Mitchell-Herzfeld, S., Izzo, C., Greene, R., Lee, E., & Lowenfels, A. (2005). Evaluation of Healthy Families New York (HFNY): First year program impacts. Albany, NY: University at Albany, Center for Human Services Research.
| Screening decision | Screening conclusion |
|---|---|
| Passes screens | Eligible for review |
| Rating | Design | Attrition | Baseline equivalence | Reassignment | Confounding factors |
|---|---|---|---|---|---|
| Moderate | Randomized controlled trial | High | Established on race/ethnicity, SES, and feasible outcomes. Statistical controls for feasible baseline outcomes included. | None | None |
In 2020, HomVEE updated this review to move "Mother has health insurance" from the Maternal Health domain to the Family Economic Self-Sufficiency domain because ACF determined that health insurance coverage belongs in that domain.
In 2020, HomVEE updated this review to move "Child has health insurance" from the Child Health domain to the Family Economic Self-Sufficiency domain because ACF determined that health insurance coverage belongs in that domain.
Attrition rating is based on overall sample sizes because sample sizes for treatment and control groups were unavailable.
| Study participants | Recruitment for the randomized controlled trial of Healthy Families New York (HFNY) occurred between March 2000 and August 2001. Pregnant women or parents with an infant 3 months of age or less who were found to be at risk for child abuse or neglect and lived in communities with high rates of teen pregnancy, infant mortality, and welfare receipt, and low rates of prenatal care were referred to HFNY. Consenting families were screened using the Kempe Family Stress Checklist (FSC); 1,297 eligible families who received scores of 25 or higher on the FSC were randomly assigned to the program group (n = 647) or the comparison group (n = 650). 1,157 mothers completed a baseline interview (589 in the program group and 568 in the comparison group). Of those who completed baseline interviews, 41.9% were African American, 17.0% were Latina, 33.7% were White, and the remaining 7.3% were of another race or ethnicity. On average, the mothers were 22.4 years of age, 52.3% had not completed high school or a GED , and 32.4% of the families were receiving welfare. This study reports on the first-year program impacts of HFNY, using a sample of 1,060 families who completed the first follow-up interview. |
|---|---|
| Setting | Three Healthy Families New York sites were included in the study: Erie, Rensselaer, and Ulster counties. Erie serves primarily African American and Latino families in inner-city neighborhoods in Buffalo. Rensselaer and Ulster counties include urban, suburban, and rural locations; both serve largely White families, but with a substantial African American population in Rensselaer and Latino population in Ulster. |
| Intervention services | Participants in the program group were assigned to an HFNY home visitor. Home visitors were scheduled to visit families biweekly during pregnancy (if they enrolled prior to the birth of the child) and at least weekly immediately following the birth of the child. The frequency of visits was gradually decreased based on family needs, and visits continued until the child turned 5 or began Head Start or kindergarten. Home visitors emphasized activities to improve the parent-child relationship, help parents understand child development and improve child growth, improve access to health care, and improve family functioning through the development and use of a Family Support Plan. |
| Comparison conditions | Members of the control group received information about and referrals to other community services, though they were not referred to home visiting services that were similar to HFNY (DuMont et al., 2008). |
| Staff characteristics and training | New HFNY staff members are required to attend an initial one-week training and to shadow and receive mentorship from experienced home visitors. “Intensive wraparound” training and ongoing training were provided to all staff. |
| Funding sources | New York State Office of Children and Families Services, Bureau of Evaluation and Research |
| Author affiliation | None of the study authors are developers of this model. |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Child ever without needed medical care | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 children | % = 2.20 | % = 1.40 | Not Reported | HomeVEE calculated = 0.28 | Not statistically significant, p ≥ 0.05 | |
| Moderate | Child has primary care provider | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 children | % = 98.40 | % = 98.60 | = -0.20 | HomeVEE calculated = -0.08 | Not statistically significant, p ≥ 0.05 | |
