Negative effect is favorable to the intervention.
Healthy Families America (HFA)®
Model effectiveness research report last updated: 2024
Effects shown in research
Child development and school readiness
Findings rated high
158
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 |
|---|---|---|---|---|---|---|---|---|---|
| BSID Cognitive score | FavorableUnfavorable or ambiguousNo Effect |
Age 2 | Children with complete medical record data, Alaska trial | 249 children | Adjusted mean = 88.00 | Adjusted mean = 84.80 | Mean difference = 3.20 | Not available | Statistically significant, p < 0.05 |
| BSID percentage within normal limits on cognitive | FavorableUnfavorable or ambiguousNo Effect |
Age 2 | Children with complete medical record data, Alaska trial | 249 children | % (adjusted) = 58.00 | Adjusted mean % = 48.00 | OR = 1.55 | HomVEE calculated = 0.24 | Statistically significant, p < 0.05 |
| BSID percentage within normal limits on psychomotor | FavorableUnfavorable or ambiguousNo Effect |
Age 2 | Children with complete medical record data, Alaska trial | 249 children | % (adjusted) = 85.00 | Adjusted mean % = 80.00 | OR = 1.36 | HomVEE calculated = 0.21 | Not statistically significant, p ≥ 0.05 |
| BSID Psychomotor score | FavorableUnfavorable or ambiguousNo Effect |
Age 2 | Children with complete medical record data, Alaska trial | 249 children | Adjusted mean = 98.10 | Adjusted mean = 96.00 | Mean difference = 2.10 | Not available | Not statistically significant, p ≥ 0.05 |
| CBCL percentage with externalizing scores in normal range | FavorableUnfavorable or ambiguousNo Effect |
Age 2 | Children in custody of biological mother at year 2 follow-up interview, Alaska trial | 249 children | % (adjusted) = 82.00 | Adjusted mean % = 77.00 | OR = 1.48 | HomVEE calculated = 0.19 | Statistically significant, p < 0.05 |
| CBCL percentage with internalizing scores in normal range | FavorableUnfavorable or ambiguousNo Effect |
Age 2 | Children in custody of biological mother at year 2 follow-up interview, Alaska trial | 249 children | % (adjusted) = 87.00 | Adjusted mean % = 79.00 | OR = 2.06 | HomVEE calculated = 0.35 | Statistically significant, p < 0.05 |
| CBCL total externalizing score | FavorableUnfavorable or ambiguousNo Effect |
Age 2 | Children in custody of biological mother at year 2 follow-up interview, Alaska trial | 249 children | Adjusted mean = 50.80 | Adjusted mean = 53.00 | Mean difference = -2.20 | Not available | Not statistically significant, p ≥ 0.05 |
| CBCL total internalizing score | FavorableUnfavorable or ambiguousNo Effect |
Age 2 | Children in custody of biological mother at year 2 follow-up interview, Alaska trial | 249 children | Adjusted mean = 48.20 | Adjusted mean = 51.00 | Mean difference = -2.80 | Not available | Statistically significant, p < 0.05 |
158
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 |
|---|---|---|---|---|---|---|---|---|---|
| Aggressive behaviors (CBCL) | FavorableUnfavorable or ambiguousNo Effect |
7 year | New York sample | 897 mothers | Adjusted mean = 6.99 | Adjusted mean = 6.72 | Mean difference = 0.27 | Study reported = 0.04 | Not statistically significant, p ≥ 0.05 |
| Anxious, depressed (CBCL) | FavorableUnfavorable or ambiguousNo Effect |
7 year | New York sample | 897 mothers | Adjusted mean = 2.89 | Adjusted mean = 2.97 | Mean difference = -0.08 | Study reported = -0.03 | Not statistically significant, p ≥ 0.05 |
| Attention problems (CBCL) | FavorableUnfavorable or ambiguousNo Effect |
7 year | New York sample | 897 mothers | Adjusted mean = 4.77 | Adjusted mean = 4.75 | Mean difference = 0.02 | Study reported = 0.01 | Not statistically significant, p ≥ 0.05 |
| Percentage participating in a gifted program | FavorableUnfavorable or ambiguousNo Effect |
7 year | New York sample | 897 mothers | Adjusted mean % = 5.38 | Adjusted mean % = 1.99 | OR = 2.80 | Not available | Statistically significant, p < 0.05 |
