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)®
| Screening decision | Screening conclusion | HomVEE procedures and standards version |
|---|---|---|
| Passes screens | Eligible for review | Version 1 |
| Rating | Design | Attrition | Baseline equivalence | Compromised randomization | Confounding factors | Valid, reliable measure(s) |
|---|---|---|---|---|---|---|
| High | Randomized controlled trial | Low | Established on race/ethnicity. | None | None | Not assessed in manuscripts reviewed before 2021 |
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In 2020, HomVEE updated this review to move the measures of withdrawn depressed, anxious depressed, and social problems (Child Behavior Checklist) from the Child Health domain to the Child Development and School Readiness domain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.
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 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, which is 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. |
| Subgroups examined |
This field lists subgroups examined in the manuscript (even if they were not replicated in other samples and not reported on the summary page for this model’s report). • Maternal age and parity (primiparous and age less than 20 years) • Child maltreatment (mother has at least one substantiated child protective services report) |
| 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. |
| Peer reviewed | Peer reviewed status is not listed for manuscripts reviewed before 2021. |
Findings that rate moderate or high
| 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 |
| 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 |