Healthy Families America (HFA)® Meets HHS Criteria

Model effectiveness research report last updated: 2020

Effects shown in research & outcome measure details

Child health

Findings rated high

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
Adequate well-child visits
FavorableUnfavorable or ambiguousNo Effect
Year 2 Children in custody of biological mother at interview, Alaska trial 249 children % (adjusted) = 4.00 Adjusted mean % = 8.00 OR = 0.96 HomeVEE calculated = -0.45 Not statistically significant, p ≥ 0.05
Has primary care provider
FavorableUnfavorable or ambiguousNo Effect
Year 2 Children in custody of biological mother at interview, Alaska trial 249 children % (adjusted) = 74.00 Adjusted mean % = 78.00 OR = 0.76 HomeVEE calculated = -0.13 Not statistically significant, p ≥ 0.05
Immunizations up-to-date
FavorableUnfavorable or ambiguousNo Effect
Year 2 Children in custody of biological mother at interview, Alaska trial 249 children % (adjusted) = 27.00 Adjusted mean % = 27.00 OR = 1.01 HomeVEE calculated = 0.00 Not statistically significant, p ≥ 0.05
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Adequate well-child visits

Percentage of children who had adequate well-child visits according to the American Academy of Pediatrics guidelines Review of medical records

Not applicable

Has primary care provider (PCP)

Percentage of children who had a PCP

Parent/caregiver report

Not applicable

Immunizations up-to-date

Percentage of children who had up-to-date immunizations according to the American Academy of Pediatrics guidelines Review of medical records

Not applicable

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
Hospitalizations for ambulatory care
FavorableUnfavorable or ambiguousNo Effect
Years 1-3 Full sample, Hawaii trial 573 children % = 12.00 % = 10.00 OR = 1.27 HomeVEE calculated = 0.12 Not statistically significant, p ≥ 0.05
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Hospitalizations for ambulatory care

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

Not applicable

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
Child has regular health care site
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, San Diego trial 435 children % = 98.10 % = 97.70 = 0.40 HomeVEE calculated = 0.12 Not statistically significant, p ≥ 0.05
Child has regular health care site
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, San Diego trial 412 children % = 98.00 % = 98.50 = -0.50 HomeVEE calculated = -0.18 Not statistically significant, p ≥ 0.05
Child has specific health care provider
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, San Diego trial 435 children % = 74.00 % = 81.60 = -7.60 HomeVEE calculated = -0.27 Not statistically significant, p ≥ 0.05
Child has specific health care provider
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, San Diego trial 412 children % = 63.60 % = 72.20 = -8.60 HomeVEE calculated = -0.24 Not statistically significant, p ≥ 0.05
Compliance with recommended number of well-child visits
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, San Diego trial 435 children % = 58.60 % = 59.60 = -1.00 HomeVEE calculated = -0.03 Not statistically significant, p ≥ 0.05
Compliance with recommended number of well-child visits
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, San Diego trial 412 children % = 85.80 % = 83.80 = 3.00 HomeVEE calculated = 0.09 Not statistically significant, p ≥ 0.05
Immunizations up-to-date
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, San Diego trial 412 children % = 96.90 % = 95.90 = 1.00 HomeVEE calculated = 0.18 Not statistically significant, p ≥ 0.05
Number of sick visits
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, San Diego trial 435 children Median = 3.00 Median = 3.00 Not reported Not available Not statistically significant, p ≥ 0.05
Number of sick visits
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, San Diego trial 412 children Median = 1.00 Median = 1.00 Not reported Not available Not statistically significant, p ≥ 0.05
Number of well-child visits
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, San Diego trial 435 children Mean = 7.00 Mean = 6.80 Mean difference = 0.20 HomeVEE calculated = 0.05 Not statistically significant, p ≥ 0.05
Number of well-child visits
FavorableUnfavorable or ambiguousNo Effect
Year 3 Full sample, San Diego trial 412 children Mean = 2.40 Mean = 1.90 Mean difference = 0.50 HomeVEE calculated = 0.22 Statistically significant,
p < 0.05
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Child has regular health care site

Percentage of children who had a location they typically went to for health care Parent/caregiver report

Not applicable

Child has specific health care provider

Percentage of children who had a specific health care provider Parent/caregiver report