| Percentage receiving remedial services | FavorableUnfavorable or ambiguousNo Effect |
7 year | New York sample | 897 mothers | Adjusted mean % = 32.83 | Adjusted mean % = 33.31 | OR = 0.98 | Not available | Not statistically significant, p ≥ 0.05 |
| Percentage receiving special education | FavorableUnfavorable or ambiguousNo Effect |
7 year | New York sample | 897 mothers | Adjusted mean % = 12.33 | Adjusted mean % = 16.74 | OR = 0.70 | Not available | Statistically significant, p < 0.05 |
| Percentage repeating a grade | FavorableUnfavorable or ambiguousNo Effect |
7 year | New York sample | 897 mothers | Adjusted mean % = 12.33 | Adjusted mean % = 16.74 | OR = 0.98 | Not available | Not statistically significant, p ≥ 0.05 |
| Percentage skipping school more than once | FavorableUnfavorable or ambiguousNo Effect |
7 year | New York sample | 897 mothers | Adjusted mean % = 2.40 | Adjusted mean % = 2.20 | OR = 1.08 | Not available | Not statistically significant, p ≥ 0.05 |
| Rule-breaking behavior (CBCL) | FavorableUnfavorable or ambiguousNo Effect |
7 year | New York sample | 897 mothers | Adjusted mean = 2.74 | Adjusted mean = 2.66 | Mean difference = 0.08 | Study reported = 0.03 | Not statistically significant, p ≥ 0.05 |
| Social problems (CBCL) | FavorableUnfavorable or ambiguousNo Effect |
7 year | New York sample | 897 mothers | Adjusted mean = 1.31 | Adjusted mean = 1.15 | Mean difference = 0.16 | Study reported = -0.04 | Not statistically significant, p ≥ 0.05 |
| Withdrawn, depressed (CBCL) | FavorableUnfavorable or ambiguousNo Effect |
7 year | New York sample | 897 mothers | Adjusted mean = 1.47 | Adjusted mean = 1.54 | Mean difference = -0.07 | Study reported = -0.04 | Not statistically significant, p ≥ 0.05 |
158
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 |
|---|---|---|---|---|---|---|---|---|---|---|
Brief Infant Toddler Social and Emotional Assessment (BITSEA), total competence score |
FavorableUnfavorable or ambiguousNo Effect |
15 months old |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
1124 children | Not reported | Not reported | Difference = 0.00 | Not available | Not statistically significant, p ≥ 0.05 |
The statistical significance after adjusting for multiple comparisons is reported. |
Received any early intervention services (%) |
FavorableUnfavorable or ambiguousNo Effect |
15 months old |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
1101 mothers | Not reported | Not reported | Difference = 0.00 | HomVEE calculated = -0.09 | Not statistically significant, p ≥ 0.05 |
The statistical significance after adjusting for multiple comparisons is reported. |
Use of nonparental child care |
FavorableUnfavorable or ambiguousNo Effect |
15 months old |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
1096 children | Not reported | Not reported | Difference = -0.02 | HomVEE calculated = -0.04 | Not statistically significant, p ≥ 0.05 |
The statistical significance after adjusting for multiple comparisons is reported. |
158
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 |
|---|---|---|---|---|---|---|---|---|---|
| BSID, Mental Development Index (MDI) | FavorableUnfavorable or ambiguousNo Effect |
Year 1 | Full sample, San Diego trial | 422 children | Mean = 105.00 | Mean = 102.50 | Mean difference = 2.50 | HomVEE calculated = 0.23 | Statistically significant, p < 0.05 |
| BSID, Motor MDI | FavorableUnfavorable or ambiguousNo Effect |
Year 1 | Full sample, San Diego trial | 422 children | Mean = 113.50 | Mean = 113.00 | Mean difference = 0.50 | HomVEE calculated = 0.04 | Not statistically significant, p ≥ 0.05 |
| CBCL Aggressive T score | FavorableUnfavorable or ambiguousNo Effect |
Year 3 | Full sample, San Diego trial | 382 children | Mean = 53.50 | Mean = 53.60 | Mean difference = -0.10 | HomVEE calculated = -0.02 | Not statistically significant, p ≥ 0.05 |
