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Easterbrooks, M. A., Fauth, R. C., Menon, M., Stargel, L. E., & Kotake, C. (n.d.). The Massachusetts Healthy Families Evaluation Phase 2 (MHFE-2): Time 6 summary report. Tufts Interdisciplinary Evaluation Research, Tufts University.

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
Moderate Randomized controlled trial High Established on race/ethnicity and SES; outcomes not feasible to assess at baseline None None
Notes:

In addition to the findings that received moderate ratings, 17 findings in the Maternal Health and Family Economic Self-Sufficiency domains received low ratings because the outcomes were assessable at baseline but were not included as controls in the statistical models that produced the study estimates.

Study characteristics
Study participants The program enrolled participants during pregnancy or as new parents and they were eligible if they were English- or Spanish-speaking females, at least 16 years old, and had not previously received the home visiting program services. Recruitment ended in 2008 and 2009. This study reported follow-up results at 8 years after enrollment, when children were 7.5 years old on average. Maternal age at enrollment was 18.7 years on average. The full study sample was 36 percent Hispanic; 35 percent White, non-Hispanic; and 23 percent Black, non-Hispanic. Of sample members at the time of enrollment, 42 percent had a high school diploma or GED, 25 percent were currently employed, 18 percent had received state cash assistance, and 16 percent had received Supplemental Nutrition Assistance Program (SNAP) benefits.
Setting Massachusetts
Intervention services Healthy Families Massachusetts offers its program to new parents from pregnancy through when the child turns 3 years old. The program offers in-home visits and health screenings, screenings for developmental milestones, and referrals for additional supportive services. The goals of Healthy Families Massachusetts include child abuse prevention; healthy childhood growth and development; and support for parents to promote health, well-being, education attainment, and job and life skills. An additional goal of the program is to promote mothers’ ability to navigate the preschool and elementary school systems as their children grow.
Comparison conditions The comparison condition received only referrals and information.
Staff characteristics and training Not described.
Funding sources Children's Trust Massachusetts and U.S. Department of Health and Human Services, Maternal, Infant, and Early Childhood Home Visiting Grant Program (grant no. X10MC29474).
Author affiliation The authors are affiliated with Tufts University and the study was conducted by the Children's Trust. The authors are not affiliated with the developer or distributer of Healthy Families America.
Study Registration:

Clinicaltrials.gov Identifier: NCT01926223. Study registration was assessed by HomVEE beginning with the 2014 review.

Findings details

Child development and school readiness
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 IEP or 504 plan

FavorableUnfavorable or ambiguousNo Effect

HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample

8 years

370 children Unadjusted proportion = 0.27 Unadjusted proportion = 0.30 Mean difference = -0.02 HomeVEE calculated = -0.07

Not statistically significant, p ≥ 0.05

Moderate

Child in afterschool program

FavorableUnfavorable or ambiguousNo Effect

HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample

8 years

368 children Adjusted proportion = 0.55 Adjusted proportion = 0.42 Odds ratio = 1.71 HomeVEE calculated = 0.32

Statistically significant, p <.05

Effect size based on study OR

Submitted by barbara on Fri, 04/12/2019 - 18:55

HomVEE calculated the effect size based on the study-reported odds ratio.

Moderate

Strengths and Difficulties Questionnaire - externalizing

FavorableUnfavorable or ambiguousNo Effect

HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample

8 years

366 children Unadjusted mean = 5.58 Unadjusted mean = 5.60 Mean difference = -0.02 HomeVEE calculated = -0.01

Not statistically significant, p ≥ 0.05

Moderate

Strengths and Difficulties Questionnaire - internalizing

FavorableUnfavorable or ambiguousNo Effect

HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample

8 years

360 children Unadjusted mean = 3.48 Unadjusted mean = 3.51 Mean difference = -0.03 HomeVEE calculated = -0.01

Not statistically significant, p ≥ 0.05

Child health
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Moderate

Asthma (diagnosed past year)

FavorableUnfavorable or ambiguousNo Effect

HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample

8 years

384 children Adjusted proportion = 0.07 Adjusted proportion = 0.14 Odds ratio = 0.46 HomeVEE calculated = -0.47

Statistically significant, p <.05

Effect size based on study OR

Submitted by barbara on Fri, 04/12/2019 - 18:55

HomVEE calculated the effect size based on the study-reported odds ratio.

