Health Access Nurturing Development Services (HANDS) Program Meets HHS Criteria

Last updated: July 2015

Effects Shown in Research & Outcome Measure Details

Summary of Findings

Please read Describing Effects for more information on these categories. Only results from studies that meet the standards for the high or moderate ratings are included above.

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Reductions in Child Maltreatment

Impact Studies Rated Moderate

Health Access Nurturing Development Services (HANDS) Program
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Outcome measure Effect Follow-up Timing Sample Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type Notes
Substantiated reports of child maltreatment (proportion)
FavorableUnfavorableNo Effect
Unknown Kentucky 2011-2012 matched 4506 infants Unadjusted mean = 0.06 Unadjusted mean = 0.11 OR = 0.53 HomeVEE calculated = -0.38 Statistically significant, p = 0.00 Primary

footnote213

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

Negative effect is favorable.

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Outcome Measure Outcome Measure Description Collection method Properties Outcome Type Operations links

Substantiated reports of child maltreatment (proportion)

Percentage of families who had a substantiated report for child maltreatment Administrative data

Not reported by author

Primary
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Family Economic Self-Sufficiency

Impact Studies Rated Moderate

Health Access Nurturing Development Services (HANDS) Program
Show Study Effects Details
Outcome measure Effect Follow-up Timing Sample Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type
Maternal receipt of WIC
FavorableUnfavorableNo Effect
Birth Kentucky 2011-2012 matched, Bluegrass 898 mother/child dyads Unadjusted mean = 0.89 Unadjusted mean = 0.71 OR = 3.31 HomeVEE calculated = 0.72 Statistically significant, p = 0.00 Primary
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Outcome Measure Outcome Measure Description Collection method Properties Outcome Type Operations links

Maternal receipt of WIC

Percentage of women who received WIC for themselves during pregnancy Live birth records

Not reported by author

Primary
Health Access Nurturing Development Services (HANDS) Program
Show Study Effects Details
Outcome measure Effect Follow-up Timing Sample Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type
Maternal receipt of WIC
FavorableUnfavorableNo Effect
Birth Kentucky 2011-2012 matched, KIPDA 376 mother/child dyads Unadjusted mean = 0.80 Unadjusted mean = 0.87 OR = 0.52 HomeVEE calculated = -0.40 Statistically significant, p = 0.04 Primary
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Outcome Measure Outcome Measure Description Collection method Properties Outcome Type Operations links

Maternal receipt of WIC

Percentage of women who received WIC for themselves during pregnancy Live birth records

Not reported by author

Primary
Health Access Nurturing Development Services (HANDS) Program
Show Study Effects Details
Outcome measure Effect Follow-up Timing Sample Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type
Maternal receipt of WIC (proportion)
FavorableUnfavorableNo Effect
Birth Kentucky 2011-2012 matched 4506 mothers Unadjusted mean = 0.92 Unadjusted mean = 0.88 OR = 1.57 HomeVEE calculated = 0.27 Statistically significant, p = 0.00 Primary
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Maternal Health

Impact Studies Rated Moderate

Health Access Nurturing Development Services (HANDS) Program
Show Study Effects Details
Outcome measure Effect Follow-up Timing Sample Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type Notes
Adequate prenatal care
FavorableUnfavorableNo Effect
Birth Kentucky 2011-2012 matched, Bluegrass 898 mother/child dyads Unadjusted mean = 0.77 Unadjusted mean = 0.50 OR = 4.23 HomeVEE calculated = 0.87 Statistically significant, p = 0.00 Primary
Pregnancy-induced hypertension
FavorableUnfavorableNo Effect
Birth Kentucky 2011-2012 matched, Bluegrass 898 mother/child dyads Unadjusted mean = 0.11 Unadjusted mean = 0.20 OR = 0.49 HomeVEE calculated = -0.43 Statistically significant, p = 0.00 Primary

footnote213

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

Negative effect is favorable.

