = 18.50 Mean difference = -0.90 Not available Not statistically significant, p ≥ 0.05
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Child’s response to a caregiver who is teaching him/her a new skill.
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
Maternal acceptance of child’s behavior (HOME)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 558 mothers Mean = 5.60 Mean = 5.70 Mean difference = -0.10 Not available Statistical significance not reported
Maternal acceptance of child’s behavior (HOME)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 549 mothers Mean = 5.40 Mean = 5.40 Mean difference = 0.00 Not available Statistical significance not reported
Maternal acceptance of child’s behavior (HOME)
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, Hawaii trial 541 mothers Mean = 3.20 Mean = 3.00 Mean difference = 0.20 Not available Statistical significance not reported
Maternal responsivity to child (HOME)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 558 mothers Mean = 9.30 Mean = 9.20 Mean difference = 0.10 Not available Statistical signifivance not reported
Maternal responsivity to child (HOME)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 549 mothers Mean = 9.30 Mean = 8.90 Mean difference = 0.40 Not available Statistical significance not reported
Maternal responsivity to child (HOME)
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, Hawaii trial 541 mothers Mean = 4.80 Mean = 4.50 Mean difference = 0.30 Not available Statistical significance not reported
Maternal responsivity to child (HOME)
FavorableUnfavorable or ambiguousNo Effect
Years 1-3 Full sample, Hawaii trial 558 mothers Not available Not available Mean difference = 0.18 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
Mother-child interaction, Caregiver total score (NCAST)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, San Diego trial 435 mothers Mean = 37.10 Mean = 35.90 Mean difference = 1.20 HomVEE calculated = 0.16 Not statistically significant, p ≥ 0.05
Mother-child interaction, Caregiver total score (NCAST)
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, San Diego trial 412 mothers Mean = 40.30 Mean = 39.80 Mean difference = 0.50 HomVEE calculated = 0.09 Not statistically significant, p ≥ 0.05
Mother-child interaction, Child total score (NCAST)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, San Diego trial 435 mothers Mean = 17.30 Mean = 16.80 Mean difference = 0.50 HomVEE calculated = 0.15 Not statistically significant, p ≥ 0.05
Mother-child interaction, Child total score (NCAST)
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, San Diego trial 412 mothers Mean = 16.60 Mean = 16.40 Mean difference = 0.20 HomVEE calculated = 0.05 Not statistically significant, p ≥ 0.05
Nonviolent discipline (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, San Diego trial 435 mothers % = 100.00 % = 99.50 = 0.50 HomVEE calculated = 0.00 Not statistically significant, p ≥ 0.05
Nonviolent discipline (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, San Diego trial 412 mothers % = 95.50 % = 95.50 = 0.00 HomVEE calculated = 0.00 Not statistically significant, p ≥ 0.05
Quality of home environment (HOME)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, San Diego trial 435 mothers Mean = 35.60 Mean = 35.20 Mean difference = 0.40 HomVEE calculated = 0.06 Not statistically significant, p ≥ 0.05
Quality of home environment (HOME)
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, San Diego trial 412 mothers Mean = 40.10 Mean = 40.10 Mean difference = 0.00 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 Notes

Depression

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 39.80 Unadjusted mean = 39.80 Mean difference = 0.00 Study reported = 0.00

Not statistically significant, p= 0.85

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Negative effect is favorable to the intervention.

Home environment

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 42.80 Unadjusted mean = 39.90 Mean difference = 2.90 Study reported = 0.47

Statistically significant, p= 0.00

Linguistic dimension - Affective processes

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 17.40 Unadjusted mean = 15.00 Mean difference = 2.40 Study reported = 0.24

Not statistically significant, p= 0.15

Linguistic dimension - Anger

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 0.39 Unadjusted mean = 0.41 Mean difference = -0.02 Study reported = 0.06

Not statistically significant, p= 0.70

Linguistic dimension - Cause

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 2.10 Unadjusted mean = 1.30 Mean difference = 0.80 Study reported = 0.39

Statistically significant, p= 0.01

Linguistic dimension - Certainty

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 1.40 Unadjusted mean = 0.82 Mean difference = 0.58 Study reported = 0.27

