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Duggan, A., McFarlane, E., Fuddy, L., Burrell, L., Higman, S. M., Windham, A., et al. (2004). Randomized trial of a statewide home visiting program: Impact in preventing child abuse and neglect. Child Abuse & Neglect, 28(6), 597–622.

Model(s) Reviewed: Healthy Families America (HFA)®
Manuscript screening details
Screening decision Screening conclusion
Passes screens Eligible for review
Study design details
Rating Design Attrition Baseline equivalence Reassignment Confounding factors
High Randomized controlled trial Low Established on race but not SES (e.g., maternal employment). Maternal employment is included as a control. Baseline equivalence on outcomes not feasible. None None
Notes:

In 2020, HomVEE updated this review to move measures of Nonviolent discipline and Time outs (CTS-PC) from the Positive Parenting Practices domain to the Reductions in Child Maltreatment because ACF determined that nonviolent discipline and corporal punishment outcomes belong in the Positive Parenting Practices domain, unless those outcome are assessed using the Conflict Tactics Scale-Parent/Child. 

Study characteristics
Study participants Families were recruited to the study between November 1994 and December 1995. Hawaii Healthy Start Program staff screened the medical records of mothers from one of four Oahu communities delivering children at Kapiolani Maternity Hospital for risk factors for child abuse and neglect. Mothers found to be at risk, or those whose records did not contain sufficient information to screen out, were screened further using the Kempe Family Stress Checklist; eligible families were those in which either parent scored 25 or greater (Duggan, 2004a). Of the 897 families who were eligible to participate in the study, 730 (81%) agreed to participate and were randomly assigned to the program group (n = 395), the main comparison group (n = 290), or a testing comparison group (n = 45). 684 families completed a baseline interview (373 families in the program group, 270 families in the main comparison group, and 41 in the testing group comparison). On average, at baseline, mothers were 23.7 years of age (program group) and 23.3 years of age (comparison group). 63% (program group) and 67% (comparison group) of participating families lived below the poverty line. The racial composition of the program group was 34% native Hawaiian or Pacific Islander, 28% Asian or Filipino, 10% Caucasian, and 27% of unknown primary ethnicity. The main comparison group consisted of 33% native Hawaiian or Pacific Islander, 28% Asian or Filipino, 14% Caucasian, and 26% of unknown primary ethnicity. This study reports results from the three follow-ups of the Hawaii Healthy Start randomized controlled trial. In each follow-up year, interviews were completed for 88% of families. 81% of participating families completed all three follow-up interviews. Data were also collected from home observations, administrative records from child protective services, and pediatric medical records.
Setting Six Healthy Start Program sites operated by three community-based organizations in Oahu, Hawaii.
Intervention services Home visiting services were designed to provide three to five years of home visiting, with weekly visits for most or all of the child’s first year of life, and visits of gradually decreasing frequency thereafter depending on family need. Home visitors endeavored to establish trusting relationships with families, help them resolve immediate crises, and help them build on existing strengths to improve their ability to function independently. Visitors helped families develop problem-solving skills, connected them to needed services, and aimed to develop an individual service plan with each family every six months and help the family reach six-month goals. The actual frequency of visits, however, was lower than that specified by the model, with families receiving an average of 13 visits in the child’s first year of life, and 51% of families not actively participating in the program by the time the child was 12 months old. Families still active at the end of year 1 received an average of 22 visits in the first year. (Duggan, et al., 1999)
Comparison conditions The main comparison group was tested annually to measure outcomes. A second “testing” comparison group was evaluated only at year 3 to ascertain the effect of repeated testing on observed outcomes (Duggan, McFarlane, Fuddy, Burrell, Higman, Windham, et al., 2004).
Staff characteristics and training Trained paraprofessionals were recruited from the community to conduct the home visits.
Funding sources Maternal and Child Health Bureau (R40MC00029 (formerly MCJ 240637) and R40 MC 00123 (formerly MCJ 240838); The Robert Wood Johnson Foundation (18303); The Annie E. Casey Foundation (94-4041); The David and Lucile Packard Foundation (93-6051, 94-7957, 97-8058, and 98-3448); National Institute of Mental Health, Epidemiological Center for Early Risk Behaviors, P30MH38725; the Hawaii State Department of Health (99-29-J); and the National Institute of Mental Health, Epidemiological Center for Early Risk Behaviors, P30MH38725.
Author affiliation None of the study authors are developers of this model.

