Healthy Families America (HFA)® Meets HHS Criteria

Last updated: September 2018

Effects Shown in Research & Outcome Measure Details

Child Health

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
Adequate well-child visits
FavorableUnfavorableNo Effect
Year 2 Children in custody of biological mother at interview, Alaska trial 249 children % (adjusted) = 4.00 Adjusted mean % = 8.00 OR = 0.96 HomeVEE calculated = -0.45 Not statistically significant,
p > 0.05
Primary
Has health care coverage
FavorableUnfavorableNo Effect
Year 2 Children in custody of biological mother at interview, Alaska trial 249 children % (adjusted) = 95.00 Adjusted mean % = 90.00 OR = 2.05 HomeVEE calculated = 0.45 Statistically significant,
p < 0.05
Secondary
Has primary care provider
FavorableUnfavorableNo Effect
Year 2 Children in custody of biological mother at interview, Alaska trial 249 children % (adjusted) = 74.00 Adjusted mean % = 78.00 OR = 0.76 HomeVEE calculated = -0.13 Not statistically significant,
p > 0.05
Secondary
Immunizations up-to-date
FavorableUnfavorableNo Effect
Year 2 Children in custody of biological mother at interview, Alaska trial 249 children % (adjusted) = 27.00 Adjusted mean % = 27.00 OR = 1.01 HomeVEE calculated = 0.00 Not statistically significant,
p > 0.05
Primary
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Outcome Measure Outcome Measure Description Collection method Properties Outcome Type Operations links

Adequate well-child visits

Percentage of children who had adequate well-child visits according to the American Academy of Pediatrics guidelines Review of medical records

Not applicable

Primary

Has health care coverage

Percentage of children who had health care coverage Parent/caregiver report

Not applicable

Secondary

Has primary care provider (PCP)

Percentage of children who had a PCP

Parent/caregiver report

Not applicable

Secondary

Immunizations up-to-date

Percentage of children who had up-to-date immunizations according to the American Academy of Pediatrics guidelines Review of medical records

Not applicable

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
Ever hospitalized for any reason
FavorableUnfavorableNo Effect
Year 1 Full sample, Hawaii trial 564 children % = 17.00 % = 18.00 = -1.00 HomeVEE calculated = -0.04 Not statistically significant,
p > 0.05
Secondary
Ever hospitalized for any reason
FavorableUnfavorableNo Effect
Years 1 and 2 Full sample, Hawaii trial 534 children % = 19.00 % = 22.00 = 3.00 HomeVEE calculated = -0.11 Not statistically significant,
p > 0.05
Secondary
Ever used emergency department
FavorableUnfavorableNo Effect
Year 1 Full sample, Hawaii trial 564 children % = 40.00 % = 44.00 = -4.00 HomeVEE calculated = -0.10 Not statistically significant,
p > 0.05
Secondary
Ever used emergency department
FavorableUnfavorableNo Effect
Years 1 and 2 Full sample, Hawaii trial 534 children % = 58.00 % = 60.00 = -2.00 HomeVEE calculated = -0.05 Not statistically significant,
p > 0.05
Secondary
Has a PCP who handles most health care needs
FavorableUnfavorableNo Effect
Year 1 Full sample, Hawaii trial 564 children % = 93.00 % = 90.00 = 3.00 HomeVEE calculated = 0.24 Not statistically significant,
p > 0.05
Secondary
Has a PCP who handles most health care needs
FavorableUnfavorableNo Effect
Year 2 Full sample, Hawaii trial 567 children % = 89.00 % = 84.00 = 5.00 HomeVEE calculated = 0.26 Not statistically significant,
p > 0.05
Secondary
Has a PCP who knows all aspects of child’s care
FavorableUnfavorableNo Effect
Year 1 Full sample, Hawaii trial 564 children % = 84.00 % = 79.00 = 5.00 HomeVEE calculated = 0.20 Not statistically significant,
p > 0.05
Secondary
Has a PCP who knows all aspects of child’s care
FavorableUnfavorableNo Effect
Year 2 Full sample, Hawaii trial 567 children % = 80.00 % = 75.00 = 5.00 HomeVEE calculated = 0.17 Not statistically significant,
p > 0.05
Secondary
Has a PCP who knows family’s concerns about child
FavorableUnfavorableNo Effect
Year 1 Full sample, Hawaii trial 564 children % = 45.00 % = 48.00 = 3.00 HomeVEE calculated = -0.07 Not statistically significant,
p > 0.05
Secondary
Has a PCP who knows family’s concerns about child
FavorableUnfavorableNo Effect
Year 2 Full sample, Hawaii trial 567 children % = 50.00 % = 39.00 = 11.00 HomeVEE calculated = 0.27 Statistically significant,
p < 0.05
Secondary
Has a primary care provider (PCP)
FavorableUnfavorableNo Effect
Year 1 Full sample, Hawaii trial 564 children % = 94.00 % = 90.00 = 4.00 HomeVEE calculated = 0.34 Not statistically significant,
p > 0.05
Secondary
Has a primary care provider (PCP)
FavorableUnfavorableNo Effect
Year 2 Full sample, Hawaii trial 567 children % = 91.00 % = 86.00 = 5.00 HomeVEE calculated = 0.30 Not statistically significant,
p > 0.05
Secondary
Immunizations up-to-date
FavorableUnfavorableNo Effect
Year 1 Full sample, Hawaii trial 564 children % = 82.00 % = 82.00 = 0.00 HomeVEE calculated = 0.00 Not statistically significant,
p > 0.05
Secondary
Immunizations up-to-date
FavorableUnfavorableNo Effect
Year 2 Full sample, Hawaii trial 567 children % = 87.00 % = 85.00 = 2.00 HomeVEE calculated = 0.10 Not statistically significant,
p > 0.05
Secondary
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Outcome Measure Outcome Measure Description Collection method Properties Outcome Type Operations links