Not statistically significant, p= 0.08

Linguistic dimension - Cognitive mechanism

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 16.40 Unadjusted mean = 13.40 Mean difference = 3.00 Study reported = 0.44

Statistically significant, p= 0.01

Linguistic dimension - Feeling expression

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 1.60 Unadjusted mean = 0.77 Mean difference = 0.83 Study reported = 0.50

Statistically significant, p= 0.00

Linguistic dimension - First person

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 3.70 Unadjusted mean = 3.30 Mean difference = 0.40 Study reported = 0.10

Not statistically significant, p= 0.60

Linguistic dimension - Future

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 0.18 Unadjusted mean = 0.20 Mean difference = -0.02 Study reported = -0.02

Not statistically significant, p= 0.81

Linguistic dimension - Insight

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 3.20 Unadjusted mean = 2.20 Mean difference = 1.00 Study reported = 0.33

Statistically significant, p= 0.05

Authors reported this finding as statistically significant.

Linguistic dimension - Negative valanced

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 1.90 Unadjusted mean = 2.80 Mean difference = -0.90 Study reported = 0.29

Not statistically significant, p= 0.08

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Negative effect is favorable to the intervention.

Linguistic dimension - Past

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 0.94 Unadjusted mean = 1.65 Mean difference = -0.71 Study reported = 0.27

Not statistically significant, p= 0.10

Linguistic dimension - Perceptual process

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 4.20 Unadjusted mean = 2.90 Mean difference = 1.30 Study reported = 0.33

Statistically significant, p= 0.04

Linguistic dimension - Positive valanced

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 15.30 Unadjusted mean = 12.00 Mean difference = 3.30 Study reported = 0.37

Statistically significant, p= 0.02

Linguistic dimension - Present

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 17.00 Unadjusted mean = 14.60 Mean difference = 2.40 Study reported = 0.34

Statistically significant, p= 0.01

Linguistic dimension - Sad

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 0.78 Unadjusted mean = 1.50 Mean difference = -0.72 Study reported = 0.42

Statistically significant, p= 0.01

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Negative effect is favorable to the intervention.

Linguistic dimension -Anxiety

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 0.20 Unadjusted mean = 0.53 Mean difference = -0.33 Study reported = 0.15

Not statistically significant, p= 0.35

Mother's reading to child

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 4.10 Unadjusted mean = 3.60 Mean difference = 0.50 Study reported = 0.38

Statistically significant, p= 0.01

Parent efficacy

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 26.20 Unadjusted mean = 25.80 Mean difference = 0.40 Study reported = 0.11

Not statistically significant, p= 0.47

Parent/child behavior

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mother/child dyads Unadjusted mean = 46.00 Unadjusted mean = 44.90 Mean difference = 1.10 Study reported = 0.24

Not statistically significant, p= 0.13

Reduced chaotic household

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 1.20 Unadjusted mean = 1.40 Mean difference = -0.20 Study reported = 0.29

Statistically significant, p= 0.04

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Negative effect is favorable to the intervention.

Regular routines

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 1.80 Unadjusted mean = 1.60 Mean difference = 0.20 Study reported = 0.36

Statistically significant, p= 0.02

Role satisfaction

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 25.70 Unadjusted mean = 26.90 Mean difference = -1.20 Study reported = -0.33