Findings details

Child health
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High Hospitalizations for ambulatory care
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Years 1-3 573 children % = 12.00 % = 10.00 OR = 1.27 HomeVEE calculated = 0.12 Not statistically significant, p ≥ 0.05
Positive parenting practices
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High Maternal acceptance of child’s behavior (HOME)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 3 541 mothers Mean = 3.20 Mean = 3.00 Mean difference = 0.20 Not available Statistical significance not reported
High Maternal acceptance of child’s behavior (HOME)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 2 549 mothers Mean = 5.40 Mean = 5.40 Mean difference = 0.00 Not available Statistical significance not reported
High Maternal acceptance of child’s behavior (HOME)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 1 558 mothers Mean = 5.60 Mean = 5.70 Mean difference = -0.10 Not available Statistical significance not reported
High Maternal responsivity to child (HOME)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Years 1-3 558 mothers Not available Not available Mean difference = 0.18 Not available Not statistically significant, p ≥ 0.05
High Maternal responsivity to child (HOME)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 3 541 mothers Mean = 4.80 Mean = 4.50 Mean difference = 0.30 Not available Statistical significance not reported
High Maternal responsivity to child (HOME)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 2 549 mothers Mean = 9.30 Mean = 8.90 Mean difference = 0.40 Not available Statistical significance not reported
High Maternal responsivity to child (HOME)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 1 558 mothers Mean = 9.30 Mean = 9.20 Mean difference = 0.10 Not available Statistical signifivance not reported
Reductions in child maltreatment
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High Assault on child’s self-esteem (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 2 549 mothers % = 35.00 % = 35.00 = 0.00 HomeVEE calculated = 0.00 Statistical significance not reported
High Assault on child’s self-esteem (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 1 558 mothers % = 20.00 % = 22.00 = -2.00 HomeVEE calculated = -0.07 Statistical significance not reported
High Assault on child’s self-esteem (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Years 1-3 558 mothers Not available Not available OR = 0.90 Not available Not statistically significant, p ≥ 0.05
High Assault on child’s self-esteem (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 3 541 mothers % = 42.00 % = 44.00 = -2.00 HomeVEE calculated = -0.05 Statistical significance not reported
High Common corporal/verbal punishment (past week) (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 3 541 mothers % = 77.00 % = 75.00 = 2.00 HomeVEE calculated = 0.07 Statistical significance not reported
High Common corporal/verbal punishment (past week) (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 2 549 mothers % = 75.00 % = 74.00 = 1.00 HomeVEE calculated = 0.03 Statistical significance not reported
High Common corporal/verbal punishment (past week) (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 1 558 mothers % = 58.00 % = 57.00 = 1.00 HomeVEE calculated = 0.02 Not available
High Common corporal/verbal punishment (past week) (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Years 1-3 558 mothers Not available Not available OR = 1.07 Not available Not statistically significant, p ≥ 0.05
High Common corporal/verbal punishment (past year) (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 1 558 mothers % = 76.00 % = 83.00 = -7.00 HomeVEE calculated = -0.26 Statistical significance not reported
High Common corporal/verbal punishment (past year) (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Years 1-3 558 mothers Not available Not available OR = 0.59 Not available Statistically significant,
p < 0.05
High Common corporal/verbal punishment (past year) (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 3 541 mothers % = 92.00 % = 95.00 = -3.00 HomeVEE calculated = -0.30 Statistical significance not reported
High Common corporal/verbal punishment (past year) (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 2 549 mothers % = 90.00 % = 94.00 = -4.00 HomeVEE calculated = 0.34 Statistical significance not reported
High Extreme physical abuse (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 3 541 mothers % = 4.00 % = 2.00 = 2.00 HomeVEE calculated = 0.43 Statistical significance not reported
High Extreme physical abuse (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 2 549 mothers % = 4.00 % = 4.00 = 0.00 HomeVEE calculated = 0.00 Statistical significance not reported
High Extreme physical abuse (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 1 558 mothers % = 1.00 % = 1.00 = 0.00 Study reported = 0.00 Statistical significance not reported
High Extreme physical abuse (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Years 1-3 558 mothers Not available Not available OR = 1.26 Not available Not statistically significant, p ≥ 0.05
High Hitting with an object (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 3 541 mothers % = 28.00 % = 22.00 = -6.00 HomeVEE calculated = 0.19 Statistical significance not reported
