Healthy Families America (HFA)® Meets HHS Criteria

Last updated: September 2018

Effects Shown in Research & Outcome Measure Details

Child Development and School Readiness

Outcomes Rated High

Healthy Families America (HFA)®
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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
BSID Cognitive score
FavorableUnfavorableNo Effect
Age 2 Children with complete medical record data, Alaska trial 249 children Adjusted mean = 88.00 Adjusted mean = 84.80 Mean difference = 3.20 Not available Statistically significant,
p < 0.05
Primary
BSID percentage within normal limits on cognitive
FavorableUnfavorableNo Effect
Age 2 Children with complete medical record data, Alaska trial 249 children % (adjusted) = 58.00 Adjusted mean % = 48.00 OR = 1.55 HomeVEE calculated = 0.24 Statistically significant,
p < 0.05
Primary
BSID percentage within normal limits on psychomotor
FavorableUnfavorableNo Effect
Age 2 Children with complete medical record data, Alaska trial 249 children % (adjusted) = 85.00 Adjusted mean % = 80.00 OR = 1.36 HomeVEE calculated = 0.21 Not statistically significant,
p > 0.05
Primary
BSID Psychomotor score
FavorableUnfavorableNo Effect
Age 2 Children with complete medical record data, Alaska trial 249 children Adjusted mean = 98.10 Adjusted mean = 96.00 Mean difference = 2.10 Not available Not statistically significant,
p > 0.05
Primary
CBCL percentage with externalizing scores in normal range
FavorableUnfavorableNo Effect
Age 2 Children in custody of biological mother at year 2 follow-up interview, Alaska trial 249 children % (adjusted) = 82.00 Adjusted mean % = 77.00 OR = 1.48 HomeVEE calculated = 0.19 Statistically significant,
p < 0.05
Primary
CBCL percentage with internalizing scores in normal range
FavorableUnfavorableNo Effect
Age 2 Children in custody of biological mother at year 2 follow-up interview, Alaska trial 249 children % (adjusted) = 87.00 Adjusted mean % = 79.00 OR = 2.06 HomeVEE calculated = 0.35 Statistically significant,
p < 0.05
Primary
CBCL total externalizing score
FavorableUnfavorableNo Effect
Age 2 Children in custody of biological mother at year 2 follow-up interview, Alaska trial 249 children Adjusted mean = 50.80 Adjusted mean = 53.00 Mean difference = -2.20 Not available Not statistically significant,
p > 0.05
Primary
CBCL total internalizing score
FavorableUnfavorableNo Effect
Age 2 Children in custody of biological mother at year 2 follow-up interview, Alaska trial 249 children Adjusted mean = 48.20 Adjusted mean = 51.00 Mean difference = -2.80 Not available Statistically significant,
p < 0.05
Primary
Child Response Score NCAST
FavorableUnfavorableNo 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
Primary

footnote56

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

Child’s response to a caregiver who is teaching him/her a new skill.

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

BSID: MDI and PDI

The BSID tests the mental, motor, and behavioral development and abilities of young children. The researchers examined the MDI and PDI as continuous and binary for scores <85 versus those greater than or equal to 85. Child assessment

Not reported by author

Primary

CBCL: Internalizing and Externalizing

The CBCL is a questionnaire that assesses behavioral problems in young children. The internalizing and externalizing scales were measured as continuous and as a binary variable using recommended cut points for normal (<60) versus borderline (60–63) and clinical scores (>63). Parent/caregiver report

Not reported by author

Primary

NCAST: Child responsiveness

The NCAST assesses the quality of caregiver-child teaching interaction. The researchers examined the composite child interaction score. Observation