Not applicable

Compliance with recommended number of well-child visits

Percentage of children who had received the recommended number of well-child visits for their age, defined as six or more visits in the first year of life, three or more visits in the second year of life, and one or more visits in third year of life Parent/caregiver report

Not applicable

Immunizations up-to-date

Percentage of children who were up-to-date on the appropriate immunizations for the child’s age Parent/caregiver report

Not applicable

Number of sick visits

Number of sick visits the child had received Parent/caregiver report

Not applicable

Number of well-child visits

Number of well-child visits the child had received Parent/caregiver report

Not applicable

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

Immunizations

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 children Unadjusted mean = 13.70 Unadjusted mean = 13.70 Mean difference = 0.00 Study reported = 0.04

Not statistically significant, p= 0.79

Well-baby checks

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 children Unadjusted mean = 4.00 Unadjusted mean = 4.10 Mean difference = -0.10 Study reported = -0.06

Not statistically significant, p= 0.70

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Immunizations

Frequency count of immunizations

Parent/caregiver report

Not reported by author

Well-baby checks

Frequency count of well-baby visits

Parent/caregiver report

Not reported by author

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
Ever hospitalized for any reason
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 children % = 17.00 % = 18.00 = -1.00 HomeVEE calculated = -0.04 Not statistically significant, p ≥ 0.05
Ever hospitalized for any reason
FavorableUnfavorable or ambiguousNo Effect
Years 1 and 2 Full sample, Hawaii trial 534 children % = 19.00 % = 22.00 = 3.00 HomeVEE calculated = -0.11 Not statistically significant, p ≥ 0.05
Ever used emergency department
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 children % = 40.00 % = 44.00 = -4.00 HomeVEE calculated = -0.10 Not statistically significant, p ≥ 0.05
Ever used emergency department
FavorableUnfavorable or ambiguousNo Effect
Years 1 and 2 Full sample, Hawaii trial 534 children % = 58.00 % = 60.00 = -2.00 HomeVEE calculated = -0.05 Not statistically significant, p ≥ 0.05
Has a PCP who handles most health care needs
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 children % = 93.00 % = 90.00 = 3.00 HomeVEE calculated = 0.24 Not statistically significant, p ≥ 0.05
Has a PCP who handles most health care needs
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 567 children % = 89.00 % = 84.00 = 5.00 HomeVEE calculated = 0.26 Not statistically significant, p ≥ 0.05
Has a PCP who knows all aspects of child’s care
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 children % = 84.00 % = 79.00 = 5.00 HomeVEE calculated = 0.20 Not statistically significant, p ≥ 0.05
Has a PCP who knows all aspects of child’s care
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 567 children % = 80.00 % = 75.00 = 5.00 HomeVEE calculated = 0.17 Not statistically significant, p ≥ 0.05
Has a PCP who knows family’s concerns about child
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 children % = 45.00 % = 48.00 = 3.00 HomeVEE calculated = -0.07 Not statistically significant, p ≥ 0.05
Has a PCP who knows family’s concerns about child
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 567 children % = 50.00 % = 39.00 = 11.00 HomeVEE calculated = 0.27 Statistically significant,
p < 0.05
Has a primary care provider (PCP)
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 children % = 94.00 % = 90.00 = 4.00 HomeVEE calculated = 0.34 Not statistically significant, p ≥ 0.05
Has a primary care provider (PCP)
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 567 children % = 91.00 % = 86.00 = 5.00 HomeVEE calculated = 0.30 Not statistically significant, p ≥ 0.05
Immunizations up-to-date
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, Hawaii trial 564 children % = 82.00 % = 82.00 = 0.00 HomeVEE calculated = 0.00 Not statistically significant, p ≥ 0.05
Immunizations up-to-date
FavorableUnfavorable or ambiguousNo Effect
Year 2 Full sample, Hawaii trial 567 children % = 87.00 % = 85.00 = 2.00 HomeVEE calculated = 0.10 Not statistically significant, p ≥ 0.05
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Ever hospitalized for any reason

Percentage of children who had ever been hospitalized for any reason Parent/caregiver report

Not applicable

Ever used emergency department

Percentage of children who had ever used the emergency department Parent/caregiver report

Not applicable

Has a PCP

Percentage of children who had a PCP Parent/caregiver report

Not applicable

Has a PCP who handles most health care needs

Percentage of children who had a PCP who handled most health care needs Parent/caregiver report

