Healthy Families America (HFA)^®

Model effectiveness research report last updated: 2020

Effects shown in research

Maternal health

Findings rated high

Duggan, A., Fuddy, L., Burrell, L., Higman, S. M., McFarlane, E., Windham, A., et al. (2004). Randomized trial of a statewide home visiting program to prevent child abuse: Impact in reducing parental risk factors. Child Abuse & Neglect, 28(6), 623–643.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Illicit drug use	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, Hawaii trial	564 mothers	% = 9.00	% = 9.00	= 0.00	HomVEE calculated = 0.00	Not statistically significant, p ≥ 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Illicit drug use	FavorableUnfavorable or ambiguousNo Effect	Year 2	Full sample, Hawaii trial	556 mothers	% = 10.00	% = 11.00	= -1.00	HomVEE calculated = -0.06	Not statistically significant, p ≥ 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Illicit drug use	FavorableUnfavorable or ambiguousNo Effect	Year 3	Full sample, Hawaii trial	548 mothers	% = 11.00	% = 9.00	= 2.00	HomVEE calculated = 0.14	Not statistically significant, p ≥ 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Illicit drug use	FavorableUnfavorable or ambiguousNo Effect	Years 1-3	Full sample, Hawaii trial	564 mothers	Not available	Not available	OR = 1.06	Not available	Not statistically significant, p ≥ 0.05
Mothers with depressive symptoms (CES-D)	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, Hawaii trial	564 mothers	% = 23.00	% = 23.00	= 0.00	HomVEE calculated = 0.00	Not statistically significant, p ≥ 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Mothers with depressive symptoms (CES-D)	FavorableUnfavorable or ambiguousNo Effect	Year 2	Full sample, Hawaii trial	556 mothers	% = 16.00	% = 18.00	= -2.00	HomVEE calculated = -0.09	Not statistically significant, p ≥ 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Mothers with depressive symptoms (CES-D)	FavorableUnfavorable or ambiguousNo Effect	Year 3	Full sample, Hawaii trial	548 mothers	% = 16.00	% = 16.00	= 0.00	HomVEE calculated = 0.00	Not statistically significant, p ≥ 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Mothers with depressive symptoms (CES-D)	FavorableUnfavorable or ambiguousNo Effect	Years 1-3	Full sample, Hawaii trial	564 mothers	Not available	Not available	OR = 0.97	Not available	Not statistically significant, p ≥ 0.05	footnote51 Submitted by user on Fri, 03/15/2019 - 14:29 Adjusted odds ratios are based on the average effect across all follow-up years.
Poor general mental health (MHI < 67)	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, Hawaii trial	564 mothers	% = 36.00	% = 46.00	= -10.00	HomVEE calculated = -0.25	Statistically significant, p < 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Poor general mental health (MHI < 67)	FavorableUnfavorable or ambiguousNo Effect	Year 2	Full sample, Hawaii trial	556 mothers	% = 35.00	% = 38.00	= -3.00	HomVEE calculated = -0.20	Statistically significant, p < 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Poor general mental health (MHI < 67)	FavorableUnfavorable or ambiguousNo Effect	Year 3	Full sample, Hawaii trial	548 mothers	% = 29.00	% = 32.00	= -3.00	HomVEE calculated = -0.09	Not statistically significant, p ≥ 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Problem alcohol use (CAGE)	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, Hawaii trial	564 mothers	% = 8.00	% = 10.00	= -2.00	HomVEE calculated = -0.15	Not statistically significant, p ≥ 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Problem alcohol use (CAGE)	FavorableUnfavorable or ambiguousNo Effect	Year 2	Full sample, Hawaii trial	556 mothers	% = 8.00	% = 9.00	= -1.00	HomVEE calculated = -0.08	Not statistically significant, p ≥ 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Problem alcohol use (CAGE)	FavorableUnfavorable or ambiguousNo Effect	Year 3	Full sample, Hawaii trial	548 mothers	% = 7.00	% = 10.00	= -3.00	HomVEE calculated = -0.24	Statistically significant, p < 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Problem alcohol use (CAGE)	FavorableUnfavorable or ambiguousNo Effect	Years 1-3	Full sample, Hawaii trial	564 mothers	Not available	Not available	OR = 0.76	Not available	Not statistically significant, p ≥ 0.05
Severe parenting stress (PSI)	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, Hawaii trial	564 mothers	% = 11.00	% = 10.00	= 1.00	HomVEE calculated = 0.06	Not statistically significant, p ≥ 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Severe parenting stress (PSI)	FavorableUnfavorable or ambiguousNo Effect	Year 2	Full sample, Hawaii trial	556 mothers	% = 8.00	% = 9.00	= -1.00	HomVEE calculated = -0.08	Not statistically significant, p ≥ 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Severe parenting stress (PSI)	FavorableUnfavorable or ambiguousNo Effect	Year 3	Full sample, Hawaii trial	548 mothers	% = 8.00	% = 8.00	= 0.00	HomVEE calculated = 0.00	Not statistically significant, p ≥ 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Severe parenting stress (PSI)	FavorableUnfavorable or ambiguousNo Effect	Years 1-3	Full sample, Hawaii trial	564 mothers	Not available	Not available	OR = 1.04	Not available	Not statistically significant, p ≥ 0.05