Not reported by author

Primary
Healthy Families America (HFA)®
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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
Aggressive behaviors (CBCL)
FavorableUnfavorableNo Effect
7 year New York sample 897 mothers Adjusted mean = 6.99 Adjusted mean = 6.72 Mean difference = 0.27 Study reported = 0.04 Not statistically significant, p > 0.05 Primary
Attention problems (CBCL)
FavorableUnfavorableNo Effect
7 year New York sample 897 mothers Adjusted mean = 4.77 Adjusted mean = 4.75 Mean difference = 0.02 Study reported = 0.01 Not statistically significant, p > 0.05 Primary
Percentage participating in a gifted program
FavorableUnfavorableNo Effect
7 year New York sample 897 mothers Adjusted mean % = 5.38 Adjusted mean % = 1.99 OR = 2.80 Not available Statistically significant, p < 0.05 Secondary
Percentage receiving remedial services
FavorableUnfavorableNo Effect
7 year New York sample 897 mothers Adjusted mean % = 32.83 Adjusted mean % = 33.31 OR = 0.98 Not available Not statistically significant, p > 0.05 Secondary
Percentage receiving special education
FavorableUnfavorableNo Effect
7 year New York sample 897 mothers Adjusted mean % = 12.33 Adjusted mean % = 16.74 OR = 0.70 Not available Statistically significant, p < 0.05 Secondary
Percentage repeating a grade
FavorableUnfavorableNo Effect
7 year New York sample 897 mothers Adjusted mean % = 12.33 Adjusted mean % = 16.74 OR = 0.98 Not available Not statistically significant, p > 0.05 Secondary
Percentage skipping school more than once
FavorableUnfavorableNo Effect
7 year New York sample 897 mothers Adjusted mean % = 2.40 Adjusted mean % = 2.20 OR = 1.08 Not available Not statistically significant, p > 0.05 Secondary
Rule-breaking behavior (CBCL)
FavorableUnfavorableNo Effect
7 year New York sample 897 mothers Adjusted mean = 2.74 Adjusted mean = 2.66 Mean difference = 0.08 Study reported = 0.03 Not statistically significant, p > 0.05 Primary
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Aggressive behaviors (CBCL)

The Achenbach Child Behavior Checklist assesses children’s emotional and behavioral problems. Researchers selected five subscales that aligned with constructs of interest: attention problems, rule breaking and aggressive behaviors, social problems, and the anxious-depressed and withdrawn-depressed syndrome scales. Parent/caregiver report

Not reported by author

Primary

Attention problems (CBCL)

The Achenbach Child Behavior Checklist assesses children’s emotional and behavioral problems. Researchers selected five subscales that aligned with constructs of interest: attention problems, rule breaking and aggressive behaviors, social problems, and the anxious-depressed and withdrawn-depressed syndrome scales. Parent/caregiver report

Not reported by author

Primary

Percentage participating in a gifted program

Percentage of children who were participating in a gifted or talented program at the time of the year 7 interview Parent/caregiver report

 Not applicable

Secondary

Percentage receiving remedial services

Percentage of children who were receiving remedial education services for math and writing at the time of the year 7 interview Parent/caregiver report

 Not applicable

Secondary

Percentage receiving special education

Percentage of children who were enrolled in special education services at the time of the year 7 interview Parent/caregiver report

 Not applicable

Secondary

Percentage repeating a grade

Percentage of children who had repeated a grade at the time of the year 7 interview Parent/caregiver report

 Not applicable

Secondary

Percentage skipping school more than once

Percentage of children who had skipped school more than once at the time of the year 7 interview Parent/caregiver report

 Not applicable

Secondary

Rule-breaking behavior (CBCL)

The Achenbach Child Behavior Checklist assesses children’s emotional and behavioral problems. Researchers selected five subscales that aligned with constructs of interest: attention problems, rule breaking and aggressive behaviors, social problems, and the anxious-depressed and withdrawn-depressed syndrome scales. Parent/caregiver report