Not statistically significant, p= 0.06

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
Learning environment (HOME)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 mothers Mean = 35.20 Mean = 35.20 Mean difference = 0.00 Not available Not statistically significant, p ≥ 0.05
Learning environment (HOME)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 567 mothers Mean = 34.60 Mean = 34.10 Mean difference = 0.50 Not available Not statistically significant, p ≥ 0.05
Mother-child interaction, Caregiver total score (NCAST)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 mothers Mean = 12.80 Mean = 12.70 Mean difference = 0.10 Not available Not statistically significant, p ≥ 0.05
Mother-child interaction, Caregiver total score (NCAST)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 567 mothers Mean = 15.00 Mean = 14.60 Mean difference = 0.40 Not available Not statistically significant, p ≥ 0.05
Mother-child interaction, Child total score (NCAST)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 mothers Mean = 6.80 Mean = 6.50 Mean difference = 0.30 Not available Not statistically significant, p ≥ 0.05
Mother-child interaction, Child total score (NCAST)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 567 mothers Mean = 7.20 Mean = 7.20 Mean difference = 0.00 Not available Not statistically significant, p ≥ 0.05
Parenting efficacy (PSOC)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 mothers Mean = 75.20 Mean = 74.40 Mean difference = 0.80 Not available Not statistically significant, p ≥ 0.05
Parenting efficacy (PSOC)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 567 mothers Mean = 76.10 Mean = 74.10 Not reported 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
Mother relinquished role (child lived separately from mother for one month or more)
FavorableUnfavorable or ambiguousNo Effect
Years 1 and 2 Full sample, Alaska trial 322 families % = 18.00 % = 16.00 OR = 1.19 HomVEE calculated = 0.09 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
Aggressive discipline
FavorableUnfavorable or ambiguousNo Effect
12 months Arizona sample 168 mothers Mean = 1.44 Mean = 1.83 Mean difference = -0.39 HomVEE calculated = -2.43 Not statistically significant, p =0.10
Belief in corporal punishment
FavorableUnfavorable or ambiguousNo Effect
6 months Arizona sample 180 mothers Mean = 2.25 Mean = 2.15 Mean difference = 0.10 HomVEE calculated = 0.15 Not statistically significant, p =0.12
Belief in corporal punishment (AAPI-2)
FavorableUnfavorable or ambiguousNo Effect
12 months Arizona sample 168 mothers Mean = 2.21 Mean = 2.23 Mean difference = -0.02 HomVEE calculated = -0.03 Not statistically significant, p =0.63
Inappropriate expectations
FavorableUnfavorable or ambiguousNo Effect
6 months Arizona sample 180 mothers Mean = 3.05 Mean = 2.88 Mean difference = 0.17 HomVEE calculated = 0.22 Not statistically significant, p =0.10
Inappropriate expectations (AAPI-2)
FavorableUnfavorable or ambiguousNo Effect
12 months Arizona sample 168 mothers Mean = 2.77 Mean = 2.77 Mean difference = 0.00 HomVEE calculated = 0.00 Not statistically significant, p =0.91
Lack of empathy
FavorableUnfavorable or ambiguousNo Effect
6 months Arizona sample 180 mothers Mean = 1.95 Mean = 1.94 Mean difference = 0.01 HomVEE calculated = 0.02 Not statistically significant, p = 0.54
Lack of empathy (AAPI-2)
FavorableUnfavorable or ambiguousNo Effect
12 months Arizona sample 168 mothers Mean = 1.80 Mean = 1.78 Mean difference = 0.02 HomVEE calculated = 0.04 Not statistically significant, p =0.91
Mother's reading
FavorableUnfavorable or ambiguousNo Effect
12 months Arizona sample 168 mothers Mean = 2.26 Mean = 2.22 Mean difference = 0.04 HomVEE calculated = 0.27 Not statistically significant, p =0.85
Mother's reading
FavorableUnfavorable or ambiguousNo Effect
6 months Arizona sample 180 mothers Mean = 2.46 Mean = 2.72 Mean difference = -0.26 HomVEE calculated = -1.62 Not statistically significant, p =0.28
Never called name, cursed
FavorableUnfavorable or ambiguousNo Effect
12 months Arizona sample 168 mothers Mean % = 96.40 Mean % = 94.10 Mean difference = 2.30 HomVEE calculated = 0.26 Not statistically significant, p =0.33
Never hit elsewhere
FavorableUnfavorable or ambiguousNo Effect
12 months Arizona sample 168 mothers Mean % = 98.80 Mean % = 96.50 Mean difference = 2.30 HomVEE calculated = 0.68 Not statistically significant, p =0.28
Never pinched child
FavorableUnfavorable or ambiguousNo Effect
12 months Arizona sample 168 mothers Mean % = 98.80 Mean % = 94.10 Mean difference = 4.70 HomVEE calculated = 1.12 Not statistically significant, p =0.15
Never shouted, yelled at child
FavorableUnfavorable or ambiguousNo Effect
12 months Arizona sample 168 mothers Mean % = 50.60 Mean % = 34.10 Mean difference = 16.50 HomVEE calculated = 0.43 Statistically significant, p =0.02
Never slapped hand
FavorableUnfavorable or ambiguousNo Effect
12 months Arizona sample 168 mothers Mean % = 56.60 Mean % = 38.80 Mean difference = 17.80 HomVEE calculated = 0.42 Statistically significant, p =0.03
Never slapped on face
FavorableUnfavorable or ambiguousNo Effect
12 months Arizona sample 168 mothers Mean % = 100.00 Mean % = 97.60 Mean difference = 2.40 Not available Not statistically significant, p =0.99
Never smacked/threatened, hit
FavorableUnfavorable or ambiguousNo Effect
12 months Arizona sample 168 mothers Mean % = 69.50 Mean % = 63.50 Mean difference = 6.00 HomVEE calculated = 0.16 Not statistically significant, p =0.30
Never spanked
FavorableUnfavorable or ambiguousNo Effect
12 months Arizona sample 168 mothers Mean % = 71.10 Mean % = 65.80 Mean difference = 5.30 HomVEE calculated = 0.14 Not statistically significant, p =0.19
Never threw object at child
FavorableUnfavorable or ambiguousNo Effect
12 months Arizona sample 168 mothers Mean % = 100.00 Mean % = 98.80 Mean difference = 1.20 Not available Not statistically significant, p =0.32
Oppressing child's independence
FavorableUnfavorable or ambiguousNo Effect
12 months Arizona sample 168 mothers Mean = Mean = 3.32 Not reported Not available Not statistically significant, p =0.68
Oppressing child's independence (AAPI-2)
FavorableUnfavorable or ambiguousNo Effect
6 months Arizona sample 180 mothers Mean = 3.62 Mean = 3.58 Mean difference = 0.04 HomVEE calculated = 0.10 Not statistically significant, p =0.06
Reversing roles
FavorableUnfavorable or ambiguousNo Effect
6 months Arizona sample 180 mothers Mean = 2.60 Mean = 2.47 Mean difference = 0.13 HomVEE calculated = 0.17 Not statistically significant, p =0.32
Reversing roles (AAPI-2)
FavorableUnfavorable or ambiguousNo Effect
12 months Arizona sample 168 mothers Mean = Mean = 2.25 Not reported Not available Not statistically significant, p =0.33
Safety practices
FavorableUnfavorable or ambiguousNo Effect
12 months Arizona sample 168 mothers Mean = 17.96 Mean = 17.07 Mean difference = 0.89 HomVEE calculated = 1.17 Not statistically significant, p =0.42
Safety practices
FavorableUnfavorable or ambiguousNo Effect
6 months Arizona sample 180 mothers Mean = 17.95 Mean = 16.05 Mean difference = 1.90 HomVEE calculated = 3.00 Statistically significant, p = 0.04