El-Kamary, S. S., Higman, S. M., Fuddy, L., McFarlane, E., Sia, C., & Duggan, A. K. (2004). Hawaii’s Healthy Start home visiting program: Determinants and impact of rapid repeat birth. Pediatrics, 114(3), e317–e326.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Did not use birth control after index child’s birth	FavorableUnfavorable or ambiguousNo Effect	One year postpartum	Full sample, Hawaii trial	564 mothers	% (adjusted) = 18.00	Adjusted mean % = 20.00	OR = 0.85	HomVEE calculated = -0.08	Not statistically significant, p ≥ 0.05
Maternal desire for RRB	FavorableUnfavorable or ambiguousNo Effect	One year postpartum	Full sample, Hawaii trial	564 mothers	% (adjusted) = 9.00	Adjusted mean % = 11.00	OR = 0.80	HomVEE calculated = -0.14	Not statistically significant, p ≥ 0.05
No family planning site	FavorableUnfavorable or ambiguousNo Effect	One year postpartum	Full sample, Hawaii trial	564 mothers	% (adjusted) = 15.00	Adjusted mean % = 14.00	OR = 1.06	HomVEE calculated = 0.05	Not statistically significant, p ≥ 0.05
Rapid repeat birth (RRB)	FavorableUnfavorable or ambiguousNo Effect	One year postpartum	Full sample, Hawaii trial	564 mothers	% (adjusted) = 21.00	Adjusted mean % = 20.00	OR = 1.05	HomVEE calculated = 0.04	Not statistically significant, p ≥ 0.05	footnote52 Submitted by user on Fri, 03/15/2019 - 14:29 Rapid repeat birth is defined as a birth occurring within 24 months after a previous birth or a repeat birth while still a teen for adolescent mothers (El-Kamary et al., 2004).