| Moderate | Mother breastfed baby | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,060 mothers | % = 45.90 | % = 44.70 | = 1.20 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Number of months breastfed | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,060 mothers | Adjusted mean = 1.01 | Adjusted mean = 1.04 | Mean difference = -0.03 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Number of well-baby visits | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 children | Adjusted mean = 4.54 | Adjusted mean = 4.61 | Mean difference = -0.07 | Not available | Not statistically significant, p ≥ 0.05 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Child has health insurance | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 children | % = 93.90 | % = 90.40 | = 3.50 | HomeVEE calculated = 0.30 | Statistically significant, p < 0.05 |
|
| Moderate | Education appropriate for age | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY trial | Year 1 | 1,061 families | % = 57.50 | % = 60.30 | = -2.80 | HomeVEE calculated = -0.07 | Not statistically significant, p > 0.05 |
|
| Moderate | Family received TANF | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY trial | Year 1 | 1,061 families | % = 35.00 | % = 30.40 | = 4.60 | HomeVEE calculated = 0.13 | Not statistically significant, p ≥ 0.05 | |
| Moderate | Family received WIC | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY trial | Year 1 | 1,061 families | % = 74.80 | % = 72.20 | = 2.60 | HomeVEE calculated = 0.08 | Not statistically significant, p ≥ 0.05 | |
| Moderate | Family received 50% income from work | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY trial | Year 1 | 1,061 families | % = 51.20 | % = 56.60 | = -5.40 | HomeVEE calculated = -0.13 | Not statistically significant, p > 0.05 |
|
| Moderate | Mother employed | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY trial | Year 1 | 1,061 families | % = 40.80 | % = 47.60 | = 6.80 | HomeVEE calculated = -0.17 | Statistically significant, p < 0.05 |
|
| Moderate | Mother has health insurance | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 mothers | % (adjusted) = 80.10 | Adjusted mean % = 78.40 | = 1.70 | Not available | Not statistically significant, p ≥ 0.05 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Above alcohol abuse cutoff (AUDIT) | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 mothers | % (adjusted) = 2.00 | Adjusted mean % = 3.80 | = -1.80 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Above depression threshold (CES-D) | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 mothers | % (adjusted) = 29.00 | Adjusted mean % = 31.20 | = -2.20 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Alcohol abuse (AUDIT) | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 mothers | Adjusted mean = 1.14 | Adjusted mean = 1.28 | Mean difference = -0.14 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Depressive symptoms (CES-D) | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 mothers | Adjusted mean = 11.45 | Adjusted mean = 11.61 | Mean difference = -0.16 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Drug use | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 mothers | % (adjusted) = 9.80 | Adjusted mean % = 10.60 | = -0.80 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Mother has primary care physician | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 mothers | % (adjusted) = 86.90 | Adjusted mean % = 85.00 | = 1.90 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Sense of personal mastery (PSM) | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 mothers | Adjusted mean = 23.80 | Adjusted mean = 23.55 | Mean difference = 0.25 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Smoking | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 mothers | % (adjusted) = 41.30 | Adjusted mean % = 43.80 | = -2.50 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Smoking frequency | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 mothers | Adjusted mean = 3.42 | Adjusted mean = 3.93 | Mean difference = -0.51 | Not available | Not statistically significant, p ≥ 0.05 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Attitudes: Empathy (AAPI-2) | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY trial | Year 1 | 1,060 mothers | Adjusted mean = 37.12 | Adjusted mean = 36.64 | Mean difference = 0.48 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Attitudes: Inappropriate expectations (AAPI-2) | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY trial | Year 1 | 1,060 mothers | Adjusted mean = 19.11 | Adjusted mean = 18.83 | Mean difference = 0.28 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Attitudes: Physical punishment (AAPI-2) | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY trial | Year 1 | 1,060 mothers | Adjusted mean = 38.43 | Adjusted mean = 38.01 | Mean difference = 0.42 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Attitudes: Power/independence (AAPI-2) | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY trial | Year 1 | 1,060 mothers | Adjusted mean = 19.39 | Adjusted mean = 19.40 | Mean difference = -0.01 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Attitudes: Role reversal (AAPI-2) | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY trial | Year 1 | 1,060 mothers | Adjusted mean = 23.59 | Adjusted mean = 23.24 | Mean difference = 0.35 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Child safety checklist | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY trial | Year 1 | 1,060 mothers | % = 86.10 | % = 85.90 | Not Reported | Not available | Not statistically significant, p ≥ 0.05 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | ER visits due to injury or ingestion | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 children | % = 3.80 | % = 6.20 | = -2.40 | HomeVEE calculated = -0.31 | Not statistically significant, p ≥ 0.05 |