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
Caregiver contingency score (NCAST)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Biological mothers with custody of index child at interview, Alaska trial 249 mothers Adjusted mean = 15.40 Adjusted mean = 15.00 Mean difference = 0.40 Not available Not statistically significant, p ≥ 0.05
Cognitive growth fostering (NCAST)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Biological mothers with custody of index child at interview, Alaska trial 249 mothers Adjusted mean = 11.80 Adjusted mean = 11.90 Mean difference = -0.10 Not available Not statistically significant, p ≥ 0.05
Infant caregiving (AAPI)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Biological mothers with custody of index child at interview, Alaska trial 249 mothers Adjusted mean = 112.10 Adjusted mean = 109.50 Mean difference = 2.60 Not available Not statistically significant, p ≥ 0.05
Maternal self-efficacy (Teti scale)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Biological mothers with custody of index child at interview, Alaska trial 249 mothers Adjusted mean = 35.10 Adjusted mean = 34.60 Mean difference = 0.50 Not available Statistically significant,
p < 0.05
Parenting attitudes (AAPI)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Biological mothers with custody of index child at interview, Alaska trial 249 mothers Adjusted mean = 130.00 Adjusted mean = 125.60 Mean difference = 4.50 Not available Not statistically significant, p ≥ 0.05
Parenting knowledge (KIDI)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Biological mothers with custody of index child at interview, Alaska trial 249 mothers Adjusted mean = 73.50 Adjusted mean = 70.70 Mean difference = 2.80 Not available Not statistically significant, p ≥ 0.05
Quality of home environment (HOME)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Biological mothers with custody of index child at interview, Alaska trial 249 mothers Adjusted mean = 36.70 Adjusted mean = 35.90 Mean difference = 0.80 Not available Not statistically significant, p ≥ 0.05
Recognition of child developmental delay
FavorableUnfavorable or ambiguousNo Effect
Year 2 Biological mothers with custody of index child at interview, Alaska trial 249 mothers % = 20.00 % = 24.00 Not reported HomVEE calculated = -0.14 Not statistically significant, p ≥ 0.05
Response to distress (NCAST)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Biological mothers with custody of index child at interview, Alaska trial 249 mothers Adjusted mean = 9.20 Adjusted mean = 8.90 Mean difference = 0.30 Not available Not statistically significant, p ≥ 0.05
Sensitivity to cues (NCAST)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Biological mothers with custody of index child at interview, Alaska trial 249 mothers Adjusted mean = 9.40 Adjusted mean = 9.20 Mean difference = 0.20 Not available Not statistically significant, p ≥ 0.05
Social-emotional growth fostering (NCAST)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Biological mothers with custody of index child at interview, Alaska trial 249 mothers Adjusted mean = 9.00 Adjusted mean = 8.80 Mean difference = 0.20 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
Change in father’s engagement score
FavorableUnfavorable or ambiguousNo Effect
Years 1-3 All families 600 families Not available Not available OR = 0.20 HomVEE calculated = -0.97 Not statistically significant, p ≥ 0.05
Change in father’s responsibility score
FavorableUnfavorable or ambiguousNo Effect
Years 1-3 All families 600 families Not available Not available OR = 0.00 Not available Not statistically significant, p ≥ 0.05
Father has daily contact with child
FavorableUnfavorable or ambiguousNo Effect
Years 1-3 All families 600 families Not available Not available OR = 1.12 HomVEE calculated = 0.07 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