Show Study Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection method Properties Outcome Type Operations links

Adequate prenatal care

Percentage of mothers who received adequate prenatal care during their pregnancy, as defined by the Kotelchuck Index Live birth records

Not reported by author

Primary

Pregnancy-induced hypertension

Percentage of women who experienced pregnancy-induced hypertension Live birth records

Not reported by author

Primary
Health Access Nurturing Development Services (HANDS) Program
Show Study Effects Details
Outcome measure Effect Follow-up Timing Sample Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type Notes
Adequate prenatal care
FavorableUnfavorableNo Effect
Birth Kentucky 2011-2012 matched, KIPDA 376 mother/child dyads Unadjusted mean = 0.65 Unadjusted mean = 0.72 OR = 0.78 HomeVEE calculated = -0.15 Not statistically significant, p = 0.17 Primary
Pregnancy-induced hypertension
FavorableUnfavorableNo Effect
Birth Kentucky 2011-2012 matched, KIPDA 376 mother/child dyads Unadjusted mean = 0.11 Unadjusted mean = 0.20 OR = 0.56 HomeVEE calculated = -0.35 Statistically significant, p = 0.02 Primary

footnote213

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

Negative effect is favorable.

Show Study Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection method Properties Outcome Type Operations links

Adequate prenatal care

Percentage of mothers who received adequate prenatal care during their pregnancy, as defined by the Kotelchuck Index Live birth records

Not reported by author

Primary

Pregnancy-induced hypertension

Percentage of women who experienced pregnancy-induced hypertension Live birth records

Not reported by author

Primary
Health Access Nurturing Development Services (HANDS) Program
Show Study Effects Details
Outcome measure Effect Follow-up Timing Sample Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type Notes
Adequate prenatal care (proportion)
FavorableUnfavorableNo Effect
Birth Kentucky 2011-2012 matched 4506 mothers Unadjusted mean = 0.74 Unadjusted mean = 0.71 OR = 1.14 HomeVEE calculated = 0.08 Statistically significant, p = 0.05 Primary
Maternal complications during delivery (proportion)
FavorableUnfavorableNo Effect
Birth Kentucky 2011-2012 matched 4506 mothers Unadjusted mean = 0.02 Unadjusted mean = 0.03 OR = 0.60 HomeVEE calculated = -0.31 Statistically significant, p = 0.01 Primary

footnote213

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

Negative effect is favorable.

Maternal weight gain during pregnancy (pounds)
FavorableUnfavorableNo Effect
Birth Kentucky 2011-2012 matched 4506 mothers Not reported Not reported Mean difference = -1.20 Not available Statistically significant, p = 0.05 Primary
Pregnancy-induced hypertension (proportion)
FavorableUnfavorableNo Effect
Birth Kentucky 2011-2012 matched 4506 mothers Unadjusted mean = 0.09 Unadjusted mean = 0.18 OR = 0.51 HomeVEE calculated = -0.41 Statistically significant, p = 0.00 Primary

footnote213

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

Negative effect is favorable.

Show Study Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection method Properties Outcome Type Operations links

Adequate prenatal care (proportion)

Percentage of mothers who received adequate prenatal care during their pregnancy, as defined by the Kotelchuck Index Live birth records

Not reported by author

Primary

Maternal complications during delivery (proportion)

Percentage of women who experienced any complications associated with labor and delivery Live birth records

Not reported by author

Primary

Maternal receipt of WIC (proportion)

Percentage of women who received WIC for themselves during pregnancy Live birth records

Not reported by author

Primary

Maternal weight gain during pregnancy (pounds)

The change in reported weight (pounds) from pre-pregnancy to delivery Live birth records

Not reported by author

Primary

Pregnancy-induced hypertension (proportion)

Percentage of women who experienced pregnancy-induced hypertension Live birth records

Not reported by author

Primary
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Child Health

Impact Studies Rated Moderate

Health Access Nurturing Development Services (HANDS) Program
Show Study Effects Details
Outcome measure Effect Follow-up Timing Sample Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type Notes
Infant deceased in hospital (proportion)
FavorableUnfavorableNo Effect
Birth Kentucky 2011-2012 matched 4506 infants Unadjusted mean = 0.00 Unadjusted mean = 0.02 OR = 0.06 HomeVEE calculated = -1.70 Statistically significant, p = 0.00 Primary

footnote213

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

Negative effect is favorable.