Ever hospitalized for any reason

Percentage of children who had ever been hospitalized for any reason Parent/caregiver report

Not applicable

Secondary

Ever used emergency department

Percentage of children who had ever used the emergency department Parent/caregiver report

Not applicable

Secondary

Has a PCP

Percentage of children who had a PCP Parent/caregiver report

Not applicable

Secondary

Has a PCP who handles most health care needs

Percentage of children who had a PCP who handled most health care needs Parent/caregiver report

Not applicable

Secondary

Has a PCP who knows all aspects of child’s care

Percentage of children who had a PCP who knew about all aspects of the child’s care Parent/caregiver report

Not applicable

Secondary

Has a PCP who knows family’s concerns about child

Percentage of children who had a PCP who understood the family’s concerns about child Parent/caregiver report

Not applicable

Secondary

Immunizations up-to-date

Percentage of children who were up-to-date on the appropriate immunizations for the child’s age Parent/caregiver report

Not applicable

Secondary
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
Hospitalizations for ambulatory care
FavorableUnfavorableNo Effect
Years 1-3 Full sample, Hawaii trial 573 children % = 12.00 % = 10.00 OR = 1.27 HomeVEE calculated = 0.12 Not statistically significant,
p > 0.05
Primary
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Outcome Measure Outcome Measure Description Collection method Properties Outcome Type Operations links

Hospitalizations for ambulatory care

Percentage of children who were hospitalized for ambulatory care Review of medical records

Not applicable

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 Notes
Child hospitalized for ambulatory care sensitive conditions (ACSC)
FavorableUnfavorableNo Effect
Years 1 and 2 Families with complete medical record data, Alaska trial 268 families % (adjusted) = 9.00 Adjusted mean % = 9.00 OR = 1.09 HomeVEE calculated = 0.00 Not statistically significant,
p > 0.05
Primary

footnote54

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

Ambulatory care sensitive conditions include: asthma, pneumonia, other upper airway conditions, gastroenteritis, dehydration, cellulitis, and seizures.

