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DuMont, K., Kirkland, K., Mitchell-Herzfeld, S., Ehrhard-Dietzel, S., Rodriguez, M. L., Lee, E., ... & Greene, R. (2010). A randomized trial of Healthy Families New York (HFNY): Does home visiting prevent child maltreatment? Rensselaer, NY: New York State Office of Children & Family Services and Albany, NY: University of Albany, State University of New York.

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/ethnicity. None None
Notes:

In 2020, HomVEE updated this review to move the measures of withdrawn depressed, anxious depressed, and social problems (Child Behavior Checklist) from the Child Health domain to the Child Development and School Readiness domain because ACF determined that HomVEE should place all child mental and behavioral health outcomes in the Child Development and School Readiness domain. 

footnote91

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

High rating applies to all outcomes except those with baseline differences that were not controlled. The moderate rating applies to the following outcomes: biological mother confirmed subject–sexual abuse, target child confirmed victim–sexual abuse, and nonviolent discipline prevalence (CTS-PC)

Study characteristics
Study participants Community agencies, including prenatal care providers and hospitals, screened expectant parents and parents with an infant younger than three months of age who lived in high-risk target areas and who were considered to be at risk for child abuse or neglect. Women were selected for the study following the same screening and assessment procedures used to determine eligibility for Healthy Families New York (HFNY). Family assessment workers (FAWs) obtained informed consent from women before the administration of a well-established risk assessment tool. In total 1,254 mothers were randomly assigned (intervention, n = 621; control, n = 633), and 1,173 mothers (intervention, n = 579; control, n = 594) completed baseline interviews. Thirty-four percent of the mothers were white, non-Latina; 45 percent were African American, non-Latina; and 18 percent were Latina.
Setting This study took place in three sites within the HFNY home visiting program.
Intervention services HFNY,whichis based on the Healthy Families America (HFA) model, was established as a strengths-based, intensive home visitation program with the explicit goals of 1) promoting positive parenting skills and parent-child interaction; 2) preventing child abuse and neglect; 3) supporting optimal prenatal care, and child health and development; and 4) improving parent’s self-sufficiency. Families are provided intensive home visitation services bi-weekly during the prenatal period, weekly until the child is at least six months old, and periodically thereafter based on the needs of the family until the child begins school or Head Start. Home visits typically emphasize content that is appropriate to the particular service level on which the family is currently assigned. For example, visits on the prenatal level focus on promoting adequate prenatal care and providing information regarding fetal development, as well as preparing the family for childbirth and providing instruction on the care and safety of a newborn. Postnatal visits focus primarily on promoting positive parent-child interactions, educating parents about child growth and development, and enhancing family functioning and self-sufficiency. HFNY programs determine the most appropriate curricula to use during home visits based on the specific needs and characteristics of individual families. At all stages, home visitors provide support, education, information, and activities designed to promote healthy parenting behaviors and child growth, including proper nutrition, age-appropriate behaviors, and positive discipline strategies. Home visitors also help mothers access health care and other services as needed; identify and address issues regarding positive family functioning; and discuss childcare, education, training, and employment options.
Comparison conditions The control group was given information on and received referrals to appropriate services other than home visiting.
Staff characteristics and training The program is primarily delivered by trained paraprofessionals who typically come from the communities that the program targets for service.
Funding sources This research was supported by Award No: 2006-MU-MU-0002 awarded by the National Institute of Justice, U.S. Department of Justice.
Author affiliation None of the study authors are developers of this model.