| Outcome measure | Description of measure | Data collection method | Properties of measure |
|---|---|---|---|
Child ever without needed medical care |
Percentage of children who had ever gone without needed medical care | Parent/caregiver report | Not applicable |
Child has PCP |
Percentage of children who had a PCP | Parent/caregiver report | Not applicable |
Mother breastfed baby |
Percentage of mothers who had breastfed their child | Parent/caregiver report | Not applicable |
Number of months breastfed |
Number of months the mother had breastfed her child | Parent/caregiver report | Not applicable |
Number of well-baby visits |
Number of well-child visits the child had received | Review of medical records | Not applicable |
| Outcome measure | Description of measure | Data collection method | Properties of measure |
|---|---|---|---|
Child has health insurance |
Percentage of children who had health insurance coverage |
Parent/caregiver report |
Not applicable |
Family received WIC |
Percentage of families who received WIC | Parent/caregiver report | Not applicable |
Family received TANF |
Percentage of households that received TANF | Parent/caregiver report | Not applicable |
Family received 50% income from work |
Percentage of households in which 50% of the household’s income came from work | Parent/caregiver report | Not applicable |
Mother employed |
Percentage of mothers who were employed | Parent/caregiver report | Not applicable |
Mother has health insurance |
Percentage of mothers who had health insurance coverage |
Parent/caregiver report |
Not applicable |
| Outcome measure | Description of measure | Data collection method | Properties of measure |
|---|---|---|---|
AUDIT: Alcohol abuse |
The AUDIT assesses the degree to which a person’s alcohol use is harmful. Respondents reported the frequency with which they experienced eight, different symptoms of alcohol abuse, with possible scores ranging from 0 to 32. A score of 8 or more indicated a strong likelihood of alcohol abuse. The researchers examined the total score and a binary variable representing whether a respondent was above or below the cutoff of 8. | Parent/caregiver report | Not reported by author |
DAST: Drug use |
The DAST assesses the degree to which a person’s use of illegal or legal drugs is harmful. The researchers used the instrument to examine the percentage of parents who reported using illegal drugs. | Parent/caregiver report | Not reported by author |
CES-D: Depressive symptoms CES-D: Above depression threshold |
The CES-D is a 20-item assessment of depressive symptoms. The researchers examined the total score (range 0–60) and a binary measure indicating whether the total depression score was at or above a cutoff of 16, which defined cases of probable depression. | Parent/caregiver report | Not reported by author |
Mastery ofPsychological CopingResources Scale(PSM): Sense of personal mastery |
The PSM assesses the extent to which respondents believe that their life chances are under their own control. The assessment measures the degree of agreement with eight statements related to the respondents’ capacity to affect events and circumstances in their lives. | Parent/caregiver report | Not reported by author |
Mother has primary care physician |
Percentage of mothers who had a primary care physician | Parent/caregiver report | Not applicable |
Smoking |
Percentage of parents who reported smoking cigarettes | Parent/caregiver report | Not applicable |
Smoking frequency |
Average number of cigarettes smoked per day | Parent/caregiver report | Not applicable |
| Outcome measure | Description of measure | Data collection method | Properties of measure |
|---|---|---|---|
AAPI-2: Physical punishment, Inappropriate expectations, Empathy, Role reversal, Power and independence |
The AAPI-2 assesses parenting and childrearing attitudes. The researchers examined five subscales: inappropriate expectations, empathy, corporal punishment, role reversal, power, and independence | Parent/caregiver report | Not reported by author |
Child Safety Checklist (CSC) |
The CSC assesses parental safety practices. Parents were asked how regularly they engaged in 23 child safety behaviors in the past year. Response choices included some of the time, none of the time, or all of the time. The authors analyzed the percentage of practices that parents reported doing all of the time. | Parent/caregiver report | Not reported by author |
| Outcome measure | Description of measure | Data collection method | Properties of measure |
|---|---|---|---|
ER visits due to injury or ingestion |
Percentage of children who, had at least one ER visit that involved injury or ingestion | Parent/caregiver report | Not applicable |