| CBCL Anxious/Depressed T score | FavorableUnfavorable or ambiguousNo Effect |
Year 3 | Full sample, San Diego trial | 382 children | Mean = 53.50 | Mean = 54.30 | Mean difference = -0.80 | HomVEE calculated = -0.14 | Not statistically significant, p ≥ 0.05 |
| CBCL Behavior Problems | FavorableUnfavorable or ambiguousNo Effect |
Year 3 | Full sample, San Diego trial | 382 children | Mean = 49.70 | Mean = 51.10 | Mean difference = -1.40 | HomVEE calculated = -0.15 | Not statistically significant, p ≥ 0.05 |
| CBCL Destructive T score | FavorableUnfavorable or ambiguousNo Effect |
Year 3 | Full sample, San Diego trial | 382 children | Mean = 53.60 | Mean = 53.35 | Mean difference = 0.30 | HomVEE calculated = 0.05 | Not statistically significant, p ≥ 0.05 |
| CBCL Externalizing problems T score | FavorableUnfavorable or ambiguousNo Effect |
Year 3 | Full sample, San Diego trial | 382 children | Mean = 49.40 | Mean = 49.90 | Mean difference = -0.50 | HomVEE calculated = -0.06 | Not statistically significant, p ≥ 0.05 |
| CBCL Internalizing problems T score | FavorableUnfavorable or ambiguousNo Effect |
Year 3 | Full sample, San Diego trial | 382 children | Mean = 50.90 | Mean = 52.60 | Mean difference = -1.70 | HomVEE calculated = -0.17 | Not statistically significant, p ≥ 0.05 |
| CBCL Sleep problems T score | FavorableUnfavorable or ambiguousNo Effect |
Year 3 | Full sample, San Diego trial | 382 children | Mean = 52.30 | Mean = 52.70 | Mean difference = -0.40 | HomVEE calculated = -0.09 | Not statistically significant, p ≥ 0.05 |
| CBCL Somatic problems T score | FavorableUnfavorable or ambiguousNo Effect |
Year 3 | Full sample, San Diego trial | 382 children | Mean = 53.80 | Mean = 55.20 | Mean difference = -1.40 | HomVEE calculated = -0.24 | Statistically significant, p < 0.05 |
| CBCL Withdrawn T score | FavorableUnfavorable or ambiguousNo Effect |
Year 3 | Full sample, San Diego trial | 382 children | Mean = 55.10 | Mean = 56.10 | Mean difference = -1.00 | HomVEE calculated = -0.13 | Not statistically significant, p ≥ 0.05 |
| Stanford Binet Abstract/Visual Reasoning SAS | FavorableUnfavorable or ambiguousNo Effect |
Year 3 | Full sample, San Diego trial | 412 children | Mean = 90.60 | Mean = 90.50 | Mean difference = 0.10 | HomVEE calculated = 0.01 | Not statistically significant, p ≥ 0.05 |
| Stanford Binet Communication Survey | FavorableUnfavorable or ambiguousNo Effect |
Year 3 | Full sample, San Diego trial | 412 children | Mean = 101.80 | Mean = 101.90 | Mean difference = -0.10 | HomVEE calculated = -0.01 | Not statistically significant, p ≥ 0.05 |
| Stanford Binet Partial Composite | FavorableUnfavorable or ambiguousNo Effect |
Year 3 | Full sample, San Diego trial | 412 children | Mean = 91.30 | Mean = 91.30 | Mean difference = 0.00 | HomVEE calculated = 0.00 | Not statistically significant, p ≥ 0.05 |
| Stanford Binet Short Term Memory SAS | FavorableUnfavorable or ambiguousNo Effect |
Year 3 | Full sample, San Diego trial | 412 children | Mean = 98.60 | Mean = 97.80 | Mean difference = 0.80 | HomVEE calculated = 0.08 | Not statistically significant, p ≥ 0.05 |
| Stanford Binet Sum of Area SAS | FavorableUnfavorable or ambiguousNo Effect |
Year 3 | Full sample, San Diego trial | 412 children | Mean = 326.90 | Mean = 331.60 | Mean difference = -4.70 | HomVEE calculated = -0.06 | Not statistically significant, p ≥ 0.05 |
| Stanford Binet Verbal Reasoning Memory SAS | FavorableUnfavorable or ambiguousNo Effect |
Year 3 | Full sample, San Diego trial | 412 children | Mean = 86.50 | Mean = 87.30 | Mean difference = -0.80 | HomVEE calculated = -0.07 | Not statistically significant, p ≥ 0.05 |
158
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 |
|---|---|---|---|---|---|---|---|---|---|---|
Brief Infant Toddler Social and Emotional Assessment (BITSEA), total problem score (fixed effect random slope analysis) |
FavorableUnfavorable or ambiguousNo Effect |