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
High Aggressive behaviors (CBCL)
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 897 mothers Adjusted mean = 6.99 Adjusted mean = 6.72 Mean difference = 0.27 Study reported = 0.04 Not statistically significant, p ≥ 0.05
High Anxious, depressed (CBCL)
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 897 mothers Adjusted mean = 2.89 Adjusted mean = 2.97 Mean difference = -0.08 Study reported = -0.03 Not statistically significant, p ≥ 0.05
High Attention problems (CBCL)
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 897 mothers Adjusted mean = 4.77 Adjusted mean = 4.75 Mean difference = 0.02 Study reported = 0.01 Not statistically significant, p ≥ 0.05
High Percentage participating in a gifted program
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 897 mothers Adjusted mean % = 5.38 Adjusted mean % = 1.99 OR = 2.80 Not available Statistically significant, p < 0.05
High Percentage receiving remedial services
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 897 mothers Adjusted mean % = 32.83 Adjusted mean % = 33.31 OR = 0.98 Not available Not statistically significant, p ≥ 0.05
High Percentage receiving special education
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 897 mothers Adjusted mean % = 12.33 Adjusted mean % = 16.74 OR = 0.70 Not available Statistically significant, p < 0.05
High Percentage repeating a grade
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 897 mothers Adjusted mean % = 12.33 Adjusted mean % = 16.74 OR = 0.98 Not available Not statistically significant, p ≥ 0.05
High Percentage skipping school more than once
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 897 mothers Adjusted mean % = 2.40 Adjusted mean % = 2.20 OR = 1.08 Not available Not statistically significant, p ≥ 0.05
High Rule-breaking behavior (CBCL)
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 897 mothers Adjusted mean = 2.74 Adjusted mean = 2.66 Mean difference = 0.08 Study reported = 0.03 Not statistically significant, p ≥ 0.05
High Social problems (CBCL)
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 897 mothers Adjusted mean = 1.31 Adjusted mean = 1.15 Mean difference = 0.16 Study reported = -0.04 Not statistically significant, p ≥ 0.05
High Withdrawn, depressed (CBCL)
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 897 mothers Adjusted mean = 1.47 Adjusted mean = 1.54 Mean difference = -0.07 Study reported = -0.04 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
High Biological mother confirmed subject—neglect, cumulative rate
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 1,173 mothers Adjusted mean % = 22.96 Adjusted mean % = 20.68 OR = 1.14 Not available Not statistically significant, p ≥ 0.05
High Biological mother confirmed subject—physical abuse, cumulative rate
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 1,173 mothers Adjusted mean % = 4.47 Adjusted mean % = 4.24 OR = 1.06 Not available Not statistically significant, p ≥ 0.05
High Biological mother confirmed subject—sexual abuse, cumulative rate
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 1,173 mothers Mean % = 0.00 Mean % = 0.70 OR = 0.00 Not available Statistically significant, p < 0.05
High Biological mother confirmed subject, cumulative number
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 1,173 mothers Adjusted mean = 0.42 Adjusted mean = 0.42 Mean difference = 0.00 Study reported = 0.00 Not statistically significant, p ≥ 0.05
High Biological mother or target child confirmed subject or victim of CPS report, cumulative number
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 1,173 mothers Adjusted mean = 0.54 Adjusted mean = 0.55 Mean difference = -0.01 Study reported = -0.01 Not statistically significant, p ≥ 0.05
High Biological mother or target child confirmed subject or victim of CPS report, cumulative rate
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 1,173 mothers Adjusted mean % = 29.55 Adjusted mean % = 27.10 OR = 1.13 Not available Not statistically significant, p ≥ 0.05
High Foster care placement—target child, cumulative rate
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 1,173 mothers Adjusted mean % = 4.83 Adjusted mean % = 4.90 OR = 0.99 Not available Not statistically significant, p ≥ 0.05
High Minor physical aggression frequency(CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 897 mothers Adjusted mean = 4.36 Adjusted mean = 4.51 Mean difference = -0.15 Study reported = -0.02 Not statistically significant, p ≥ 0.05
High Minor physical aggression prevalence(CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 897 mothers Adjusted mean % = 64.12 Adjusted mean % = 59.17 OR = 1.25 Not available Not statistically significant, p ≥ 0.05
High Neglect frequency(CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 897 mothers Adjusted mean = 0.53 Adjusted mean = 0.64 Mean difference = -0.11 Study reported = 0.05 Not statistically significant, p ≥ 0.05
High Neglect prevalence(CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 897 mothers Adjusted mean % = 15.77 Adjusted mean % = 16.74 OR = 0.93 Not available Not statistically significant, p ≥ 0.05
High Non-violent discipline frequency(CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 897 mothers Adjusted mean = 49.27 Adjusted mean = 45.27 Mean difference = 4.00 Study reported = 0.14 Statistically significant, p < 0.05
High Non-violent discipline prevalence)(CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 897 mothers Unadjusted mean % = 100.00 Unadjusted mean % = 98.60 Mean difference = 1.40 Not available Not statistically significant, p ≥ 0.05
High Psychological aggression frequency(CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 897 mothers Adjusted mean = 15.33 Adjusted mean = 15.21 Mean difference = 0.12 Study reported = 0.01 Not statistically significant, p ≥ 0.05
High Psychological aggression prevalence(CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 897 mothers Adjusted mean % = 87.92 Adjusted mean % = 86.49 OR = 1.18 Not available Not statistically significant, p ≥ 0.05
High Serious physical abuse frequency(CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 897 mothers Adjusted mean = 0.03 Adjusted mean = 0.15 Mean difference = -0.12 Study reported = -0.20 Statistically significant, p < 0.05
High Serious physical aggressionprevalence (CTS-PC)
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 897 mothers Adjusted mean % = 1.76 Adjusted mean % = 3.18 OR = 0.55 Not available Not statistically significant, p ≥ 0.05
High Target child confirmed victim—neglect, cumulative rate
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 1,173 mothers Adjusted mean % = 24.29 Adjusted mean % = 22.95 OR = 1.08 Not available Not statistically significant, p ≥ 0.05
High Target child confirmed victim—physical abuse, cumulative rate
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 1,173 mothers Adjusted mean % = 4.09 Adjusted mean % = 3.05 OR = 1.36 Not available Not statistically significant, p ≥ 0.05
High Target child confirmed victim—sexual abuse, cumulative rate
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 1,173 mothers Mean % = 0.20 Mean % = 0.70 OR = 0.26 Not available Not statistically significant, p ≥ 0.05
High Target child confirmed victim, cumulative number
FavorableUnfavorable or ambiguousNo Effect
New York sample 7 year 1,173 mothers Adjusted mean = 0.39 Adjusted mean = 0.41 Mean difference = -0.02 Study reported = -0.02 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

