Healthy Families America (HFA)^®

Last updated: September 2018

Effects Shown in Research & Outcome Measure Details

Child Development and School Readiness

Outcomes Rated High

Caldera, D., Burrell, L., Rodriguez, K., Crowne, S. S., Rohde, C., & Duggan, A. (2007). Impact of a statewide home visiting program on parenting and on child health and development. Child Abuse & Neglect, 31(8), 829–852. doi:10.1016/j.chiabu.2007.02.008

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
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.

Show Study Outcome Measure Summary

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

DuMont, K., Kirkland, K., Mitchell-Herzfeld, S., Ehrhard-Dietzel, S., Rodriguez, M. L., Lee, E., ... & Greene, R. (2010). A randomized trial of Healthy Families New York (HFNY): Does home visiting prevent child maltreatment? Rensselaer, NY: New York State Office of Children & Family Services and Albany, NY: University of Albany, State University of New York.

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
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

Show Study Outcome Measure Summary

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

Landsverk, J., Carrilio, T., Connelly, C. D., Ganger, W., Slymen, D., Newton, R., et al. (2002). Healthy Families San Diego clinical trial: Technical report. San Diego, CA: The Stuart Foundation, California Wellness Foundation, State of California Department of Social Services: Office of Child Abuse Prevention.

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

Show Study Outcome Measure Summary

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 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

Anisfeld, E., Sandy, J., & Guterman, N. B. (2004). Best Beginnings: A randomized controlled trial of a paraprofessional home visiting program: Technical report. Report to the Smith Richardson Foundation and New York State Office of Children and Family Services. New York: Columbia University School of Social Work.

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

Show Study Outcome Measure Summary

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

King, T., Rosenberg, L., Fuddy, L., McFarlane, E., Sia, C., & Duggan, A. (2005). Prevalence and early identification of language delays among at-risk three year olds. Journal of Developmental & Behavioral Pediatrics, 26(4), 293–303.

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

Show Study Outcome Measure Summary

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

Kirkland, K., & Mitchell-Herzfeld, S. (2012). Evaluating the effectiveness of home visiting services in promoting children’s adjustment in school: Final report to the Pew Center on the States. Rensselaer, NY: New York State Office of Children and Family Services, Bureau of Evaluation and Research.

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.

Show Study Outcome Measure Summary

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

View Revisions