Healthy Families America (HFA)^®

Model effectiveness research report last updated: 2020

Effects shown in research & outcome measure details

Reductions in juvenile delinquency, family violence, and crime

Findings rated high

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.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
Family court	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, San Diego trial	422 families	% = 11.00	% = 10.00	= 1.00	HomeVEE calculated = 0.06	Not statistically significant, p ≥ 0.05
Family court	FavorableUnfavorable or ambiguousNo Effect	Year 3	Full sample, San Diego trial	382 families	% = 10.00	% = 7.00	= 3.00	HomeVEE calculated = 0.24	Not statistically significant, p ≥ 0.05
Incident of physical assault, frequency (CTS)	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, San Diego trial	422 families	Mean = 24.70	Mean = 2.20	Mean difference = -0.20	HomeVEE calculated = -0.04	Not statistically significant, p ≥ 0.05
Incident of physical assault, frequency (CTS)	FavorableUnfavorable or ambiguousNo Effect	Year 3	Full sample, San Diego trial	382 families	Mean = 0.93	Mean = 0.87	Mean difference = 0.06	HomeVEE calculated = 0.02	Not statistically significant, p ≥ 0.05
Incident of physical assault, prevalence (CTS)	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, San Diego trial	422 families	% = 36.00	% = 39.00	= -3.00	HomeVEE calculated = -0.08	Not statistically significant, p ≥ 0.05
Incident of physical assault, prevalence (CTS)	FavorableUnfavorable or ambiguousNo Effect	Year 3	Full sample, San Diego trial	382 families	% = 18.00	% = 17.00	= 1.00	HomeVEE calculated = 0.04	Not statistically significant, p ≥ 0.05
Partner violence resulting in injury (CTS)	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, San Diego trial	422 families	% = 15.00	% = 15.00	= 1.00	HomeVEE calculated = 0.00	Not statistically significant, p ≥ 0.05
Partner violence resulting in injury (CTS)	FavorableUnfavorable or ambiguousNo Effect	Year 3	Full sample, San Diego trial	382 families	% = 8.00	% = 6.00	= 2.00	HomeVEE calculated = 0.19	Not statistically significant, p ≥ 0.05
Restraining order	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, San Diego trial	422 families	% = 7.00	% = 7.00	= 0.00	HomeVEE calculated = 0.00	Not statistically significant, p ≥ 0.05
Restraining order	FavorableUnfavorable or ambiguousNo Effect	Year 3	Full sample, San Diego trial	382 families	% = 6.00	% = 4.00	= 2.00	HomeVEE calculated = 0.26	Not statistically significant, p ≥ 0.05

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Outcome measure	Outcome measure description	Collection method	Properties
CTS: Partner violence resulting in injury Incident of physical assault, prevalence	The CTS assesses victimization and perpetration related to intimate partner violence and maltreatment. The researchers examined the prevalence and the frequency of physical assault and partner violence that resulted in injury.	Parent/caregiver report	Not reported by author
Family court	Percentage of program participants who had been connected to resources that helped them enter family court	Parent/caregiver report	Not applicable
Restraining order	Percentage of program participants who had been connected to resources that helped them obtain a restraining order	Parent/caregiver report	Not applicable

Bair-Merritt, M. H., Jennings, J. M., Chen, R., Burrell, L., McFarlane, E., Fuddy, L., et al. (2010). Reducing maternal intimate partner violence after the birth of a child: A randomized controlled trial of the Hawaii Healthy Start home visitation program. Archives of Pediatrics and Adolescent Medicine, 164(1), 16–23.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Maternal perpetration (CTS)	FavorableUnfavorable or ambiguousNo Effect	Average across 3 years of program	Full sample, Hawaii trial	640 mothers	Mean = 5.08	Mean = 7.72	IRR = 0.83	Not available	Statistically significant, p < 0.05	footnote60 Submitted by user on Fri, 03/15/2019 - 14:29 Actual p-value was not reported by the authors.
Maternal perpetration (CTS)	FavorableUnfavorable or ambiguousNo Effect	Average when child was 7-9 years old	Full sample, Hawaii trial	640 mothers	Mean = 2.45	Mean = 2.51	IRR = 0.98	Not available	Not statistically significant, p ≥ 0.05
Maternal victimization (CTS)	FavorableUnfavorable or ambiguousNo Effect	Average across 3 years of program	Full sample, Hawaii trial	640 mothers	Mean = 7.50	Mean = 9.55	IRR = 0.86	Not available	Not statistically significant, p ≥ 0.05	footnote59 Submitted by user on Fri, 03/15/2019 - 14:29 Incidence rate ratio is calculated using imputed data and adjusted for baseline covariates.
Maternal victimization (CTS)	FavorableUnfavorable or ambiguousNo Effect	Average when child was 7-9 years old	Full sample, Hawaii trial	640 mothers	Mean = 3.35	Mean = 4.01	IRR = 0.95	Not available	Not statistically significant, p ≥ 0.05