15 months old |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
1126 children | Not reported | Not reported | Not reported | Study reported = -0.07 | Not statistically significant, p= 0.15 |
|
Brief Infant Toddler Social and Emotional Assessment (BITSEA), total problem score (restricted maximum likelihood analysis) |
FavorableUnfavorable or ambiguousNo Effect |
15 months old |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
1126 children | Not reported | Not reported | Not reported | Study reported = -0.07 | Not statistically significant, p= 0.23 |
Negative effect is favorable to the intervention. |
Brief Infant Toddler Social and Emotional Assessment (BITSEA), total problem score (split-sample analysis) |
FavorableUnfavorable or ambiguousNo Effect |
15 months old |
HFA vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample |
1126 children | Not reported | Not reported | Difference = -0.10 | Study reported = -0.10 | Not statistically significant, p= 0.08 |
Negative effect is favorable to the intervention. |
Findings rated moderate
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 |
|---|---|---|---|---|---|---|---|---|---|
| ASQ Communication score | FavorableUnfavorable or ambiguousNo Effect |
6 months | Program group children not affected by substance abuse, NY Best Beginnings trial |
359 children | Mean = 55.70 | Mean = 55.30 | Mean difference = 0.40 | HomVEE calculated = 0.07 | Statistical significance not reported |
| ASQ Composite score | FavorableUnfavorable or ambiguousNo Effect |
6 months | Program group children not affected by substance abuse, NY Best Beginnings trial |
359 children | Mean = 54.80 | Mean = 54.00 | Mean difference = 0.80 | HomVEE calculated = 0.15 | Statistical significance not reported |
| ASQ Fine Motor score | FavorableUnfavorable or ambiguousNo Effect |
6 months | Program group children not affected by substance abuse, NY Best Beginnings trial |
359 children | Mean = 55.10 | Mean = 54.20 | Mean difference = 0.90 | HomVEE calculated = 0.12 | Statistical significance not reported |
| ASQ Gross Motor score | FavorableUnfavorable or ambiguousNo Effect |
6 months | Program group children not affected by substance abuse, NY Best Beginnings trial |
359 children | Mean = 52.90 | Mean = 51.80 | Mean difference = 1.10 | HomVEE calculated = 0.12 | Statistical significance not reported |
| ASQ Social score | FavorableUnfavorable or ambiguousNo Effect |
6 months | Program group children not affected by substance abuse, NY Best Beginnings trial |
359 children | Mean = 53.70 | Mean = 54.20 | Mean difference = -0.50 | HomVEE calculated = -0.06 | Statistical significance not reported |
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 |
|---|---|---|---|---|---|---|---|---|---|---|
Child has IEP or 504 plan |
FavorableUnfavorable or ambiguousNo Effect |
8 years |
HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample |
370 children | Unadjusted proportion = 0.27 | Unadjusted proportion = 0.30 | Mean difference = -0.02 | HomVEE calculated = -0.07 | Not statistically significant, p ≥ 0.05 |
|
Child in afterschool program |
FavorableUnfavorable or ambiguousNo Effect |
8 years |
HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample |
368 children | Adjusted proportion = 0.55 | Adjusted proportion = 0.42 | Odds ratio = 1.71 | HomVEE calculated = 0.32 | Statistically significant, p <.05 |
HomVEE calculated the effect size based on the study-reported odds ratio. |
Strengths and Difficulties Questionnaire - externalizing |
FavorableUnfavorable or ambiguousNo Effect |
8 years |
HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample |
366 children | Unadjusted mean = 5.58 | Unadjusted mean = 5.60 | Mean difference = -0.02 | HomVEE calculated = -0.01 | Not statistically significant, p ≥ 0.05 |
Negative effect is favorable to the intervention. |
Strengths and Difficulties Questionnaire - internalizing |
FavorableUnfavorable or ambiguousNo Effect |