Child seen in emergency department for ACSC
FavorableUnfavorableNo Effect
Years 1 and 2 Families with complete medical record data, Alaska trial 268 families % (adjusted) = 81.00 Adjusted mean % = 78.00 OR = 1.23 HomeVEE calculated = 0.11 Not statistically significant,
p > 0.05
Primary
Number of times hospitalized for ACSC
FavorableUnfavorableNo Effect
Years 1 and 2 Families with complete medical record data, Alaska trial 268 families Adjusted mean = 0.11 Adjusted mean = 0.12 Mean difference = -0.01 Not available Not statistically significant,
p > 0.05
Primary
Number of times seen in emergency department for ACSC
FavorableUnfavorableNo Effect
Years 1 and 2 Families with complete medical record data, Alaska trial 268 families Adjusted mean = 3.13 Adjusted mean = 4.09 Mean difference = -0.96 Not available Not statistically significant,
p > 0.05
Primary
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Outcome Measure Outcome Measure Description Collection method Properties Outcome Type Operations links

Child hospitalized forACSCChild seen in emergency department for ACSCNumber of timeshospitalized for ACSCNumber of timesseen in emergency department for ACSC

The researchersused the Parker& Schoendorf (2000) definitionof ACSC to examine hospitalizations that might have been avoided with adequate primary care. The list of conditions includes asthma, pneumonia, other upper airway conditions, gastroenteritis, dehydration, cellulitis, and seizures. The percentage of children hospitalized for ACSC, the percentage of children that were seen in the emergency department for ACSC, the number of times the child was seen in the emergency department for ACSC, and the number of times the child was hospitalized for ACSC were analyzed. Parent/caregiver report and review of medical records

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
Anxious, depressed (CBCL)
FavorableUnfavorableNo Effect
7 year New York sample 897 mothers Adjusted mean = 2.89 Adjusted mean = 2.97 Mean difference = -0.08 Study reported = -0.03 Not statistically significant, p > 0.05 Primary
Social problems (CBCL)
FavorableUnfavorableNo Effect
7 year New York sample 897 mothers Adjusted mean = 1.31 Adjusted mean = 1.15 Mean difference = 0.16 Study reported = -0.04 Not statistically significant, p > 0.05 Primary
Withdrawn, depressed (CBCL)
FavorableUnfavorableNo Effect
7 year New York sample 897 mothers Adjusted mean = 1.47 Adjusted mean = 1.54 Mean difference = -0.07 Study reported = -0.04 Not statistically significant, p > 0.05 Primary
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Anxious, depressed (CBCL)

The Child BehaviorChecklist for Ages6ndash;8(CBCL/6-18) 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

Social problems (CBCL)

The Child BehaviorChecklist for Ages6ndash;8(CBCL/6-18) 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

Withdrawn, depressed (CBCL)

The Child BehaviorChecklist for Ages6ndash;8(CBCL/6-18) 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
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
Child has insurance coverage
FavorableUnfavorableNo Effect
Year 1 Full sample, San Diego trial 435 children % = 84.20 % = 87.20 = -3.00 HomeVEE calculated = -0.15 Not statistically significantNot statistically significant,
p > 0.05
Secondary

footnote55

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

This study was assigned a moderate rating for this outcome due to statistically significant differences between the program and comparison groups at baseline.