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Outcome measure	Outcome measure description	Collection method	Properties
CTS: Maternal perpetration	The CTS assesses victimization and perpetration related to intimate partner violence and maltreatment. The researchers used the 38-item CTS1 at baseline and the 78-item revised CTS2 at subsequent follow-ups. The CTS2 includes questions on verbal aggression/abuse, physical assault, sexual coercion/abuse, and injury. The researchers transformed the CTS’s categorical response categories into counts: never (0), once (1), twice (2), 3 to 5 times (4), 6 to 10 times (8), 11 to 20 times (15), and more than 20 times (25).	Parent/caregiver report	Cronbach’s α: verbal aggression and abuse (.79), physical assault (.86), sexual coercion and abuse (.87), and injury (.95),
CTS: Maternal victimization	The CTS assesses victimization and perpetration related to intimate partner violence and maltreatment. The researchers used the 38-item CTS1 at baseline and the 78-item revised CTS2 at subsequent follow-ups. The CTS2 includes questions on verbal aggression/abuse, physical assault, sexual coercion/abuse, and injury. The researchers transformed the CTS’s categorical response categories into counts: never (0), once (1), twice (2), 3 to 5 times (4), 6 to 10 times (8), 11 to 20 times (15), and more than 20 times (25).	Parent/caregiver report	Cronbach’s α: verbal aggression and abuse (.79), physical assault (.86), sexual coercion and abuse (.87), and injury (.95),

Duggan, A., Fuddy, L., Burrell, L., Higman, S. M., McFarlane, E., Windham, A., et al. (2004). Randomized trial of a statewide home visiting program to prevent child abuse: Impact in reducing parental risk factors. Child Abuse & Neglect, 28(6), 623–643.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Partner incident resulting in injury (CTS)	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, Hawaii trial	564 mothers	% = 24.00	% = 26.00	= -2.00	HomeVEE calculated = -0.06	Not statistically significant, p ≥ 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Partner incident resulting in injury (CTS)	FavorableUnfavorable or ambiguousNo Effect	Year 2	Full sample, Hawaii trial	556 mothers	% = 14.00	% = 20.00	= -6.00	HomeVEE calculated = -0.26	Statistically significant, p < 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Partner incident resulting in injury (CTS)	FavorableUnfavorable or ambiguousNo Effect	Year 3	Full sample, Hawaii trial	548 mothers	% = 17.00	% = 18.00	= -1.00	HomeVEE calculated = -0.04	Not statistically significant, p ≥ 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Partner incident resulting in injury (CTS)	FavorableUnfavorable or ambiguousNo Effect	Years 1-3	Full sample, Hawaii trial	564 mothers	% = 24.00	% = 26.00	OR = 0.81	Not available	Not statistically significant, p ≥ 0.05
Partner physical abuse (CTS)	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, Hawaii trial	564 mothers	% = 37.00	% = 42.00	= -5.00	HomeVEE calculated = -0.13	Not statistically significant, p ≥ 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Partner physical abuse (CTS)	FavorableUnfavorable or ambiguousNo Effect	Year 2	Full sample, Hawaii trial	556 mothers	% = 26.00	% = 32.00	= -6.00	HomeVEE calculated = -0.18	Statistically significant, p < 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Partner physical abuse (CTS)	FavorableUnfavorable or ambiguousNo Effect	Year 3	Full sample, Hawaii trial	548 mothers	% = 29.00	% = 30.00	= -1.00	HomeVEE calculated = -0.03	Not statistically significant, p ≥ 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Partner physical abuse (CTS)	FavorableUnfavorable or ambiguousNo Effect	Years 1-3	Full sample, Hawaii trial	564 mothers	% = 37.00	% = 42.00	OR = 0.83	Not available	Not statistically significant, p ≥ 0.05
Partner psychological abuse (CTS)	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, Hawaii trial	564 mothers	% = 49.00	% = 49.00	= 0.00	HomeVEE calculated = 0.00	Not statistically significant, p ≥ 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Partner psychological abuse (CTS)	FavorableUnfavorable or ambiguousNo Effect	Year 2	Full sample, Hawaii trial	556 mothers	% = 42.00	% = 42.00	= 0.00	HomeVEE calculated = 0.00	Not statistically significant, p ≥ 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Partner psychological abuse (CTS)	FavorableUnfavorable or ambiguousNo Effect	Year 3	Full sample, Hawaii trial	548 mothers	% = 42.00	% = 38.00	= -4.00	HomeVEE calculated = 0.10	Not statistically significant, p ≥ 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Partner psychological abuse (CTS)	FavorableUnfavorable or ambiguousNo Effect	Years 1-3	Full sample, Hawaii trial	564 mothers	% = 49.00	% = 49.00	OR = 1.05	Not available	Not statistically significant, p ≥ 0.05	footnote51 Submitted by user on Fri, 03/15/2019 - 14:29 Adjusted odds ratios are based on the average effect across all follow-up years.