High Hitting with an object (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 2 549 mothers % = 22.00 % = 20.00 = 2.00 HomeVEE calculated = 0.07 Statistical significance not reported
High Hitting with an object (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 1 558 mothers % = 9.00 % = 8.00 = 1.00 HomeVEE calculated = 0.08 Statistical significance not reported
High Hitting with an object (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Years 1-3 558 mothers Not available Not available OR = 1.22 Not available Not statistically significant, p ≥ 0.05
High Hospitalizations for trauma
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Years 1-3 573 children % = 1.50 % = 1.70 = 0.20 HomeVEE calculated = -0.08 Statistical significance not reported
High Minor physical assault (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Years 1-3 558 mothers Not available Not available OR = 0.90 Not available Not statistically significant, p ≥ 0.05
High Minor physical assault (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 3 541 mothers % = 86.00 % = 86.00 = 0.00 HomeVEE calculated = 0.00 Statistical significance not reported
High Minor physical assault (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 2 549 mothers % = 86.00 % = 85.00 = 1.00 HomeVEE calculated = 0.05 Statistical significance not reported
High Minor physical assault (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 1 558 mothers % = 68.00 % = 70.00 = -2.00 HomeVEE calculated = -0.06 Statistical significance not reported
High Neglect (Revised CTS measure) (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Years 1-3 558 mothers Not available Not available OR = 0.72 Not available Statistically significant,
p < 0.05
High Neglect (Revised CTS measure) (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 3 541 mothers % = 22.00 % = 27.00 = -5.00 HomeVEE calculated = -0.16 Statistical significance not reported
High Neglect (Revised CTS measure) (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 2 549 mothers % = 23.00 % = 28.00 = -5.00 HomeVEE calculated = -0.16 Statistical significance not reported
High Neglect (Revised CTS measure) (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 1 558 mothers % = 22.00 % = 30.00 = -8.00 HomeVEE calculated = -0.25 Statistical significance not reported
High Neglect (Traditional CTS measure) (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Years 1-3 558 mothers Not available Not available OR = 0.80 Not available Not statistically significant, p ≥ 0.05
High Neglect (Traditional CTS measure) (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 3 541 mothers % = 26.00 % = 29.00 = -7.00 HomeVEE calculated = -0.09 Statistical significance not reported
High Neglect (Traditional CTS measure) (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 2 549 mothers % = 27.00 % = 26.00 = 1.00 HomeVEE calculated = 0.03 Statistical significance not reported
High Neglect (Traditional CTS measure) (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 1 558 mothers % = 24.00 % = 32.00 = -8.00 HomeVEE calculated = -0.24 Statistical significance not reported
High Nonviolent discipline, ever used in past year (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 3 541 mothers % = 100.00 % = 100.00 = 0.00 HomeVEE calculated = 0.00 Statistical significance not reported
High Nonviolent discipline, ever used in past year (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 2 549 mothers % = 100.00 % = 100.00 = 0.00 HomeVEE calculated = 0.00 Statistical significance not reported
High Nonviolent discipline, ever used in past year (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 1 558 mothers % = 98.00 % = 99.00 = -1.00 HomeVEE calculated = -0.43 Statistical significance not reported
High Nonviolent discipline, times used in past year (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 1 558 mothers Mean = 33.00 Mean = 30.90 Mean difference = 2.10 Not available Statistical significance not reported
High Nonviolent discipline, times used in past year (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Years 1-3 558 mothers Not available Not available Mean difference = 1.80 Not available Not statistically significant, p ≥ 0.05
High Nonviolent discipline, times used in past year (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 3 541 mothers Mean = 47.00 Mean = 46.10 Mean difference = 0.90 Not available Statistical significance not reported
High Nonviolent discipline, times used in past year (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 2 549 mothers Mean = 45.70 Mean = 42.40 Mean difference = 3.30 Not available Statistical significance not reported
High Psychological aggression (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 3 541 mothers % = 88.00 % = 89.00 = -2.00 HomeVEE calculated = -0.06 Statistical significance not reported
High Psychological aggression (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 2 549 mothers % = 86.00 % = 88.00 = -2.00 HomeVEE calculated = -0.11 Statistical significance not reported
High Psychological aggression (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 1 558 mothers % = 69.00 % = 74.00 = -5.00 HomeVEE calculated = -0.15 Not statistically significant, p ≥ 0.05

footnote58

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

Sample size is the largest reported across the time period.