Landsverk, J., Carrilio, T., Connelly, C. D., Ganger, W., Slymen, D., Newton, R., et al. (2002). Healthy Families San Diego clinical trial: Technical report. San Diego, CA: The Stuart Foundation, California Wellness Foundation, State of California Department of Social Services: Office of Child Abuse Prevention.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
Above threshold for depression (CES-D = 16)	FavorableUnfavorable or ambiguousNo Effect	Year 1 follow-up	Full sample, San Diego trial	435 mothers	% = 39.00	% = 42.00	= -3.00	HomVEE calculated = -0.08	Not statistically significant, p ≥ 0.05
Above threshold for depression (CES-D = 16)	FavorableUnfavorable or ambiguousNo Effect	Year 3 follow-up	Full sample, San Diego trial	412 mothers	% = 33.00	% = 29.00	= 4.00	HomVEE calculated = 0.11	Not statistically significant, p ≥ 0.05
Confidence in adult relationships	FavorableUnfavorable or ambiguousNo Effect	Year 1 follow-up	Full sample, San Diego trial	435 mothers	Mean = 33.40	Mean = 33.80	Mean difference = -0.40	HomVEE calculated = -0.08	Not statistically significant, p ≥ 0.05
Confidence in adult relationships	FavorableUnfavorable or ambiguousNo Effect	Year 3 follow-up	Full sample, San Diego trial	412 mothers	Mean = 33.70	Mean = 33.80	Mean difference = -0.10	HomVEE calculated = -0.02	Not statistically significant, p ≥ 0.05
Depressive symptoms (CES-D)	FavorableUnfavorable or ambiguousNo Effect	Year 1 follow-up	Full sample, San Diego trial	435 mothers	Mean = 14.50	Mean = 15.50	Mean difference = -1.00	HomVEE calculated = -0.10	Not statistically significant, p ≥ 0.05
Depressive symptoms (CES-D)	FavorableUnfavorable or ambiguousNo Effect	Year 3 follow-up	Full sample, San Diego trial	412 mothers	Mean = 12.50	Mean = 12.90	Mean difference = -0.40	HomVEE calculated = -0.04	Not statistically significant, p ≥ 0.05
Drinks per day	FavorableUnfavorable or ambiguousNo Effect	Year 1 follow-up	Full sample, San Diego trial	435 mothers	Mean = 2.50	Mean = 2.30	Mean difference = 0.20	HomVEE calculated = 0.08	Not statistically significant, p ≥ 0.05
Drinks per day	FavorableUnfavorable or ambiguousNo Effect	Year 3 follow-up	Full sample, San Diego trial	412 mothers	Mean = 2.10	Mean = 2.40	Mean difference = -0.30	HomVEE calculated = -0.15	Not statistically significant, p ≥ 0.05
Maternal social support (MHI)	FavorableUnfavorable or ambiguousNo Effect	Year 1 follow-up	Full sample, San Diego trial	435 mothers	Mean = 18.60	Mean = 19.10	Mean difference = -0.50	HomVEE calculated = 0.00	Not statistically significant, p ≥ 0.05
Mental Health (MHI)	FavorableUnfavorable or ambiguousNo Effect	Year 1 follow-up	Full sample, San Diego trial	435 mothers	Mean = 22.90	Mean = 22.20	Mean difference = 0.70	HomVEE calculated = 0.15	Not statistically significant, p ≥ 0.05
Mental Health (MHI)	FavorableUnfavorable or ambiguousNo Effect	Year 3 follow-up	Full sample, San Diego trial	412 mothers	Mean = 24.00	Mean = 24.10	Mean difference = -0.10	HomVEE calculated = -0.02	Not statistically significant, p ≥ 0.05
Parenting Stress (PSI)	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, San Diego trial	435 mothers	Mean = 72.40	Mean = 71.22	Mean difference = 1.20	HomVEE calculated = 0.06	Not statistically significant, p ≥ 0.05
Parenting Stress (PSI)	FavorableUnfavorable or ambiguousNo Effect	Year 3	Full sample, San Diego trial	412 mothers	Mean = 71.20	Mean = 72.82	Mean difference = -1.60	HomVEE calculated = -0.08	Not statistically significant, p ≥ 0.05
Problem substance use (CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE)	FavorableUnfavorable or ambiguousNo Effect	Year 1 follow-up	Full sample, San Diego trial	435 mothers	% = 21.00	% = 18.00	= 3.00	HomVEE calculated = 0.54	Not statistically significant, p ≥ 0.05
Problem substance use (CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE)	FavorableUnfavorable or ambiguousNo Effect	Year 3 follow-up	Full sample, San Diego trial	412 mothers	% = 9.00	% = 10.00	= -1.00	HomVEE calculated = -0.07	Not statistically significant, p ≥ 0.05
Repeat birth within 36 months of index birth	FavorableUnfavorable or ambiguousNo Effect	Year 3 follow-up	Full sample, San Diego trial	412 mothers	% = 27.00	% = 22.00	= 5.00	HomVEE calculated = 0.16	Not statistically significant, p ≥ 0.05
Repeat pregnancy within 36 months of index birth	FavorableUnfavorable or ambiguousNo Effect	Year 3 follow-up	Full sample, San Diego trial	412 mothers	% = 43.00	% = 50.00	= -7.00	HomVEE calculated = 0.15	Not statistically significant, p ≥ 0.05

LeCroy, C. W., & Lopez, D. (2018). A randomized controlled trial of Healthy Families: 6-month and 1-year follow-up. Prevention Science. Advance online publication. https://doi.org/10.1007/s11121-018-0931-4