Not applicable

Has a PCP who knows all aspects of child’s care

Percentage of children who had a PCP who knew about all aspects of the child’s care Parent/caregiver report

Not applicable

Has a PCP who knows family’s concerns about child

Percentage of children who had a PCP who understood the family’s concerns about child Parent/caregiver report

Not applicable

Immunizations up-to-date

Percentage of children who were up-to-date on the appropriate immunizations for the child’s age Parent/caregiver report

Not applicable

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 hospitalized for ambulatory care sensitive conditions (ACSC)
FavorableUnfavorable or ambiguousNo Effect
Years 1 and 2 Families with complete medical record data, Alaska trial 268 families % (adjusted) = 9.00 Adjusted mean % = 9.00 OR = 1.09 HomeVEE calculated = 0.00 Not statistically significant, p ≥ 0.05

footnote54

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

Ambulatory care sensitive conditions include: asthma, pneumonia, other upper airway conditions, gastroenteritis, dehydration, cellulitis, and seizures.

Child seen in emergency department for ACSC
FavorableUnfavorable or ambiguousNo Effect
Years 1 and 2 Families with complete medical record data, Alaska trial 268 families % (adjusted) = 81.00 Adjusted mean % = 78.00 OR = 1.23 HomeVEE calculated = 0.11 Not statistically significant, p ≥ 0.05
Number of times hospitalized for ACSC
FavorableUnfavorable or ambiguousNo Effect
Years 1 and 2 Families with complete medical record data, Alaska trial 268 families Adjusted mean = 0.11 Adjusted mean = 0.12 Mean difference = -0.01 Not available Not statistically significant, p ≥ 0.05
Number of times seen in emergency department for ACSC
FavorableUnfavorable or ambiguousNo Effect
Years 1 and 2 Families with complete medical record data, Alaska trial 268 families Adjusted mean = 3.13 Adjusted mean = 4.09 Mean difference = -0.96 Not available Not statistically significant, p ≥ 0.05
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Child hospitalized forACSCChild seen in emergency department for ACSCNumber of timeshospitalized for ACSCNumber of timesseen in emergency department for ACSC

The researchersused the Parker& Schoendorf (2000) definitionof ACSC to examine hospitalizations that might have been avoided with adequate primary care. The list of conditions includes asthma, pneumonia, other upper airway conditions, gastroenteritis, dehydration, cellulitis, and seizures. The percentage of children hospitalized for ACSC, the percentage of children that were seen in the emergency department for ACSC, the number of times the child was seen in the emergency department for ACSC, and the number of times the child was hospitalized for ACSC were analyzed. Parent/caregiver report and review of medical records

Not applicable

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
Low birth weight
FavorableUnfavorable or ambiguousNo Effect
At birth Full sample Adjusted proportion = 0.05 Adjusted proportion = 0.10 OR = 0.43 HomeVEE calculated = -0.51 Statistically significant, p = 0.02

footnote162

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

Negative value is favorable to the intervention.

Preterm birth
FavorableUnfavorable or ambiguousNo Effect
At birth Full sample Not reported Not reported Not reported Not available Not statistically significant, p ≥ 0.05
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Low birth weight

The study considered a baby born weighing less than 2,500 grams as low birth weight. The study determined birth weight using birth certificates. Birth certificate

Not applicable

Preterm birth

The study considered a baby born after 37 or fewer weeks of gestation as a preterm birth. New York State Department of Health birth records

Not applicable

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 Notes

Asthma (diagnosed past year)

FavorableUnfavorable or ambiguousNo Effect

8 years

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

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.

Child had dental visit (past year)

FavorableUnfavorable or ambiguousNo Effect

8 years

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

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

Not statistically significant, p ≥ 0.05

Child had well visit (past year)

FavorableUnfavorable or ambiguousNo Effect

8 years

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

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

Not statistically significant, p ≥ 0.05

Child visited emergency room (past year)

FavorableUnfavorable or ambiguousNo Effect

8 years

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

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

Not statistically significant, p ≥ 0.05

Obesity/overweight (past year)

FavorableUnfavorable or ambiguousNo Effect

8 years

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

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

Not statistically significant, p ≥ 0.05

Pediatric Quality of Life Inventory - physical functioning

FavorableUnfavorable or ambiguousNo Effect

8 years

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

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

Pediatric Quality of Life Inventory - school functioning

FavorableUnfavorable or ambiguousNo Effect

8 years

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

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

Not statistically significant, p ≥ 0.05

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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