High Psychological aggression (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Years 1-3 558 mothers Not available Not available OR = 0.76 Not available Not statistically significant, p ≥ 0.05

footnote58

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

Sample size is the largest reported across the time period.

High Severe physical abuse (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Years 1-3 558 mothers Not available Not available OR = 1.30 Not available Not statistically significant, p ≥ 0.05
High Severe physical abuse (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 3 541 mothers % = 22.00 % = 15.00 = 7.00 HomeVEE calculated = 0.28 Statistical significance not reported
High Severe physical abuse (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 2 549 mothers % = 14.00 % = 15.00 = -1.00 HomeVEE calculated = -0.05 Statistical significance not reported
High Severe physical abuse (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 1 558 mothers % = 6.00 % = 4.00 = 2.00 HomeVEE calculated = 0.26 Statistical significance not reported
High Shook child (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 3 541 mothers % = 6.00 % = 7.00 = -1.00 HomeVEE calculated = -0.10 Statistical significance not reported
High Shook child (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 2 549 mothers % = 6.00 % = 6.00 = 0.00 HomeVEE calculated = 0.00 Statistical significance not reported
High Shook child (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 1 558 mothers % = 6.00 % = 6.00 = 0.00 HomeVEE calculated = 0.00 Statistical significance not reported
High Shook child (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Years 1-3 558 mothers Not available Not available OR = 0.94 Not available Not statistically significant, p ≥ 0.05
High Substantiated CPS reports abuse or neglect
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 2 549 mothers % = 0.80 % = 1.10 = -0.30 HomeVEE calculated = -0.19 Statistical significance not reported
High Substantiated CPS reports abuse or neglect
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 1 558 mothers = 0.00 % = 0.40 = -0.40 HomeVEE calculated = 0.00 Statistical significance not reported
High Substantiated CPS reports abuse or neglect
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 3 541 mothers % = 0.20 = 0.00 = 0.20 HomeVEE calculated = 0.00 Statistical significance not reported
High Substantiated CPS reports all types
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 1 558 mothers % = 0.80 % = 1.10 = -0.30 HomeVEE calculated = -0.19 Statistical significance not reported
High Substantiated CPS reports all types
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 3 541 mothers % = 1.10 % = 0.70 = 0.40 HomeVEE calculated = 0.28 Statistical significance not reported
High Substantiated CPS reports all types
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 2 549 mothers % = 1.30 % = 2.20 = -0.90 HomeVEE calculated = -0.32 Statistical significance not reported
High Substantiated CPS reports threatened abuse neglect or harm
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 3 541 mothers % = 1.10 % = 0.70 = -0.40 HomeVEE calculated = 0.28 Statistical significance not reported
High Substantiated CPS reports threatened abuse neglect or harm
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 2 549 mothers % = 1.30 % = 1.50 = -0.20 HomeVEE calculated = -0.09 Statistical significance not reported
High Substantiated CPS reports threatened abuse neglect or harm
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 1 558 mothers % = 0.80 % = 1.10 = -0.30 HomeVEE calculated = -0.19 Statistical significance not reported
High Timeouts, ever used in past week (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Years 1-3 558 mothers Not available Not available OR = 1.01 Not available Not statistically significant, p ≥ 0.05
High Timeouts, ever used in past week (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 3 541 mothers % = 71.00 % = 67.00 = 4.00 HomeVEE calculated = 0.11 Not statistically significant, p ≥ 0.05
High Timeouts, ever used in past week (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 2 549 mothers % = 62.00 % = 62.00 = 0.00 HomeVEE calculated = 0.00 Not statistically significant, p ≥ 0.05
High Timeouts, ever used in past week (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 1 558 mothers % = 35.00 % = 36.00 = -1.00 HomeVEE calculated = -0.03 Not statistically significant, p ≥ 0.05
High Timeouts, times used in past year (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 1 558 mothers Mean = 1.50 Mean = 1.10 Mean difference = 0.40 Not available Statistical significance not reported
High Timeouts, times used in past year (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Years 1-3 558 mothers Not available Not available Mean difference = 0.10 Not available Not statistically significant, p ≥ 0.05
High Timeouts, times used in past year (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 3 541 mothers Mean = 5.20 Mean = 5.40 Mean difference = -0.20 Not available Statistical significance not reported
High Timeouts, times used in past year (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 2 549 mothers Mean = 2.90 Mean = 3.00 Mean difference = -0.10 Not available Statistical significance not reported
High Very severe physical abuse (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 3 541 mothers % = 6.00 % = 7.00 = -1.00 HomeVEE calculated = -0.10 Statistical significance not reported
High Very severe physical abuse (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 2 549 mothers % = 6.00 % = 6.00 = 0.00 HomeVEE calculated = 0.00 Statistical significance not reported
High Very severe physical abuse (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
Full sample, Hawaii trial Year 1 558 mothers % = 5.00 % = 6.00 = -1.00 HomeVEE calculated = -0.12 Statistical significance not reported