Not applicable

Primary
Healthy Families America (HFA)®
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
BSID, Mental Development Index (MDI)
FavorableUnfavorableNo Effect
Year 1 Full sample, San Diego trial 422 children Mean = 105.00 Mean = 102.50 Mean difference = 2.50 HomeVEE calculated = 0.23 Statistically significant,
p < 0.05
Primary
BSID, Motor MDI
FavorableUnfavorableNo Effect
Year 1 Full sample, San Diego trial 422 children Mean = 113.50 Mean = 113.00 Mean difference = 0.50 HomeVEE calculated = 0.04 Not statistically significant,
p > 0.05
Primary
CBCL Aggressive T score
FavorableUnfavorableNo Effect
Year 3 Full sample, San Diego trial 382 children Mean = 53.50 Mean = 53.60 Mean difference = -0.10 HomeVEE calculated = -0.02 Not statistically significant,
p > 0.05
Primary
CBCL Anxious/Depressed T score
FavorableUnfavorableNo Effect
Year 3 Full sample, San Diego trial 382 children Mean = 53.50 Mean = 54.30 Mean difference = -0.80 HomeVEE calculated = -0.14 Not statistically significant,
p > 0.05
Primary
CBCL Behavior Problems
FavorableUnfavorableNo Effect
Year 3 Full sample, San Diego trial 382 children Mean = 49.70 Mean = 51.10 Mean difference = -1.40 HomeVEE calculated = -0.15 Not statistically significant,
p > 0.05
Primary
CBCL Destructive T score
FavorableUnfavorableNo Effect
Year 3 Full sample, San Diego trial 382 children Mean = 53.60 Mean = 53.35 Mean difference = 0.30 HomeVEE calculated = 0.05 Not statistically significant,
p > 0.05
Primary
CBCL Externalizing problems T score
FavorableUnfavorableNo Effect
Year 3 Full sample, San Diego trial 382 children Mean = 49.40 Mean = 49.90 Mean difference = -0.50 HomeVEE calculated = -0.06 Not statistically significant,
p > 0.05
Primary
CBCL Internalizing problems T score
FavorableUnfavorableNo Effect
Year 3 Full sample, San Diego trial 382 children Mean = 50.90 Mean = 52.60 Mean difference = -1.70 HomeVEE calculated = -0.17 Not statistically significant,
p > 0.05
Primary
CBCL Sleep problems T score
FavorableUnfavorableNo Effect
Year 3 Full sample, San Diego trial 382 children Mean = 52.30 Mean = 52.70 Mean difference = -0.40 HomeVEE calculated = -0.09 Not statistically significant,
p > 0.05
Primary
CBCL Somatic problems T score
FavorableUnfavorableNo Effect
Year 3 Full sample, San Diego trial 382 children Mean = 53.80 Mean = 55.20 Mean difference = -1.40 HomeVEE calculated = -0.24 Statistically significant,
p < 0.05
Primary
CBCL Withdrawn T score
FavorableUnfavorableNo Effect
Year 3 Full sample, San Diego trial 382 children Mean = 55.10 Mean = 56.10 Mean difference = -1.00 HomeVEE calculated = -0.13 Not statistically significant,
p > 0.05
Primary
Stanford Binet Abstract/Visual Reasoning SAS
FavorableUnfavorableNo Effect
Year 3 Full sample, San Diego trial 412 children Mean = 90.60 Mean = 90.50 Mean difference = 0.10 HomeVEE calculated = 0.01 Not statistically significant,
p > 0.05
Primary
Stanford Binet Communication Survey
FavorableUnfavorableNo Effect
Year 3 Full sample, San Diego trial 412 children Mean = 101.80 Mean = 101.90 Mean difference = -0.10 HomeVEE calculated = -0.01 Not statistically significant,
p > 0.05
Primary
Stanford Binet Partial Composite
FavorableUnfavorableNo Effect
Year 3 Full sample, San Diego trial 412 children Mean = 91.30 Mean = 91.30 Mean difference = 0.00 HomeVEE calculated = 0.00 Not statistically significant,
p > 0.05
Primary
Stanford Binet Short Term Memory SAS
FavorableUnfavorableNo Effect
Year 3 Full sample, San Diego trial 412 children Mean = 98.60 Mean = 97.80 Mean difference = 0.80 HomeVEE calculated = 0.08 Not statistically significant,
p > 0.05
Primary
Stanford Binet Sum of Area SAS
FavorableUnfavorableNo Effect
Year 3 Full sample, San Diego trial 412 children Mean = 326.90 Mean = 331.60 Mean difference = -4.70 HomeVEE calculated = -0.06 Not statistically significant,
p > 0.05
Primary
Stanford Binet Verbal Reasoning Memory SAS
FavorableUnfavorableNo Effect
Year 3 Full sample, San Diego trial 412 children Mean = 86.50 Mean = 87.30 Mean difference = -0.80 HomeVEE calculated = -0.07 Not statistically significant,
p > 0.05
Primary
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BSID: MDI and PDI

The BSID tests the mental, motor, and behavioral development and abilities of young children. The researchers examined both the mental development and psychomotor development scales. Child assessment

Not reported by author

Primary

CBCL:

  • Anxious/Depressed
  • Withdrawn
  • Sleep problems
  • Somatic problems
  • Aggressive
  • Destructive
  • Behavior problems
  • Internalizing problems
  • Externalizing problems
The CBCL is a questionnaire that assesses behavioral problems in young children. The researchers analyzed subscales related to withdrawal, sleep, somatic, aggressiveness, destructiveness, internalizing, and externalizing problems and behaviors. Parent/caregiver report

Not reported by author

Primary

Stanford Binet:

  • Short Term Memory SAS
  • Abstract/Visual Reasoning SAS
  • Verbal Reasoning Memory SAS
  • Sum of Area SAS
  • Partial Composite
  • Communication Survey
The Stanford-Binet assesses intelligence in young children. The researchers examined abstract/visual reasoning, verbal reasoning memory, communication, and summary and composite measures of intelligence. Child assessment

Not reported by author

Primary

Outcomes Rated Moderate

Healthy Families America (HFA)®
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
ASQ Communication score
FavorableUnfavorableNo Effect
6 months Program group children not affected by substance abuse,
NY Best Beginnings trial
359 children Mean = 55.70 Mean = 55.30 Mean difference = 0.40 HomeVEE calculated = 0.07 Statistical significance not reported Primary
ASQ Composite score
FavorableUnfavorableNo Effect
6 months Program group children not affected by substance abuse,
NY Best Beginnings trial
359 children Mean = 54.80 Mean = 54.00 Mean difference = 0.80 HomeVEE calculated = 0.15 Statistical significance not reported Primary
ASQ Fine Motor score
FavorableUnfavorableNo Effect
6 months Program group children not affected by substance abuse,
NY Best Beginnings trial
359 children Mean = 55.10 Mean = 54.20 Mean difference = 0.90 HomeVEE calculated = 0.12 Statistical significance not reported Primary
ASQ Gross Motor score
FavorableUnfavorableNo Effect
6 months Program group children not affected by substance abuse,
NY Best Beginnings trial
359 children Mean = 52.90 Mean = 51.80 Mean difference = 1.10 HomeVEE calculated = 0.12 Statistical significance not reported Primary
ASQ Social score
FavorableUnfavorableNo Effect
6 months Program group children not affected by substance abuse,
NY Best Beginnings trial
359 children Mean = 53.70 Mean = 54.20 Mean difference = -0.50 HomeVEE calculated = -0.06 Statistical significance not reported Primary
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Outcome Measure Outcome Measure Description Collection method Properties Outcome Type Operations links

ASQ:

  • Communication score
  • Gross Motor score
  • Fine Motor score
  • Social score
  • Composite score
The ASQ assesses the status of development in young children. The researchers examined subscales related to communication, motor development, and social practices. Parent/caregiver report

Not reported by author

Primary
Healthy Families America (HFA)®
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
PLS-3 Score
FavorableUnfavorableNo Effect
Age 3 Children with developmental testing results, Hawaii trial 513 children Adjusted mean = 87.90 Adjusted mean = 87.10 Mean difference = 0.80 Not available Not statistically significant,
p > 0.05
Primary
Prevalence of any delays (PLS-3 score ≤ 85)
FavorableUnfavorableNo Effect
Age 3 Children with developmental testing results, Hawaii trial 513 children % (adjusted) = 48.00 Adjusted mean % = 49.00 OR = 0.97 Not available Not statistically significant,
p > 0.05
Primary
Prevalence of severe delays (PLS-3 score ≤ 70)
FavorableUnfavorableNo Effect
Age 3 Children with developmental testing results, Hawaii trial 513 children % (adjusted) = 9.00 Adjusted mean % = 11.00 OR = 0.80 Not available Not statistically significant,
p > 0.05
Primary
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PLS-3 score

The PLS assesses communication and language development in young children. The researchers examined the mean PLS score in addition to the prevalence of severe delays (PLS-3 score ≤ 70) and the prevalence of any language delays (PLS-3 score ≤ 85). Child assessment

Not reported by author

Primary
Healthy Families America (HFA)®
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
Days absent
FavorableUnfavorableNo Effect
1st grade Healthy Families New York (HFNY) RCT, Year 7 577 mother/child dyads = 16.36 = 15.28 Mean difference = 1.08 HomeVEE calculated = 1.37 Not statistically significant, p > 0.05 Primary

footnote163

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

Positive value is favorable to the comparison group.