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Emotional loneliness	FavorableUnfavorable or ambiguousNo Effect	6 months	HFA vs. comparison group, Arizona, full sample	199 mothers	Unadjusted mean = 9.80	Unadjusted mean = 10.00	Mean difference = -0.20	Study reported = -0.03	Not statistically significant, p= 0.94
Hope	FavorableUnfavorable or ambiguousNo Effect	6 months	HFA vs. comparison group, Arizona, full sample	199 mothers	Unadjusted mean = 26.90	Unadjusted mean = 26.60	Mean difference = 0.30	Study reported = 0.15	Not statistically significant, p= 0.31
Subsequent pregnancy	FavorableUnfavorable or ambiguousNo Effect	6 months	HFA vs. comparison group, Arizona, full sample	199 mothers	Cases = 1.00	Cases = 3.00	Not reported	Not available	Not statistically significant, p ≥ 0.05	Authors describe reduced subsequent pregnancies as favorable to the intervention.
Substance abuse treatment	FavorableUnfavorable or ambiguousNo Effect	6 months	HFA vs. comparison group, Arizona, full sample	199 mothers	Unadjusted proportion = 0.01	Unadjusted proportion = 0.01	Mean difference = 0.00	HomVEE calculated = 0.26	Not statistically significant, p = 0.07	Negative effect is favorable Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention. HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.

Duggan, A. K., McFarlane, E. C., Windham, A. M., Rohde, C. A., Salkever, D. S., Fuddy, L., et al. (1999). Evaluation of Hawaii’s Healthy Start program. Future of Children, 9(1), 66–90; discussion 177–178.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
Confidence in adult relations	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, Hawaii trial	564 mothers	Mean = 34.30	Mean = 33.80	Mean difference = 0.50	Not available	Not statistically significant, p ≥ 0.05
Confidence in adult relations	FavorableUnfavorable or ambiguousNo Effect	Year 2	Full sample, Hawaii trial	567 mothers	Mean = 34.40	Mean = 33.70	Mean difference = 0.70	Not available	Not statistically significant, p ≥ 0.05
Maternal life skills (CLSS)	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, Hawaii trial	564 mothers	Mean = 24.20	Mean = 24.30	Mean difference = -0.10	Not available	Not statistically significant, p ≥ 0.05
Maternal life skills (CLSS)	FavorableUnfavorable or ambiguousNo Effect	Year 2	Full sample, Hawaii trial	567 mothers	Mean = 23.90	Mean = 23.90	Mean difference = 0.00	Not available	Not statistically significant, p ≥ 0.05
Maternal social support (MSSI)	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, Hawaii trial	564 mothers	Mean = 21.50	Mean = 21.90	Mean difference = -0.40	Not available	Not statistically significant, p ≥ 0.05
Maternal social support (MSSI)	FavorableUnfavorable or ambiguousNo Effect	Year 2	Full sample, Hawaii trial	567 mothers	Mean = 21.40	Mean = 21.70	Mean difference = -0.30	Not available	Not statistically significant, p ≥ 0.05

Duggan, A., Caldera, D., Rodriguez, K., Burrell, L., Rohde, C., & Crowne, S. S. (2007). Impact of a statewide home visiting program to prevent child abuse. Child Abuse & Neglect, 31(8), 801–827.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
Alcohol or drug use	FavorableUnfavorable or ambiguousNo Effect	Year 2	Biological mothers with custody of index child at interview, Alaska trial	249 mothers	% = 28.00	% = 33.00	OR = 0.80	HomVEE calculated = -0.14	Not statistically significant, p ≥ 0.05
Any illicit drug use	FavorableUnfavorable or ambiguousNo Effect	Year 2	Biological mothers with custody of index child at interview, Alaska trial	249 mothers	% = 21.00	% = 18.00	OR = 1.23	HomVEE calculated = 0.12	Not statistically significant, p ≥ 0.05
Problem alcohol use	FavorableUnfavorable or ambiguousNo Effect	Year 2	Biological mothers with custody of index child at interview, Alaska trial	249 mothers	% = 13.00	% = 22.00	OR = 0.52	HomVEE calculated = -0.39	Not statistically significant, p ≥ 0.05