Aggressive behaviors (CBCL)

The Achenbach Child Behavior Checklist assesses children’s emotional and behavioral problems. Researchers selected five subscales that aligned with constructs of interest: attention problems, rule breaking and aggressive behaviors, social problems, and the anxious-depressed and withdrawn-depressed syndrome scales. Parent/caregiver report

Not reported by author

Anxious, depressed (CBCL)

The Child BehaviorChecklist for Ages6ndash;8(CBCL/6-18) assesses children’s emotional and behavioral problems. Researchers selected five subscales that aligned with constructs of interest: attention problems, rule breaking and aggressive behaviors, social problems, and the anxious-depressed and withdrawn-depressed syndrome scales.

Parent/caregiver report

Not reported by author

Attention problems (CBCL)

The Achenbach Child Behavior Checklist assesses children’s emotional and behavioral problems. Researchers selected five subscales that aligned with constructs of interest: attention problems, rule breaking and aggressive behaviors, social problems, and the anxious-depressed and withdrawn-depressed syndrome scales. Parent/caregiver report

Not reported by author

Percentage participating in a gifted program

Percentage of children who were participating in a gifted or talented program at the time of the year 7 interview Parent/caregiver report

 Not applicable

Percentage receiving remedial services

Percentage of children who were receiving remedial education services for math and writing at the time of the year 7 interview Parent/caregiver report

 Not applicable

Percentage receiving special education

Percentage of children who were enrolled in special education services at the time of the year 7 interview Parent/caregiver report

 Not applicable

Percentage repeating a grade

Percentage of children who had repeated a grade at the time of the year 7 interview Parent/caregiver report

 Not applicable

Percentage skipping school more than once

Percentage of children who had skipped school more than once at the time of the year 7 interview Parent/caregiver report

 Not applicable

Rule-breaking behavior (CBCL)

The Achenbach Child Behavior Checklist assesses children’s emotional and behavioral problems. Researchers selected five subscales that aligned with constructs of interest: attention problems, rule breaking and aggressive behaviors, social problems, and the anxious-depressed and withdrawn-depressed syndrome scales. Parent/caregiver report

Not applicable

Social problems (CBCL)

The Child BehaviorChecklist for Ages6ndash;8(CBCL/6-18) assesses children’s emotional and behavioral problems. Researchers selected five subscales that aligned with constructs of interest: attention problems, rule breaking and aggressive behaviors, social problems, and the anxious-depressed and withdrawn-depressed syndrome scales.

Parent/caregiver report

Not reported by author

Withdrawn, depressed (CBCL)

The Child BehaviorChecklist for Ages6ndash;8(CBCL/6-18) assesses children’s emotional and behavioral problems. Researchers selected five subscales that aligned with constructs of interest: attention problems, rule breaking and aggressive behaviors, social problems, and the anxious-depressed and withdrawn-depressed syndrome scales.