Family Involvement Questionnaire - Home-Based Involvement

FavorableUnfavorable or ambiguousNo Effect

8 years

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

373 mothers Unadjusted mean = 22.16 Unadjusted mean = 21.74 Mean difference = 0.42 HomVEE calculated = 0.10

Not statistically significant, p ≥ 0.05

Family Involvement Questionnaire - Home-School Conferencing

FavorableUnfavorable or ambiguousNo Effect

8 years

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

388 mothers Unadjusted mean = 20.18 Unadjusted mean = 19.34 Mean difference = 0.84 HomVEE calculated = 0.14

Not statistically significant, p ≥ 0.05

Family Involvement Questionnaire: School-Based Involvement

FavorableUnfavorable or ambiguousNo Effect

8 years

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

341 mothers Unadjusted mean = 13.30 Unadjusted mean = 13.28 Mean difference = 0.02 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 Notes
Adult Adolescent Parenting Inventory Corporal Punishment Subscale (AAPI-CP) Score - full sample
FavorableUnfavorable or ambiguousNo Effect
Child's 1st birthday HF Oregon 2010-2012 763 mothers Adjusted mean = 1.89 Adjusted mean = 1.97 Mean difference = -0.08 HomVEE calculated = -0.10 Not statistically significant, p ≥ 0.05
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Negative value is favorable to the intervention.
Number of times in last month parent read to child - full sample
FavorableUnfavorable or ambiguousNo Effect
Child's 1st birthday HF Oregon 2010-2012 764 mothers Adjusted mean = 4.74 Adjusted mean = 4.43 Mean difference = 0.31 HomVEE calculated = 0.26 Statistically significant, p = 0.00
Parent-Child Activities Scale (PCAS) score - full sample
FavorableUnfavorable or ambiguousNo Effect
Child's 1st birthday HF Oregon 2010-2012 764 mothers Adjusted mean = 4.84 Adjusted mean = 4.73 Mean difference = 0.11 HomVEE calculated = 0.15 Statistically significant, p = 0.02
Protective Factors Survey (PFS) - Family Functioning Subscale - full sample
FavorableUnfavorable or ambiguousNo Effect
Child's 1st birthday HF Oregon 2010-2012 764 mothers Adjusted mean = 4.16 Adjusted mean = 4.15 Mean difference = 0.01 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