LeCroy, C. W., & Krysik, J. (2011). Randomized trial of the Healthy Families Arizona home visiting program. Children and Youth Services Review, 33(10), 1761–1766.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
Alcohol use	FavorableUnfavorable or ambiguousNo Effect	12 months	Arizona sample	171 mothers	Mean % = 12.00	Mean % = 20.50	Mean difference = -8.50	HomVEE calculated = -0.40	Statistically significant, p = 0.04
Alcohol use	FavorableUnfavorable or ambiguousNo Effect	6 months	Arizona sample	180 mothers	Mean % = 16.50	Mean % = 35.20	Mean difference = -18.70	HomVEE calculated = -0.59	Not available
Using birth control	FavorableUnfavorable or ambiguousNo Effect	12 months	Arizona sample	171 mothers	Mean % =	Mean % = 72.20	Not reported	Not available	Not statistically significant, p = 0.54
Using birth control	FavorableUnfavorable or ambiguousNo Effect	6 months	Arizona sample	180 mothers	Mean % = 65.80	Mean % = 65.10	Mean difference = 0.70	HomVEE calculated = 0.03	Not statistically significant, p = 0.061

Findings rated moderate

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Anisfeld, E., Sandy, J., & Guterman, N. B. (2004). Best Beginnings: A randomized controlled trial of a paraprofessional home visiting program: Technical report. Report to the Smith Richardson Foundation and New York State Office of Children and Family Services. New York: Columbia University School of Social Work.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
Perceived social support (MSSI)	FavorableUnfavorable or ambiguousNo Effect	12 months	Program group members not affected by substance abuse, NY Best Beginnings trial	325 mothers	Mean = 6.50	Mean = 6.60	Mean difference = -0.10	HomVEE calculated = -0.03	Statistical significance not reported
Perceived social support (MSSI)	FavorableUnfavorable or ambiguousNo Effect	24 months	Program group members not affected by substance abuse, NY Best Beginnings trial	274 mothers	Mean = 6.20	Mean = 6.60	Mean difference = -0.40	HomVEE calculated = -0.12	Statistical significance not reported
Perceived social support (MSSI)	FavorableUnfavorable or ambiguousNo Effect	6 months	Program group members not affected by substance abuse, NY Best Beginnings trial	354 mothers	Mean = 6.20	Mean = 7.20	Mean difference = -1.00	HomVEE calculated = -0.31	Statistical significance not reported

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.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Parenting Stress Index - difficult child	FavorableUnfavorable or ambiguousNo Effect	8 years	HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample	380 mothers	Unadjusted mean = 24.14	Unadjusted mean = 25.97	Mean difference = -1.83	HomVEE calculated = -0.24	Not statistically significant, p ≥ 0.05	Negative effect is favorable Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
Parenting Stress Index - parental child-dysfunctional interaction	FavorableUnfavorable or ambiguousNo Effect	8 years	HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample	380 mothers	Unadjusted mean = 18.38	Unadjusted mean = 19.71	Mean difference = -1.33	HomVEE calculated = -0.22	Not statistically significant, p ≥ 0.05	Negative effect is favorable Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
Parenting Stress Index - parental distress	FavorableUnfavorable or ambiguousNo Effect	8 years	HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample	379 mothers	Unadjusted mean = 24.41	Unadjusted mean = 26.32	Mean difference = -1.91	HomVEE calculated = -0.22	Not statistically significant, p ≥ 0.05	Negative effect is favorable Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.