Moderate

Child had dental visit (past year)

FavorableUnfavorable or ambiguousNo Effect

HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample

8 years

379 children Unadjusted proportion = 0.95 Unadjusted proportion = 0.98 Mean difference = -0.03 HomeVEE calculated = -0.60

Not statistically significant, p ≥ 0.05

Moderate

Child had well visit (past year)

FavorableUnfavorable or ambiguousNo Effect

HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample

8 years

383 children Unadjusted proportion = 0.99 Unadjusted proportion = 0.99 Mean difference = 0.00 HomeVEE calculated = 0.00

Not statistically significant, p ≥ 0.05

Moderate

Child visited emergency room (past year)

FavorableUnfavorable or ambiguousNo Effect

HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample

8 years

383 children Unadjusted proportion = 0.27 Unadjusted proportion = 0.24 Mean difference = 0.03 HomeVEE calculated = 0.11

Not statistically significant, p ≥ 0.05

Moderate

Obesity/overweight (past year)

FavorableUnfavorable or ambiguousNo Effect

HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample

8 years

384 children Unadjusted proportion = 0.05 Unadjusted proportion = 0.05 Mean difference = 0.01 HomeVEE calculated = 0.08

Not statistically significant, p ≥ 0.05

Moderate

Pediatric Quality of Life Inventory - physical functioning

FavorableUnfavorable or ambiguousNo Effect

HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample

8 years

381 children Adjusted mean = 93.91 Adjusted mean = 91.91 Mean difference = 2.00 Study reported = 0.20

Statistically significant, p <.05

Effect size is the Cohen's d

Moderate

Pediatric Quality of Life Inventory - school functioning

FavorableUnfavorable or ambiguousNo Effect

HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample

8 years

383 children Unadjusted mean = 78.24 Unadjusted mean = 78.06 Mean difference = 0.18 HomeVEE calculated = 0.01

Not statistically significant, p ≥ 0.05

Maternal health
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Moderate

Parenting Stress Index - difficult child

FavorableUnfavorable or ambiguousNo Effect

HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample

8 years

380 mothers Unadjusted mean = 24.14 Unadjusted mean = 25.97 Mean difference = -1.83 HomeVEE calculated = -0.24

Not statistically significant, p ≥ 0.05

Moderate

Parenting Stress Index - parental child-dysfunctional interaction

FavorableUnfavorable or ambiguousNo Effect

HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample

8 years

380 mothers Unadjusted mean = 18.38 Unadjusted mean = 19.71 Mean difference = -1.33 HomeVEE calculated = -0.22

Not statistically significant, p ≥ 0.05

Moderate

Parenting Stress Index - parental distress

FavorableUnfavorable or ambiguousNo Effect

HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample

8 years

379 mothers Unadjusted mean = 24.41 Unadjusted mean = 26.32 Mean difference = -1.91 HomeVEE calculated = -0.22

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
Moderate

Family Involvement Questionnaire - Home-Based Involvement

FavorableUnfavorable or ambiguousNo Effect

HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample

8 years

373 mothers Unadjusted mean = 22.16 Unadjusted mean = 21.74 Mean difference = 0.42 HomeVEE calculated = 0.10

Not statistically significant, p ≥ 0.05

Moderate

Family Involvement Questionnaire - Home-School Conferencing

FavorableUnfavorable or ambiguousNo Effect

HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample

8 years

388 mothers Unadjusted mean = 20.18 Unadjusted mean = 19.34 Mean difference = 0.84 HomeVEE calculated = 0.14