Parent/caregiver report

Not reported by author

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

Biological mother confirmed subject—neglect, cumulative rate

The cumulative percentage of biological mothers that were a confirmed subject of a child neglect CPS report from random assignment to target child’s seventh birthday  Review of CPS records

Not applicable

Biological mother confirmed subject—physical abuse, cumulative rate

The cumulative percentage of biological mothers that were a confirmed subject of a physical abuse CPS report from random assignment to target child’s seventh birthday  Review of CPS records

Not applicable

Biological mother confirmed subject, cumulative number

The cumulative number of biological mothers that were a confirmed subject of a CPS report from random assignment to target child’s seventh birthday  Review of CPS records

Not applicable

Biological mother or target child confirmed subject or victim of CPS report, cumulative number

The cumulative number of biological mothers or target children that were a confirmed subject of a CPS report from random assignment to target child’s seventh birthday  Review of CPS records

Not applicable

Biological mother or target child confirmed subject or victim of CPS report, cumulative rate

The cumulative percentage of biological mothers or target children that were a confirmed subject of a CPS report from random assignment to target child’s seventh birthday  Review of CPS records

Not applicable

Foster care placement—target child, cumulative rate

The cumulative percentage of children that were placed in foster care from random assignment to target child’s seventh birthday  Review of CPS records

Not applicable

Minor physical aggression frequency(CTS-PC)

CTS -PC is a 27-item instrument designed to assess parenting practices. The authors used subscales that described the prevalence or frequency of parenting behaviors during the previous year, including non-violent discipline, psychological aggression, minor physical aggression, serious physical abuse, and neglect. The CTS -PCV consists of pictures depicting parenting behavior and acts of maltreatment. The pictures were accompanied by an audio description of the depicted act and a question asking the child if his/her mother has ever treated him/her that way. The instrument was restricted to pictures that depict non-violent discipline strategies, psychological aggression, and minor physical aggression. Scores were used to indicate the frequency and/or prevalence of a child’s experience of specific parenting practices. Parent/caregiver report

Not reported by author 

Minor physical aggression prevalence(CTS-PC)

CTS -PC is a 27-item instrument designed to assess parenting practices. The authors used subscales that described the prevalence or frequency of parenting behaviors during the previous year, including non-violent discipline, psychological aggression, minor physical aggression, serious physical abuse, and neglect. The CTS -PCV consists of pictures depicting parenting behavior and acts of maltreatment. The pictures were accompanied by an audio description of the depicted act and a question asking the child if his/her mother has ever treated him/her that way. The instrument was restricted to pictures that depict non-violent discipline strategies, psychological aggression, and minor physical aggression. Scores were used to indicate the frequency and/or prevalence of a child’s experience of specific parenting practices. Parent/caregiver report

Not reported by author 

Neglect frequency(CTS-PC)

CTS -PC is a 27-item instrument designed to assess parenting practices. The authors used subscales that described the prevalence or frequency of parenting behaviors during the previous year, including non-violent discipline, psychological aggression, minor physical aggression, serious physical abuse, and neglect. The CTS -PCV consists of pictures depicting parenting behavior and acts of maltreatment. The pictures were accompanied by an audio description of the depicted act and a question asking the child if his/her mother has ever treated him/her that way. The instrument was restricted to pictures that depict non-violent discipline strategies, psychological aggression, and minor physical aggression. Scores were used to indicate the frequency and/or prevalence of a child’s experience of specific parenting practices. Parent/caregiver report

Not reported by author 

Neglect prevalence(CTS-PC)

CTS -PC is a 27-item instrument designed to assess parenting practices. The authors used subscales that described the prevalence or frequency of parenting behaviors during the previous year, including non-violent discipline, psychological aggression, minor physical aggression, serious physical abuse, and neglect. The CTS -PCV consists of pictures depicting parenting behavior and acts of maltreatment. The pictures were accompanied by an audio description of the depicted act and a question asking the child if his/her mother has ever treated him/her that way. The instrument was restricted to pictures that depict non-violent discipline strategies, psychological aggression, and minor physical aggression. Scores were used to indicate the frequency and/or prevalence of a child’s experience of specific parenting practices. Parent/caregiver report