Child has insurance coverage
FavorableUnfavorableNo Effect
Year 3 Full sample, San Diego trial 412 children % = 82.40 % = 84.00 = -1.60 HomeVEE calculated = -0.07 Not statistically significant,
p > 0.05
Secondary
Child has regular health care site
FavorableUnfavorableNo Effect
Year 1 Full sample, San Diego trial 435 children % = 98.10 % = 97.70 = 0.40 HomeVEE calculated = 0.12 Not statistically significant,
p > 0.05
Secondary
Child has regular health care site
FavorableUnfavorableNo Effect
Year 3 Full sample, San Diego trial 412 children % = 98.00 % = 98.50 = -0.50 HomeVEE calculated = -0.18 Not statistically significant,
p > 0.05
Secondary
Child has specific health care provider
FavorableUnfavorableNo Effect
Year 1 Full sample, San Diego trial 435 children % = 74.00 % = 81.60 = -7.60 HomeVEE calculated = -0.27 Not statistically significant,
p > 0.05
Secondary
Child has specific health care provider
FavorableUnfavorableNo Effect
Year 3 Full sample, San Diego trial 412 children % = 63.60 % = 72.20 = -8.60 HomeVEE calculated = -0.24 Not statistically significant,
p > 0.05
Secondary
Compliance with recommended number of well-child visits
FavorableUnfavorableNo Effect
Year 1 Full sample, San Diego trial 435 children % = 58.60 % = 59.60 = -1.00 HomeVEE calculated = -0.03 Not statistically significant,
p > 0.05
Secondary
Compliance with recommended number of well-child visits
FavorableUnfavorableNo Effect
Year 3 Full sample, San Diego trial 412 children % = 85.80 % = 83.80 = 3.00 HomeVEE calculated = 0.09 Not statistically significant,
p > 0.05
Secondary
Immunizations up-to-date
FavorableUnfavorableNo Effect
Year 3 Full sample, San Diego trial 412 children % = 96.90 % = 95.90 = 1.00 HomeVEE calculated = 0.18 Not statistically significant,
p > 0.05
Secondary
Number of sick visits
FavorableUnfavorableNo Effect
Year 1 Full sample, San Diego trial 435 children Median = 3.00 Median = 3.00 Not reported Not available Not statistically significant,
p > 0.05
Secondary
Number of sick visits
FavorableUnfavorableNo Effect
Year 3 Full sample, San Diego trial 412 children Median = 1.00 Median = 1.00 Not reported Not available Not statistically significant,
p > 0.05
Secondary
Number of well-child visits
FavorableUnfavorableNo Effect
Year 1 Full sample, San Diego trial 435 children Mean = 7.00 Mean = 6.80 Mean difference = 0.20 HomeVEE calculated = 0.05 Not statistically significant,
p > 0.05
Secondary
Number of well-child visits
FavorableUnfavorableNo Effect
Year 3 Full sample, San Diego trial 412 children Mean = 2.40 Mean = 1.90 Mean difference = 0.50 HomeVEE calculated = 0.22 Statistically significant,
p < 0.05
Secondary
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Outcome Measure Outcome Measure Description Collection method Properties Outcome Type Operations links

Child has insurance coverage

Percentage of children who had health insurance coverage Parent/caregiver report

Not applicable

Secondary

Child has regular health care site

Percentage of children who had a location they typically went to for health care Parent/caregiver report

Not applicable

Secondary

Child has specific health care provider

Percentage of children who had a specific health care provider Parent/caregiver report

Not applicable

Secondary

Compliance with recommended number of well-child visits

Percentage of children who had received the recommended number of well-child visits for their age, defined as six or more visits in the first year of life, three or more visits in the second year of life, and one or more visits in third year of life Parent/caregiver report

Not applicable

Secondary

Immunizations up-to-date

Percentage of children who were up-to-date on the appropriate immunizations for the child’s age Parent/caregiver report

Not applicable

Secondary

Number of sick visits

Number of sick visits the child had received Parent/caregiver report

Not applicable

Secondary

Number of well-child visits

Number of well-child visits the child had received Parent/caregiver report

Not applicable

Secondary
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
Low birth weight
FavorableUnfavorableNo Effect
At birth Full sample Adjusted proportion = 0.05 Adjusted proportion = 0.10 OR = 0.43 HomeVEE calculated = -0.51 Statistically significant, p = 0.02 Primary

footnote162

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

Negative value is favorable to the intervention.

Preterm birth
FavorableUnfavorableNo Effect
At birth Full sample Not reported Not reported Not reported Not available Not statistically significant, p > 0.05 Primary
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Low birth weight

The study considered a baby born weighing less than 2,500 grams as low birth weight. The study determined birth weight using birth certificates. Birth certificate

Not applicable

Primary

Preterm birth

The study considered a baby born after 37 or fewer weeks of gestation as a preterm birth. New York State Department of Health birth records