Green, B. L., Tarte, J. M., Harrison, P. M., Nygren, M., & Sanders, M. B. (2014). Results from a randomized trial of the Healthy Families Oregon accredited statewide program: Early program impacts on parenting. Children and Youth Services Review, 44, 288-298.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
CDC Pregnancy Risk Assessment Monitoring System (PRAMS) measure of maternal depression- full sample	FavorableUnfavorable or ambiguousNo Effect	Child's 1st birthday	HF Oregon 2010-2012	764 mothers	Adjusted mean = 2.17	Adjusted mean = 2.22	Mean difference = -0.05	HomVEE calculated = -0.06	Not statistically significant, p ≥ 0.05	footnote162 Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.
Parenting Stress Index - Short Form (PSI) - General Distress subscale score - full sample	FavorableUnfavorable or ambiguousNo Effect	Child's 1st birthday	HF Oregon 2010-2012	764 mothers	Adjusted mean = 1.78	Adjusted mean = 1.86	Mean difference = -0.08	HomVEE calculated = -0.11	Not statistically significant, p ≥ 0.05	footnote162 Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.
Parenting Stress Index - Short Form (PSI) - Parenting Stress subscale score - full sample	FavorableUnfavorable or ambiguousNo Effect	Child's 1st birthday	HF Oregon 2010-2012	764 mothers	Adjusted mean = 2.02	Adjusted mean = 2.14	Mean difference = -0.12	HomVEE calculated = -0.14	Not statistically significant, p = 0.07	footnote162 Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.
Parenting Stress Index - Short Form (PSI) Total Score	FavorableUnfavorable or ambiguousNo Effect	Child's 1st birthday	HF Oregon 2010-2012	764 mothers	Adjusted mean = 1.90	Adjusted mean = 2.00	Mean difference = -0.10	HomVEE calculated = -0.14	Not statistically significant, p = 0.06	footnote162 Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.

Jacobs, F., Easterbrooks, A., & Mistry, J. (2015). The Massachusetts Healthy Families evaluation-2 (MHFE-2): A randomized, controlled trial of a statewide home visiting program for young parents: Final report to the Children's Trust of Massachusetts. Medford, MA: Tufts Interdisciplinary Evaluation Research.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Repeat pregnancy (self report), time 3	FavorableUnfavorable or ambiguousNo Effect	2 years post enrollment	MA sample	612 mothers	Not reported	Not reported	OR = 0.94	HomVEE calculated = -0.04	Not statistically significant, p = 0.72	footnote162 Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.

Johns Hopkins University. (2005). Evaluation of the Healthy Families Alaska program. Report to Alaska State Department of Health and Social Services, Alaska Mental Health Trust Authority. Baltimore, MD: Author.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Rapid repeat birth	FavorableUnfavorable or ambiguousNo Effect	Child age 2	Full sample, Alaska trial	325 mothers	% = 16.00	% = 17.00	OR = 0.96	HomVEE calculated = -0.04	Not statistically significant, p ≥ 0.05	footnote52 Submitted by user on Fri, 03/15/2019 - 14:29 Rapid repeat birth is defined as a birth occurring within 24 months after a previous birth or a repeat birth while still a teen for adolescent mothers (El-Kamary et al., 2004).

LeCroy, C. W., & Lopez, D. (2018). A randomized controlled trial of Healthy Families: 6-month and 1-year follow-up. Prevention Science. Advance online publication. https://doi.org/10.1007/s11121-018-0931-4

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Contraception use	FavorableUnfavorable or ambiguousNo Effect	6 months	HFA vs. comparison group, Arizona, full sample	199 mothers	Unadjusted proportion = 0.76	Unadjusted proportion = 0.66	Mean difference = 0.10	Study reported = 0.21	Not statistically significant, p= 0.14
Mental health index	FavorableUnfavorable or ambiguousNo Effect	6 months	HFA vs. comparison group, Arizona, full sample	199 mothers	Unadjusted mean = 19.00	Unadjusted mean = 24.70	Mean difference = -5.70	Study reported = 0.35	Statistically significant, p= 0.02	Negative effect is favorable Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
Subsequent pregnancy	FavorableUnfavorable or ambiguousNo Effect	12 months	HFA vs. comparison group, Arizona, full sample	165 mothers	Unadjusted mean = 0.05	Unadjusted mean = 0.12	Mean difference = -0.07	Study reported = 0.25	Not statistically significant, p=0.10	Authors describe reduced subsequent pregnancies as favorable to the intervention.

Lee, E., Mitchell-Herzfeld, S., Lowenfels, A. A., Greene, R., Dorabawila, V., & DuMont, K. A. (2009). Reducing low birth weight through home visitation: A randomized controlled trial. American Journal of Preventive Medicine, 36(2), 154–160.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Frequency of prenatal care visits during third trimester	FavorableUnfavorable or ambiguousNo Effect	At birth	Full sample		Not reported	Not reported	Not reported	Not available	Statistically significant, p<0.05¹
Mother has primary care provider	FavorableUnfavorable or ambiguousNo Effect	At birth	Full sample		Unadjusted proportion = 0.94	Unadjusted proportion = 0.88	Not reported	Not available	Statistically significant, p<0.05	footnote250 Submitted by user on Fri, 03/15/2019 - 14:29 <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr> reported p value.