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
Baby received developmental screening in first year of life
FavorableUnfavorable or ambiguousNo Effect
Child's 1st birthday HF Oregon 2010-2012 762 mothers Adjusted proportion = 0.94 Adjusted proportion = 0.87 OR = 0.41 Not available Statistically significant, p = 0.00
Child ever breastfed - full sample
FavorableUnfavorable or ambiguousNo Effect
Child's 1st birthday HF Oregon 2010-2012 752 mothers Adjusted proportion = 0.91 Adjusted proportion = 0.91 OR = 0.91 Not available Not statistically significant, p ≥ 0.05
Parent ever told that child was not on track developmentally - full sample
FavorableUnfavorable or ambiguousNo Effect
Child's 1st birthday HF Oregon 2010-2012 762 mothers Adjusted proportion = 0.05 Adjusted proportion = 0.09 OR = 1.46 Not available Not statistically significant, p = 0.08

footnote162

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

Negative value is favorable to the intervention.

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Baby received developmental screening in first year of life

This survey item asks whether the baby received a developmental screening in first year of life. Parent/caregiver report

Not reported by author

Child ever breastfed - full sample

This survey item asks whether the child was ever breastfed. Parent/caregiver report

Not reported by author

Parent ever told that child was not on track developmentally - full sample

This survey item asks whether the parent was ever told that the child was not on track developmentally. Parent/caregiver report

Not reported by author

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

Breastfeeding

FavorableUnfavorable or ambiguousNo Effect

6 months

HFA vs. comparison group, Arizona, full sample

199 mothers Unadjusted proportion = 0.89 Unadjusted proportion = 0.79 Mean difference = 0.10 Study reported = 0.29

Statistically significant, p= 0.04

Immunizations

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 children Unadjusted mean = 19.00 Unadjusted mean = 19.80 Mean difference = -0.80 Study reported = -0.02

Not statistically significant, p= 0.23

Well-baby checks

FavorableUnfavorable or ambiguousNo Effect

12 months

HFA vs. comparison group, Arizona, full sample

165 children Unadjusted mean = 0.98 Unadjusted mean = 1.00 Mean difference = -0.02 Study reported = -0.15

Not statistically significant, p= 0.15

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Breastfeeding

Ever breastfed

Parent/caregiver report

Not reported by author

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
Child ever without needed medical care
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY Trial 1061 children % = 2.20 % = 1.40 Not reported HomeVEE calculated = 0.28 Not statistically significant, p ≥ 0.05
Child has primary care provider
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY Trial 1061 children % = 98.40 % = 98.60 = -0.20 HomeVEE calculated = -0.08 Not statistically significant, p ≥ 0.05
Mother breastfed baby
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY Trial 1060 mothers % = 45.90 % = 44.70 = 1.20 Not available Not statistically significant, p ≥ 0.05
Number of months breastfed
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY Trial 1060 mothers Adjusted mean = 1.01 Adjusted mean = 1.04 Mean difference = -0.03 Not available Not statistically significant, p ≥ 0.05
Number of well-baby visits
FavorableUnfavorable or ambiguousNo Effect
Year 1 Full sample, NY Trial 1061 children Adjusted mean = 4.54 Adjusted mean = 4.61 Mean difference = -0.07 Not available Not statistically significant, p ≥ 0.05
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Child ever without needed medical care

Percentage of children who had ever gone without needed medical care Parent/caregiver report

Not applicable

Child has PCP

Percentage of children who had a PCP Parent/caregiver report

Not applicable

Mother breastfed baby

Percentage of mothers who had breastfed their child Parent/caregiver report

Not applicable

Number of months breastfed

Number of months the mother had breastfed her child Parent/caregiver report

Not applicable

Number of well-baby visits

Number of well-child visits the child had received Review of medical records

Not applicable

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
Number of pediatric emergency department visits
FavorableUnfavorable or ambiguousNo Effect
36 months Program group children not affected by substance abuse,
NY Best Beginnings trial
271 children Not available Not available Beta = 0.12 Not available Statistically significant,
p < 0.05
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Number of pediatric emergency department visits

Number of pediatric emergency department visits between birth and age 36 months Parent/caregiver report

Not applicable

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