Not applicable

Primary

Outcomes Rated Moderate

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
Number of pediatric emergency department visits
FavorableUnfavorableNo Effect
36 months Program group children not affected by substance abuse,
NY Best Beginnings trial
271 children Not available Not available Beta = 0.12 Not available Statistically significant,
p < 0.05
Secondary
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Outcome Measure Outcome Measure Description Collection method Properties Outcome Type Operations links

Number of pediatric emergency department visits

Number of pediatric emergency department visits between birth and age 36 months Parent/caregiver report

Not applicable

Secondary
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
Baby received developmental screening in first year of life
FavorableUnfavorableNo Effect
Child's 1st birthday HF Oregon 2010-2012 762 mothers Adjusted proportion = 0.94 Adjusted proportion = 0.87 OR = 0.41 Not available Statistically significant, p = 0.00 Secondary
Child ever breastfed - full sample
FavorableUnfavorableNo Effect
Child's 1st birthday HF Oregon 2010-2012 752 mothers Adjusted proportion = 0.91 Adjusted proportion = 0.91 OR = 0.91 Not available Not statistically significant, p>0.05 Secondary
Parent ever told that child was not on track developmentally - full sample
FavorableUnfavorableNo Effect
Child's 1st birthday HF Oregon 2010-2012 762 mothers Adjusted proportion = 0.05 Adjusted proportion = 0.09 OR = 1.46 Not available Not statistically significant, p = 0.08 Secondary

footnote162

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

Negative value is favorable to the intervention.

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

Baby received developmental screening in first year of life

This survey item asks whether the baby received a developmental screening in first year of life. Parent/caregiver report

Not reported by author

Secondary

Child ever breastfed - full sample

This survey item asks whether the child was ever breastfed. Parent/caregiver report

Not reported by author

Secondary

Parent ever told that child was not on track developmentally - full sample

This survey item asks whether the parent was ever told that the child was not on track developmentally. Parent/caregiver report

Not reported by author

Secondary
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
Child ever without needed medical care
FavorableUnfavorableNo Effect
Year 1 Full sample, NY Trial 1061 children % = 2.20 % = 1.40 Not reported HomeVEE calculated = 0.28 Not statistically significant,
p > 0.05
Secondary
Child has health insurance
FavorableUnfavorableNo Effect
Year 1 Full sample, NY Trial 1061 children % = 93.90 % = 90.40 = 3.50 HomeVEE calculated = 0.30 Statistically significant,
p < 0.05
Secondary
Child has primary care provider
FavorableUnfavorableNo Effect
Year 1 Full sample, NY Trial 1061 children % = 98.40 % = 98.60 = -0.20 HomeVEE calculated = -0.08 Not statistically significant,
p > 0.05
Secondary
Mother breastfed baby
FavorableUnfavorableNo Effect
Year 1 Full sample, NY Trial 1060 mothers % = 45.90 % = 44.70 = 1.20 Not available Not statistically significant,
p > 0.05
Secondary
Number of months breastfed
FavorableUnfavorableNo Effect
Year 1 Full sample, NY Trial 1060 mothers Adjusted mean = 1.01 Adjusted mean = 1.04 Mean difference = -0.03 Not available Not statistically significant,
p > 0.05
Secondary
Number of well-baby visits
FavorableUnfavorableNo Effect
Year 1 Full sample, NY Trial 1061 children Adjusted mean = 4.54 Adjusted mean = 4.61 Mean difference = -0.07 Not available Not statistically significant,
p > 0.05
Secondary
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Outcome Measure Outcome Measure Description Collection method Properties Outcome Type Operations links

Child ever without needed medical care

Percentage of children who had ever gone without needed medical care Parent/caregiver report

Not applicable

Secondary

Child has PCP

Percentage of children who had a PCP Parent/caregiver report

Not applicable

Secondary

Child has health insurance

Percentage of children who had health insurance coverage Parent/caregiver report

Not applicable

Secondary

Mother breastfed baby

Percentage of mothers who had breastfed their child Parent/caregiver report

Not applicable

Secondary

Number of months breastfed

Number of months the mother had breastfed her child Parent/caregiver report

Not applicable

Secondary

Number of well-baby visits

Number of well-child visits the child had received Review of medical records

Not applicable

Primary
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