8 years |
HFM vs. comparison, Massachusetts Healthy Families Evaluation 2 (MHFE -2), Tier 6 full sample |
360 children | Unadjusted mean = 3.48 | Unadjusted mean = 3.51 | Mean difference = -0.03 | HomVEE calculated = -0.01 | Not statistically significant, p ≥ 0.05 |
Negative effect is favorable to the intervention. |
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 |
|---|---|---|---|---|---|---|---|---|---|
| PLS-3 Score | FavorableUnfavorable or ambiguousNo Effect |
Age 3 | Children with developmental testing results, Hawaii trial | 513 children | Adjusted mean = 87.90 | Adjusted mean = 87.10 | Mean difference = 0.80 | Not available | Not statistically significant, p ≥ 0.05 |
| Prevalence of any delays (PLS-3 score ≤ 85) | FavorableUnfavorable or ambiguousNo Effect |
Age 3 | Children with developmental testing results, Hawaii trial | 513 children | % (adjusted) = 48.00 | Adjusted mean % = 49.00 | OR = 0.97 | Not available | Not statistically significant, p ≥ 0.05 |
| Prevalence of severe delays (PLS-3 score ≤ 70) | FavorableUnfavorable or ambiguousNo Effect |
Age 3 | Children with developmental testing results, Hawaii trial | 513 children | % (adjusted) = 9.00 | Adjusted mean % = 11.00 | OR = 0.80 | Not available | Not statistically significant, p ≥ 0.05 |
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 |
|---|---|---|---|---|---|---|---|---|---|---|
| Days absent | FavorableUnfavorable or ambiguousNo Effect |
1st grade | Healthy Families New York (HFNY) RCT, Year 7 | 577 mother/child dyads | = 16.36 | = 15.28 | Mean difference = 1.08 | HomVEE calculated = 1.37 | Not statistically significant, p ≥ 0.05 | Positive value is favorable to the comparison group.
|
| Doing poorly academically | FavorableUnfavorable or ambiguousNo Effect |
1st grade | Healthy Families New York (HFNY) RCT, Year 7 | 577 mother/child dyads | = 0.30 | = 0.33 | Mean difference = -0.03 | HomVEE calculated = -0.07 | Not statistically significant, p ≥ 0.05 | Negative value is favorable to the intervention.
|
| Doing poorly academically - Any of the 3 behaviors that promote learning | FavorableUnfavorable or ambiguousNo Effect |
1st grade | Healthy Families New York (HFNY) RCT, Year 7 | 577 mother/child dyads | = 0.15 | = 0.16 | Mean difference = -0.01 | HomVEE calculated = -0.03 | Not statistically significant, p ≥ 0.05 | Negative value is favorable to the intervention.
|
| Doing poorly academically - Reading or Math | FavorableUnfavorable or ambiguousNo Effect |
1st grade | Healthy Families New York (HFNY) RCT, Year 7 | 577 mother/child dyads | = 0.21 | = 0.25 | Mean difference = -0.04 | HomVEE calculated = -0.14 | Not statistically significant, p ≥ 0.05 | Negative value is favorable to the intervention.
|
| Excelling academically | FavorableUnfavorable or ambiguousNo Effect |
1st grade | Healthy Families New York (HFNY) RCT, Year 7 | 577 mother/child dyads | = 0.26 | = 0.20 | Mean difference = 0.06 | HomVEE calculated = 0.19 | Not statistically significant, p ≥ 0.05 | |
| Excelling academically - All 3 behaviors that promote learning | FavorableUnfavorable or ambiguousNo Effect |
1st grade | Healthy Families New York (HFNY) RCT, Year 7 | 577 mother/child dyads | = 0.13 | = 0.08 | Mean difference = 0.05 | HomVEE calculated = 0.36 | Statistically significant, p < 0.05 | |
| Excelling academically - Reading and Math | FavorableUnfavorable or ambiguousNo Effect |
1st grade | Healthy Families New York (HFNY) RCT, Year 7 | 577 mother/child dyads | = 0.16 | = 0.16 | Mean difference = 0.00 | HomVEE calculated = 0.01 | Not statistically significant, p ≥ 0.05 | |
| Retained in first grade | FavorableUnfavorable or ambiguousNo Effect |
1st grade | Healthy Families New York (HFNY) RCT, Year 7 | 577 mother/child dyads | = 0.04 | = 0.07 | Mean difference = -0.04 | HomVEE calculated = -0.44 | Statistically significant, p < 0.05 | Negative value is favorable to the intervention.
|