Father contact with child

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 children Unadjusted mean = 0.85 Unadjusted mean = 0.84 Mean difference = 0.01 Study reported = 0.02

Not statistically significant, p= 0.86

Home environment

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 mothers Unadjusted mean = 43.50 Unadjusted mean = 41.80 Mean difference = 1.70 Study reported = 0.32

Statistically significant, p= 0.04

Linguistic dimension - Affective processes

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 mothers Unadjusted mean = 18.90 Unadjusted mean = 18.10 Mean difference = 0.80 Study reported = 0.08

Not statistically significant, p= 0.67

Linguistic dimension - Anger

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 mothers Unadjusted mean = 0.57 Unadjusted mean = 0.52 Mean difference = 0.05 Study reported = -0.04

Not statistically significant, p= 0.84

Linguistic dimension - Cause

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 mothers Unadjusted mean = 2.90 Unadjusted mean = 1.20 Mean difference = 1.70 Study reported = 0.50

Statistically significant, p= 0.01

Linguistic dimension - Certainty

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 mothers Unadjusted mean = 1.20 Unadjusted mean = 1.90 Mean difference = -0.70 Study reported = -0.26

Statistically significant, p= 0.03

Linguistic dimension - Cognitive mechanism

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 mothers Unadjusted mean = 16.50 Unadjusted mean = 13.40 Mean difference = 3.10 Study reported = 0.42

Statistically significant, p= 0.02

Linguistic dimension - Feeling expression

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 mothers Unadjusted mean = 2.00 Unadjusted mean = 0.81 Mean difference = 1.19 Study reported = 0.39

Statistically significant, p= 0.02

Linguistic dimension - First person

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 mothers Unadjusted mean = 3.10 Unadjusted mean = 1.80 Mean difference = 1.30 Study reported = 0.34

Statistically significant, p= 0.00

Linguistic dimension - Future

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 mothers Unadjusted mean = 0.22 Unadjusted mean = 0.13 Mean difference = 0.09 Study reported = 0.12

Not statistically significant, p= 0.55

Linguistic dimension - Insight

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 mothers Unadjusted mean = 3.70 Unadjusted mean = 2.60 Mean difference = 1.10 Study reported = 0.28

Not statistically significant, p= 0.12

Linguistic dimension - Negative valanced

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 mothers Unadjusted mean = 0.59 Unadjusted mean = 1.50 Mean difference = -0.91 Study reported = 0.54

Statistically significant, p= 0.03

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Negative effect is favorable to the intervention.

Linguistic dimension - Past

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 mothers Unadjusted mean = 0.65 Unadjusted mean = 0.61 Mean difference = 0.04 Study reported = -0.02

Not statistically significant, p= 0.87

Linguistic dimension - Perceptual process

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 mothers Unadjusted mean = 3.50 Unadjusted mean = 3.10 Mean difference = 0.40 Study reported = 0.10

Not statistically significant, p= 0.50

Linguistic dimension - Positive valanced

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 mothers Unadjusted mean = 17.10 Unadjusted mean = 16.20 Mean difference = 0.90 Study reported = 0.08

Not statistically significant, p= 0.63

Linguistic dimension - Present

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 mothers Unadjusted mean = 17.80 Unadjusted mean = 16.70 Mean difference = 1.10 Study reported = 0.15

Not statistically significant, p= 0.37

Linguistic dimension - Sad

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 mothers Unadjusted mean = 0.56 Unadjusted mean = 0.67 Mean difference = -0.11 Study reported = 0.08

Not statistically significant, p= 0.64

Submitted by user on

Negative effect is favorable to the intervention.