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Outcome measure	Outcome measure description	Collection method	Properties
CTS: Partner psychological abuse Partner physical abuse Partner incident resulting in injury	The CTS assesses victimization and perpetration related to intimate partner violence and maltreatment. The researchers examined the prevalence of psychological abuse, physical abuse, and an incident of injury. The father was considered to be physically violent if he had committed three or more incidents of physical violence toward the mother in the year prior to the baseline interview and was psychologically aggressive if he had committed acts of psychological aggression more than 35 times in the year prior to the interview.	Parent/caregiver report	Not reported by author

Findings rated moderate

Duggan, A., Fuddy, L., McFarlane, E., Burrell, L., Windham, A., Higman, S., & Sia, C. (2004). Evaluating a statewide home visiting program to prevent child abuse in at-risk families of newborns: Fathers’ participation and outcomes. Child Maltreatment, 9(1), 3–17.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Maternally reported father violence	FavorableUnfavorable or ambiguousNo Effect	Years 1-3	All families	600 families	Not available	Not available	OR = 0.78	HomeVEE calculated = -0.15	Not statistically significant, p = 0.12	Negative effect is favorable Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.

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Outcome measure	Outcome measure description	Collection method	Properties
Maternally reported father violence	Physical violence towards mother three or more times in year before baseline interview, based on Conflict Tactics Scale.	Parent/caregiver report	Not applicable

LeCroy, C. W., & Krysik, J. (2011). Randomized trial of the Healthy Families Arizona home visiting program. Children and Youth Services Review, 33(10), 1761–1766.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
Family violence	FavorableUnfavorable or ambiguousNo Effect	12 months	Arizona sample	168 mothers	Mean = 0.43	Mean = 0.52	Mean difference = -0.09	HomeVEE calculated = -1.12	Not statistically significant, p =0.37
Family violence	FavorableUnfavorable or ambiguousNo Effect	6 months	Arizona sample	180 mothers	Mean = 0.51	Mean = 0.43	Mean difference = 0.08	HomeVEE calculated = 1.87	Not statistically significant, p =0.15

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Outcome measure	Outcome measure description	Collection method	Properties
Family violence	The authors used common indicators of violence to create a family violence index similar to the Conflict Tactics Scale. The index included items that describe violent behaviors in the home such as pushing and shoving, slapping, and throwing objects.	Parent/caregiver report	Not reported by author

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