Outcome measure summary

Child health
Outcome measure Description of measure Data collection method Properties of measure

Hospitalizations for ambulatory care

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

Not applicable

Positive parenting practices
Outcome measure Description of measure Data collection method Properties of measure

HOME: Acceptance of child’s behavior HOME: Responsivity

The HOME assesses parenting practices and aspects of the home environment. The HOME includes several subscales, including scales that describe the extent to which parents respond to their child’s behavior and parental acceptance of challenging child behaviors. Parent/caregiver interview and observational assessment

Not reported by author

Reductions in child maltreatment
Outcome measure Description of measure Data collection method Properties of measure

CTS-PC: Nonviolent discipline

The CTS-PC assesses neglectful, psychologically aggressive, and abusive parenting behaviors and acts. The assessment is divided into six subscales, including a scale of nonviolent discipline

Parent/caregiver report

Not reported by author

CTS-PC: Timeouts

The CTS-PC assesses neglectful, psychologically aggressive, and abusive parenting behaviors and acts. The assessment is divided into six subscales, including a scale of nonviolent discipline. The assessment also asks how often parents used specific parenting behaviors, such as timeouts, in the recent past. The researchers examined both the prevalence and frequency (times used in the past week or past year) of timeouts and nonviolent discipline.

Parent/caregiver report

Not reported by author

Conflict Tactics Scale-Parent Child (CTS-PC):

  • Psychological aggression
  • Minor physical assault
  • Severe physical abuse
  • Common corporal/verbal punishment during the past year
  • Assault on child’s self-esteem
  • Hitting with an object
  • Extreme physical abuse
  • Shook child
  • Common corporal/verbal punishment during the past week
  • Traditional neglect
  • Revised neglect
The CTS-PC assesses neglectful, psychologically aggressive, and abusive parenting behaviors and acts. The assessment is divided into six subscales: (1) nonviolent discipline, (2) psychological aggression, (3) minor physical assault, (4) severe physical assault, (5) very severe physical assault, and (6) neglect. The researchers conducted factor analysis to determine whether a different set of subscales may be more applicable to the sample. This process produced five revised subscales: (1) common corporal and verbal punishment, (2) assault on child’s self-esteem, (3) hitting with an object, (4) extreme physical violence, and (5) neglect. They assessed program impact for both the traditional and revised subscales. Parent/caregiver report

Not reported by author

Hospitalizations for trauma

Percentage of children who were hospitalized for trauma Review of medical records

Not applicable

Substantiated CPS reports, abuse or neglect

Percentage of families who had a substantiated report for child abuse or neglect Review of CPS records

Not applicable

Substantiated CPS reports, all types

Percentage of families who had a substantiated report across all child abuse or neglect classifications Review of CPS records

Not applicable

Substantiated CPS reports, threatened abuse, neglect or harm

Percentage of families who had a substantiated report for threatened child abuse, neglect, or harm Review of CPS records

Not applicable