Not reported by author 

Non-violent discipline frequency(CTS-PC)

CTS -PC is a 27-item instrument designed to assess parenting practices. The authors used subscales that described the prevalence or frequency of parenting behaviors during the previous year, including non-violent discipline, psychological aggression, minor physical aggression, serious physical abuse, and neglect. The CTS -PCV consists of pictures depicting parenting behavior and acts of maltreatment. The pictures were accompanied by an audio description of the depicted act and a question asking the child if his/her mother has ever treated him/her that way. The instrument was restricted to pictures that depict non-violent discipline strategies, psychological aggression, and minor physical aggression. Scores were used to indicate the frequency and/or prevalence of a child’s experience of specific parenting practices. Parent/caregiver report

Not reported by author 

Psychological aggression frequency(CTS-PC)

CTS -PC is a 27-item instrument designed to assess parenting practices. The authors used subscales that described the prevalence or frequency of parenting behaviors during the previous year, including non-violent discipline, psychological aggression, minor physical aggression, serious physical abuse, and neglect. The CTS -PCV consists of pictures depicting parenting behavior and acts of maltreatment. The pictures were accompanied by an audio description of the depicted act and a question asking the child if his/her mother has ever treated him/her that way. The instrument was restricted to pictures that depict non-violent discipline strategies, psychological aggression, and minor physical aggression. Scores were used to indicate the frequency and/or prevalence of a child’s experience of specific parenting practices. Parent/caregiver report

Not reported by author 

Psychological aggression prevalence(CTS-PC)

CTS -PC is a 27-item instrument designed to assess parenting practices. The authors used subscales that described the prevalence or frequency of parenting behaviors during the previous year, including non-violent discipline, psychological aggression, minor physical aggression, serious physical abuse, and neglect. The CTS -PCV consists of pictures depicting parenting behavior and acts of maltreatment. The pictures were accompanied by an audio description of the depicted act and a question asking the child if his/her mother has ever treated him/her that way. The instrument was restricted to pictures that depict non-violent discipline strategies, psychological aggression, and minor physical aggression. Scores were used to indicate the frequency and/or prevalence of a child’s experience of specific parenting practices. Parent/caregiver report

Not reported by author 

Serious physical abuse frequency(CTS-PC)

CTS -PC is a 27-item instrument designed to assess parenting practices. The authors used subscales that described the prevalence or frequency of parenting behaviors during the previous year, including non-violent discipline, psychological aggression, minor physical aggression, serious physical abuse, and neglect. The CTS -PCV consists of pictures depicting parenting behavior and acts of maltreatment. The pictures were accompanied by an audio description of the depicted act and a question asking the child if his/her mother has ever treated him/her that way. The instrument was restricted to pictures that depict non-violent discipline strategies, psychological aggression, and minor physical aggression. Scores were used to indicate the frequency and/or prevalence of a child’s experience of specific parenting practices. Parent/caregiver report

Not reported by author 

Serious physical aggressionprevalence (CTS-PC)

CTS -PC is a 27-item instrument designed to assess parenting practices. The authors used subscales that described the prevalence or frequency of parenting behaviors during the previous year, including non-violent discipline, psychological aggression, minor physical aggression, serious physical abuse, and neglect. The CTS -PCV consists of pictures depicting parenting behavior and acts of maltreatment. The pictures were accompanied by an audio description of the depicted act and a question asking the child if his/her mother has ever treated him/her that way. The instrument was restricted to pictures that depict non-violent discipline strategies, psychological aggression, and minor physical aggression. Scores were used to indicate the frequency and/or prevalence of a child’s experience of specific parenting practices. Parent/caregiver report

Not reported by author 

Target child confirmed victim—neglect, cumulative rate

The cumulative percentage of children that were the confirmed victim in an indicated CPS neglect investigation from random assignment to target child’s seventh birthday Review of CPS records

 Not applicable

Target child confirmed victim—physical abuse, cumulative rate

The cumulative percentage of children that were the confirmed victim in an indicated CPS physical abuse investigation from random assignment to target child’s seventh birthday Review of CPS records

 Not applicable

Target child confirmed victim, cumulative number

The cumulative number of children that were the confirmed victim in an indicated CPS investigation from random assignment to target child’s seventh birthday Review of CPS records

 Not applicable