Linguistic dimension -Anxiety

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 mothers Unadjusted mean = 0.17 Unadjusted mean = 0.30 Mean difference = -0.13 Study reported = 0.15

Not statistically significant, p= 0.44

Mobilizing resources

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 24.60 Unadjusted mean = 22.20 Mean difference = 2.40 Study reported = 0.43

Statistically significant, p= 0.01

Mother's reading to child

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 children Unadjusted mean = 3.90 Unadjusted mean = 4.00 Mean difference = -0.10 Study reported = -0.09

Not statistically significant, p= 0.53

Parent/child behavior

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 mother/child dyads Unadjusted mean = 46.00 Unadjusted mean = 45.10 Mean difference = 0.90 Study reported = 0.21

Not statistically significant, p= 0.21

Personal care

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 19.20 Unadjusted mean = 18.70 Mean difference = 0.50 Study reported = 0.14

Not statistically significant, p= 0.38

Problem solving

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 24.60 Unadjusted mean = 23.80 Mean difference = 0.80 Study reported = 0.20

Not statistically significant, p= 0.20

Reduced chaotic household

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 mothers Unadjusted mean = 1.80 Unadjusted mean = 1.80 Mean difference = 0.00 Study reported = 0.00

Not statistically significant, p= 0.95

Submitted by user on

Negative effect is favorable to the intervention.

Regular routines

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 mothers Unadjusted mean = 2.40 Unadjusted mean = 2.20 Mean difference = 0.20 Study reported = 0.25

Not statistically significant, p= 0.18

Safety practices

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted proportion = 0.70 Unadjusted proportion = 0.53 Mean difference = 0.17 Study reported = 0.17

Statistically significant, p= 0.01

Social support

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted mean = 21.60 Unadjusted mean = 20.60 Mean difference = 1.00 Study reported = 0.17

Not statistically significant, p= 0.26

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
Attitudes: Empathy (AAPI-2)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY trial 1060 mothers Adjusted mean = 37.12 Adjusted mean = 36.64 Mean difference = 0.48 Not available Not statistically significant, p ≥ 0.05
Attitudes: Inappropriate expectations (AAPI-2)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY trial 1060 mothers Adjusted mean = 19.11 Adjusted mean = 18.83 Mean difference = 0.28 Not available Not statistically significant, p ≥ 0.05
Attitudes: Physical punishment (AAPI-2)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY trial 1060 mothers Adjusted mean = 38.43 Adjusted mean = 38.01 Mean difference = 0.42 Not available Not statistically significant, p ≥ 0.05
Attitudes: Power/independence (AAPI-2)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY trial 1060 mothers Adjusted mean = 19.39 Adjusted mean = 19.40 Mean difference = -0.01 Not available Not statistically significant, p ≥ 0.05
Attitudes: Role reversal (AAPI-2)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY trial 1060 mothers Adjusted mean = 23.59 Adjusted mean = 23.24 Mean difference = 0.35 Not available Not statistically significant, p ≥ 0.05
Child safety checklist
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY trial 1060 mothers % = 86.10 % = 85.90 Not reported Not available Not statistically significant, p ≥ 0.05
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
Attitudes toward corporal punishment (AAPI)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Biological mothers with custody of index child at follow-up, Alaska trial 246 mothers Adjusted mean = 20.50 Adjusted mean = 10.10 Mean difference = 0.38 Not available Not statistically significant, p ≥ 0.05
Poor caregiver interaction, (NCAST score = 35)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Biological mothers with custody of index child at follow-up, Alaska trial 246 mothers % = 17.00 % = 21.00 OR = 0.79 HomVEE calculated = -0.16 Not statistically significant, p ≥ 0.05
Poor quality home environment (HOME score = 33)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Biological mothers with custody of index child at follow-up, Alaska trial 246 mothers % = 20.00 % = 31.00 OR = 0.51 HomVEE calculated = -0.36 Statistically significant,
p < 0.05
Total AAPI score
FavorableUnfavorable or ambiguousNo Effect
Year 2 Biological mothers with custody of index child at follow-up, Alaska trial 246 mothers Adjusted mean = 130.00 Adjusted mean = 125.60 Mean difference = 4.47 Not available Not Statistically significant,
p >: 0.05
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