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

Implementation last updated: 2015

The information in this profile reflects feedback, if provided, from this model’s developer as of the above date. The description of the implementation of the model(s) here may differ from how the model(s) was implemented in the research reviewed to determine this model’s evidence of effectiveness. Inclusion in the implementation report does not mean the practices described meet the HHS criteria for evidence of effectiveness. Similarly, models described here may not all have impact studies, and those with impact studies may vary in their effectiveness. Please see the Effectiveness button on the left for more information about research on the effectiveness of the models discussed here.

Materials and forms to support implementation

Operations manuals

A policies and procedures handbook is available in written form or can be accessed through the HANDS web-based system.

View Revisions

Service delivery forms

Sites must complete nearly 40 forms on family demographics, screenings, service delivery, childproofing, parenting assessment, stressors and risks, progress of goals, and family status updates. These forms are entered into the HANDS 2.0 web-based system. The forms capture data on supervision (such as shadowing, caseload management, and quarterly chart reviews); referrals and screening, family progress and service delivery (such as goals, parent completion levels, contact log, health progress, and exit); and quality assurance (including the HANDS Site Satisfaction Survey and the Parent Satisfaction Survey).

View Revisions

Assessment tools

Candidate families are screened using a universal screening tool that evaluates family stress indicators. Families who screen positive for risk factors receive an assessment using a standardized assessment tool.

Developmental screenings, using the Ages & Stages Questionnaires, begin at 4 months of age and are provided every two months. Developmental social-emotional screenings are completed on each child beginning at 6 months of age and continue every six months. Mothers also receive a perinatal depression screening at three intervals (prenatally, 2-8 weeks postnatal, and 8-12 months after birth). Family support workers also screen families for domestic violence.

View Revisions


Sites are required to follow the Growing Great Kids™ Curriculum, developed by Great Kids, Inc.

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, and exercise through a series of questions and parent handouts called Helping HANDS for Homes.

View Revisions

Available languages

Materials for the HANDS program are available in English and Spanish.

View Revisions

Fidelity measurement

Following a site visit, QAs complete the HANDS Quality Assurance Site Review Summary, which examines each site’s implementation of the HANDS Core Components, including referral screening, parent survey/assessment, training, supervision, community collaboration, use of curriculum, administration of the developmental screening tool, service referrals, program management, required documentation completion, and data entry into the HANDS web-based system. QAs complete the summary through interviewing staff, chart and documentation reviews, and data report analysis. Results from the summary are entered into the HANDS web-based data system. This enables state staff to review results of site visits per site, by assigned QA, or statewide.

Sites can access reports based on the summary, including the site’s level of adherence, strengths, and opportunities for program growth. The site, with the assistance of the TA, then prioritizes its needs and develops a plan for growth, which includes strategies and activities to meet the HANDS quality indicators.

In addition to annual site visits, sites complete a Site Satisfaction Survey, which asks questions about the annual visit, the technical support they have received throughout the fiscal year, areas in which they need additional support to implement, printed HANDS materials, and training needs.

Also, Parent Satisfaction Surveys are distributed to families participating in HANDS each fiscal year. This enables families to rate the screening process, their home visitor, the curriculum, and how the program has benefited them.

View Revisions

Fidelity standards

HANDS programs must adhere to the 12 HFA critical elements (see the HFA Implementation Profile for more information).

View Revisions

Implementation notes

The information contained on this page was last updated in June 2015. Recommended Further Reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by the HANDS program office on April 24, 2015. HomVEE reserves the right to edit the profile for clarity and consistency.

View Revisions