Low birth weight (proportion)
FavorableUnfavorableNo Effect
Birth Kentucky 2011-2012 matched 4506 infants Unadjusted mean = 0.07 Unadjusted mean = 0.12 OR = 0.54 HomeVEE calculated = -0.37 Statistically significant, p = 0.00 Primary

footnote213

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

Negative effect is favorable.

Preterm birth (proportion)
FavorableUnfavorableNo Effect
Birth Kentucky 2011-2012 matched 4506 infants Unadjusted mean = 0.11 Unadjusted mean = 0.14 OR = 0.74 HomeVEE calculated = -0.18 Statistically significant, p = 0.00 Primary

footnote213

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

Negative effect is favorable.

Show Study Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection method Properties Outcome Type Operations links

Infant deceased in hospital (proportion)

Percentage of infants who were not living at the time the birth certificate was completed Live birth records

Not reported by author

Primary

Low birth weight (proportion)

Percentage of children who were identified as low birth weight (<2500 grams) Live birth records

Not reported by author

Primary

Preterm birth (proportion)

Percentage of children who were delivered at less than 37 weeks’ gestation Live birth records

Not reported by author

Primary
Health Access Nurturing Development Services (HANDS) Program
Show Study Effects Details
Outcome measure Effect Follow-up Timing Sample Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type Notes
Low birth weight
FavorableUnfavorableNo Effect
Birth Kentucky 2011-2012 matched, Bluegrass 898 mother/child dyads Unadjusted mean = 0.08 Unadjusted mean = 0.05 OR = 1.57 HomeVEE calculated = 0.27 Not statistically significant, p = 0.10 Primary
Preterm birth
FavorableUnfavorableNo Effect
Birth Kentucky 2011-2012 matched, Bluegrass 898 mother/child dyads Unadjusted mean = 0.10 Unadjusted mean = 0.31 OR = 0.21 HomeVEE calculated = -0.95 Statistically significant, p = 0.00 Primary

footnote213

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

Negative effect is favorable.

Show Study Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection method Properties Outcome Type Operations links

Low birth weight

Percentage of children who were identified as low birth weight (<2500 grams) Live birth records

Not reported by author

Primary

Preterm birth

Percentage of children who were delivered at less than 37 weeks’ gestation Live birth records

Not reported by author

Primary
Health Access Nurturing Development Services (HANDS) Program
Show Study Effects Details
Outcome measure Effect Follow-up Timing Sample Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type Notes
Breastfeeding
FavorableUnfavorableNo Effect
Birth Kentucky 2011-2012 matched, KIPDA 376 mother/child dyads Unadjusted mean = 0.70 Unadjusted mean = 0.54 OR = 2.16 HomeVEE calculated = 0.47 Statistically significant, p = 0.00 Primary
Low birth weight
FavorableUnfavorableNo Effect
Birth Kentucky 2011-2012 matched, KIPDA 376 mother/child dyads Unadjusted mean = 0.07 Unadjusted mean = 0.15 OR = 0.44 HomeVEE calculated = -0.50 Statistically significant, p = 0.02 Primary

footnote213

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

Negative effect is favorable.

Preterm birth
FavorableUnfavorableNo Effect
Birth Kentucky 2011-2012 matched, KIPDA 376 mother/child dyads Unadjusted mean = 0.12 Unadjusted mean = 0.15 OR = 0.76 HomeVEE calculated = -0.17 Not statistically significant, p = 0.36 Primary
Show Study Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection method Properties Outcome Type Operations links

Breastfeeding

Percentage of women who were breastfeeding when discharged from the hospital Live birth records

Not reported by author

Primary

Low birth weight

Percentage of children who were identified as low birth weight (<2500 grams) Live birth records

Not reported by author

Primary

Preterm birth

Percentage of children who were delivered at less than 37 weeks’ gestation Live birth records

Not reported by author

Primary
Health Access Nurturing Development Services (HANDS) Program
Show Study Effects Details
Outcome measure Effect Follow-up Timing Sample Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type
Breastfeeding (proportion)
FavorableUnfavorableNo Effect
Birth Kentucky 2011-2012 matched 4506 mothers Unadjusted mean = 0.55 Unadjusted mean = 0.57 OR = 0.91 HomeVEE calculated = -0.06 Not statistically significant, p = 0.15 Primary
Show Study Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection method Properties Outcome Type Operations links