Not statistically significant, p ≥ 0.05

Moderate

Family Involvement Questionnaire: School-Based Involvement

FavorableUnfavorable or ambiguousNo Effect

HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample

8 years

341 mothers Unadjusted mean = 13.30 Unadjusted mean = 13.28 Mean difference = 0.02 HomeVEE calculated = 0.00

Not statistically significant, p ≥ 0.05

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
Moderate

Permanent custody loss

FavorableUnfavorable or ambiguousNo Effect

HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample

8 years

408 mother/child dyads Unadjusted proportion = 0.03 Unadjusted proportion = 0.02 Mean difference = 0.01 HomeVEE calculated = 0.17

Not statistically significant, p ≥ 0.05

Moderate

Substantiated child maltreatment reports

FavorableUnfavorable or ambiguousNo Effect

HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample

8 years

408 mother/child dyads Unadjusted proportion = 0.36 Unadjusted proportion = 0.39 Mean difference = -0.03 HomeVEE calculated = -0.09

Not statistically significant, p ≥ 0.05

Outcome measure summary

Child development and school readiness
Outcome measure Description of measure Data collection method Properties of measure

Child has IEP or 504 plan

Mothers asked if child currently had an Individualized Education Plan or 504 Plan in place (target child)

Parent self-report

Not reported

Child in afterschool program

Mothers asked if target child currently participated in any afterschool programs (target child)

Parent self-report

Not reported

Strengths and Difficulties Questionnaire - externalizing

Strengths and Difficulties Questionnaire - Externalizing subscale

Self-report questionnaire

Not reported

Strengths and Difficulties Questionnaire - internalizing

Strengths and Difficulties Questionnaire - Internalizing subscale

Self-report questionnaire

Not reported

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

Asthma (diagnosed past year)

Mothers asked if child was diagnosed with asthma in past year (target child)

Parent self-report

Not reported

Child had dental visit (past year)

Mothers reported if their child had visited dentist in the past year (target child)

Parent self-report

Not reported

Child had well visit (past year)

Mothers reported if their child had a well visit in past year (target child)

Parent self-report

Not reported

Child visited emergency room (past year)

Mothers reported if they had been to emergency room for their child in the past year (target child)

Parent self-report

Not reported

Obesity/overweight (past year)

Mothers asked if child had been diagnosed as overweight or obese in past year (target child)

Parent self-report

Not reported

Pediatric Quality of Life Inventory - physical functioning

Pediatric Quality of Life Inventory (PedsQL) - Physical Functioning subscale

Self-report questionnaire

Not reported

Pediatric Quality of Life Inventory - school functioning

Pediatric Quality of Life Inventory (PedsQL) - School Functioning subscale

Self-report questionnaire

Not reported

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

Parenting Stress Index - difficult child

Parenting Stress Index - Difficult Child subscale

Self-report questionnaire

Not reported

Parenting Stress Index - parental child-dysfunctional interaction

Parenting Stress Index - Parental-Child Dysfunctional Interaction subscale

Self-report questionnaire

Not reported

Parenting Stress Index - parental distress

Parenting Stress Index - Parental Distress subscale

Self-report questionnaire

Not reported

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

Family Involvement Questionnaire - Home-Based Involvement

Family Involvement Questionnaire-Short Form (FIQ-SF)

Self-report questionnaire

Not reported

Family Involvement Questionnaire - Home-School Conferencing

Family Involvement Questionnaire-Short Form (FIQ-SF)

Self-report questionnaire

Not reported

Family Involvement Questionnaire: School-Based Involvement

Family Involvement Questionnaire-Short Form (FIQ-SF)

Self-report questionnaire

Not reported

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

Permanent custody loss

Permanent loss of custody (target child)

Agency administrative data

Not reported

Substantiated child maltreatment reports

Substantiated reports of child maltreatment (target child)

Agency administrative data

Not reported