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.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
Above alcohol abuse cutoff (AUDIT)	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, NY Trial	1061 mothers	% (adjusted) = 2.00	Adjusted mean % = 3.80	= -1.80	Not available	Not statistically significant, p ≥ 0.05
Above depression threshold (CES-D)	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, NY Trial	1061 mothers	% (adjusted) = 29.00	Adjusted mean % = 31.20	= -2.20	Not available	Not statistically significant, p ≥ 0.05
Alcohol abuse (AUDIT)	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, NY Trial	1061 mothers	Adjusted mean = 1.14	Adjusted mean = 1.28	Mean difference = -0.14	Not available	Not statistically significant, p ≥ 0.05
Depressive symptoms (CES-D)	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, NY Trial	1061 mothers	Adjusted mean = 11.45	Adjusted mean = 11.61	Mean difference = -0.16	Not available	Not statistically significant, p ≥ 0.05
Drug use	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, NY Trial	1061 mothers	% (adjusted) = 9.80	Adjusted mean % = 10.60	= -0.80	Not available	Not statistically significant, p ≥ 0.05
Mother has primary care physician	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, NY Trial	1061 mothers	% (adjusted) = 86.90	Adjusted mean % = 85.00	= 1.90	Not available	Not statistically significant, p ≥ 0.05
Sense of personal mastery (PSM)	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, NY Trial	1061 mothers	Adjusted mean = 23.80	Adjusted mean = 23.55	Mean difference = 0.25	Not available	Not statistically significant, p ≥ 0.05
Smoking	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, NY Trial	1061 mothers	% (adjusted) = 41.30	Adjusted mean % = 43.80	= -2.50	Not available	Not statistically significant, p ≥ 0.05
Smoking frequency	FavorableUnfavorable or ambiguousNo Effect	Year 1	Full sample, NY Trial	1061 mothers	Adjusted mean = 3.42	Adjusted mean = 3.93	Mean difference = -0.51	Not available	Not statistically significant, p ≥ 0.05

Jacobs, F., Easterbrooks, M. A., Goldberg, J., Mistry, J., Bumgarner, E., Raskin, M., Fosse, N., & Fauth, R. (2015). Improving adolescent parenting: Results from a randomized controlled trial of a home visiting program for young families. American Journal of Public Health, published online ahead of print, e1-e7.

Healthy Families America (HFA)^®

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Repeated birth	FavorableUnfavorable or ambiguousNo Effect	2 years post enrollment	MA sample	612 mothers	Not reported	Not reported	OR = 0.73	HomVEE calculated = -0.19	Not statistically significant, p = 0.16¹	footnote244 Submitted by user on Fri, 03/15/2019 - 14:29 The <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr>-calculated p-value of the effect size is statistically significant (p=0.02)

LeCroy, C. W., & Krysik, J. (2011). Randomized trial of the Healthy Families Arizona home visiting program. Children and Youth Services Review, 33(10), 1761–1766.

Healthy Families America (HFA)^®

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
Emotional loneliness	FavorableUnfavorable or ambiguousNo Effect	6 months	Arizona sample	180 mothers	Mean = 1.75	Mean = 1.74	Mean difference = 0.01	HomVEE calculated = 0.01	Not statistically significant, p = 0.34
Pathways to goal	FavorableUnfavorable or ambiguousNo Effect	12 months	Arizona sample	171 mothers	Mean = 12.96	Mean = 12.69	Mean difference = 0.27	HomVEE calculated = 1.69	Not statistically significant, p =0.87
Pathways to goal	FavorableUnfavorable or ambiguousNo Effect	6 months	Arizona sample	180 mothers	Mean = 13.00	Mean = 13.17	Mean difference = -0.17	HomVEE calculated = -0.89	Not statistically significant, p =0.12
Use of resources	FavorableUnfavorable or ambiguousNo Effect	12 months	Arizona sample	171 mothers	Mean = 2.53	Mean = 1.95	Mean difference = 0.58	HomVEE calculated = 1.58	Statistically significant, p =0.001

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