Breastfeeding (proportion)

Percentage of women who were breastfeeding when discharged from the hospital Live birth records

Not reported by author

Primary
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Model Overview

Theoretical Model

HANDS is based on several key assumptions:

  • All families have strengths.
  • Families are responsible for their children.
  • Families are the primary decision makers regarding their children.
  • Communities recognize their roles in children’s lives.
  • Communities recognize that all children must succeed.
  • Prevention and early intervention improve the community’s well-being.
  • Public and private partnerships are vital to a successful program.
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Model Components

HANDS providers first screen referred families for risk factors. Screening may occur prenatally or after birth until the child is 3 months old. Risk factors include unemployment; isolation; substance abuse; unstable housing; low parental education; domestic violence; poor prenatal care; depression; single parenting; noncompliance with prenatal care; unsuccessful abortion; or current use of tobacco, including prenatal and infant exposure to secondhand smoke. Any family that (1) is single, separated, or divorced; (2) began prenatal care after 12 weeks of pregnancy or has had poor care compliance or no prenatal care; (3) has considered abortion during this pregnancy; or (4) has two or more risk factors is eligible to receive services.

A trained home visitor conducts home visits; frequency is determined on the basis of the family’s needs. Home visitors use the Growing Great Kids™ (GGK) curriculum and provide services that focus on supporting the family, family-child interaction, child development, and personal responsibility. Services include developmental and social-emotional screenings for children and domestic violence and perinatal depression screening for parents. Health prevention is also a key focus of HANDS home visitation. Visitors work with families to establish medical homes and maintain up-to-date immunizations and well-child checks. In addition, a registered nurse or social worker provides quarterly visits to focus on the signs of premature labor, labor and delivery, home safety, basic care, nutrition, exercise, safe sleeping, effects of smoking and secondhand smoke, stress, babies’ cues, injury prevention, child development and temperament, and adjusting to parenting.

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Target Population

HANDS targets first-time parents beginning during pregnancy or any time before a child is 3 months old. Eligible families face multiple challenges, including single-parent status, low incomes, substance abuse, and domestic violence.

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Where to Find Out More

Health Access Nurturing Development Services (HANDS)
Cabinet for Health and Family Services
275 East Main Street
Frankfort, KY 40621
(502) 564-3756

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In Brief

Evidence of Model Effectiveness

This model meets the criteria established by the Department of Health and Human Services (HHS) for an “evidence-based early childhood home visiting service delivery model’ for the general population, but does not meet the criteria for tribal populations.

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Model Description

HANDS is a voluntary home visiting program designed to prevent child maltreatment, improve family functioning, facilitate positive pregnancy and child health outcomes, and maximize child growth and development. The program targets first-time pregnant mothers or parents with children up to 3 months old, who have multiple challenges, such as single parenthood, low income, substance abuse problems, or being victims of abuse or domestic violence. A trained paraprofessional or professional home visitor, such as a social worker, conducts prenatal and postnatal home visits with parents; provides parenting information, problem solving techniques, parenting skill development; and addresses basic needs. The level of services offered to families varies and is based on the needs of the family and the pace at which they progress through the program. For more information, please read the Model Overview.

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Extent of Evidence

Results of Research and Review
Number of studies
Eligible for review
10
Rated high
0
Rated moderate
4
Rated low
4
Additional source1
2

For more information, see the study database. For more information on the criteria used to determine the study ratings, please read Producing Study Ratings.

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Summary of Findings

Please read Describing Effects for more information on these categories. Only results from studies that meet the standards for the high or moderate ratings are included above.

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Criteria Established by the Department of Health and Human Services

Information Based on Comprehensive Review of All High- and Moderate-Impact Studies for this Model
High- or moderate-quality impact study?
Yes
Across high- or moderate-quality studies, favorable impacts in at least two outcome domains within one sample OR the same domain for at least two non-overlapping samples?
Yes
Favorable impacts on full sample?
Yes
Any favorable impacts on outcome measures sustained at least 12 months after model enrollment?1
Yes
One or more favorable, statistically significant impact reported in a peer-reviewed journal?1
No

Please read the HHSCriteria for Evidence-Based Models for more information.

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