Doing poorly academically
FavorableUnfavorableNo Effect
1st grade Healthy Families New York (HFNY) RCT, Year 7 577 mother/child dyads = 0.30 = 0.33 Mean difference = -0.03 HomeVEE calculated = -0.07 Not statistically significant, p > 0.05 Primary

footnote162

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

Negative value is favorable to the intervention.

Doing poorly academically - Any of the 3 behaviors that promote learning
FavorableUnfavorableNo Effect
1st grade Healthy Families New York (HFNY) RCT, Year 7 577 mother/child dyads = 0.15 = 0.16 Mean difference = -0.01 HomeVEE calculated = -0.03 Not statistically significant, p > 0.05 Primary

footnote162

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

Negative value is favorable to the intervention.

Doing poorly academically - Reading or Math
FavorableUnfavorableNo Effect
1st grade Healthy Families New York (HFNY) RCT, Year 7 577 mother/child dyads = 0.21 = 0.25 Mean difference = -0.04 HomeVEE calculated = -0.14 Not statistically significant, p > 0.05 Primary

footnote162

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

Negative value is favorable to the intervention.

Excelling academically
FavorableUnfavorableNo Effect
1st grade Healthy Families New York (HFNY) RCT, Year 7 577 mother/child dyads = 0.26 = 0.20 Mean difference = 0.06 HomeVEE calculated = 0.19 Not statistically significant, p > 0.05 Primary
Excelling academically - All 3 behaviors that promote learning
FavorableUnfavorableNo Effect
1st grade Healthy Families New York (HFNY) RCT, Year 7 577 mother/child dyads = 0.13 = 0.08 Mean difference = 0.05 HomeVEE calculated = 0.36 Statistically significant, p < 0.05 Primary
Excelling academically - Reading and Math
FavorableUnfavorableNo Effect
1st grade Healthy Families New York (HFNY) RCT, Year 7 577 mother/child dyads = 0.16 = 0.16 Mean difference = 0.00 HomeVEE calculated = 0.01 Not statistically significant, p > 0.05 Primary
Retained in first grade
FavorableUnfavorableNo Effect
1st grade Healthy Families New York (HFNY) RCT, Year 7 577 mother/child dyads = 0.04 = 0.07 Mean difference = -0.04 HomeVEE calculated = -0.44 Statistically significant, p < 0.05 Primary

footnote162

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

Negative value is favorable to the intervention.

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Days absent

Mean number of days absent in the first grade First grade school record

Interrater agreement ranged from 89% to 99%

Primary

Doing poorly academically

Percentage of first-grade students whose best grade was below grade level in reading or math, or any of the behaviors that promote learning (working or playing cooperatively with others, following directions or classroom rules, or completing home or class work on time). First grade school record

Interrater agreement ranged from 89% to 99%

Primary

Doing poorly academically - Any of the 3 behaviors that promote learning

Percentage of first-grade students whose best grade was below grade level in any of the behaviors that promote learning (working or playing cooperatively with others, following directions or classroom rules, or completing home or class work on time). First grade school record

Interrater agreement ranged from 89% to 99%

Primary

Doing poorly academically - Reading or Math

Percentage of first-grade students whose best grade was below grade level in reading or math First grade school record

Interrater agreement ranged from 89% to 99%

Primary

Excelling academically

Percentage of first-grade students whose best grade was above grade level in either reading and math, or in all three behaviors that promote learning (working or playing cooperatively with others, following directions or classroom rules and completing home or class work on time). First grade school record

Interrater agreement ranged from 89% to 99%

Primary

Excelling academically - All 3 behaviors that promote learning

Percentage of first-grade students whose best grade was above grade level in all three behaviors that promote learning (working or playing cooperatively with others, following directions or classroom rules and completing home or class work on time). First grade school record

Interrater agreement ranged from 89% to 99%

Primary

Excelling academically - Reading and Math

Percentage of first-grade students whose best grade was above grade level in reading and math First grade school record

Interrater agreement ranged from 89% to 99%

Primary

Retained in first grade

Percentage of students who were retained in first grade First grade school record

Interrater agreement ranged from 89% to 99%

Primary
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