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.
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) |
|---|---|---|---|---|---|---|
| Moderate | Randomized controlled trial | High | Established on race/ethnicity, SES, and feasible outcomes. Statistical controls for feasible baseline outcomes included. | None | None | Not assessed in manuscripts reviewed before 2021 |
Notes:
In 2020, HomVEE updated this review to move "Mother has health insurance" from the Maternal Health domain to the Family Economic Self-Sufficiency domain because ACF determined that health insurance coverage belongs in that domain.
In 2020, HomVEE updated this review to move "Child has health insurance" from the Child Health domain to the Family Economic Self-Sufficiency domain because ACF determined that health insurance coverage belongs in that domain.
Attrition rating is based on overall sample sizes because sample sizes for treatment and control groups were unavailable.
| Study participants | Recruitment for the randomized controlled trial of Healthy Families New York (HFNY) occurred between March 2000 and August 2001. Pregnant women or parents with an infant 3 months of age or less who were found to be at risk for child abuse or neglect and lived in communities with high rates of teen pregnancy, infant mortality, and welfare receipt, and low rates of prenatal care were referred to HFNY. Consenting families were screened using the Kempe Family Stress Checklist (FSC); 1,297 eligible families who received scores of 25 or higher on the FSC were randomly assigned to the program group (n = 647) or the comparison group (n = 650). 1,157 mothers completed a baseline interview (589 in the program group and 568 in the comparison group). Of those who completed baseline interviews, 41.9% were African American, 17.0% were Latina, 33.7% were White, and the remaining 7.3% were of another race or ethnicity. On average, the mothers were 22.4 years of age, 52.3% had not completed high school or a GED , and 32.4% of the families were receiving welfare. This study reports on the first-year program impacts of HFNY, using a sample of 1,060 families who completed the first follow-up interview. |
|---|---|
| Setting | Three Healthy Families New York sites were included in the study: Erie, Rensselaer, and Ulster counties. Erie serves primarily African American and Latino families in inner-city neighborhoods in Buffalo. Rensselaer and Ulster counties include urban, suburban, and rural locations; both serve largely White families, but with a substantial African American population in Rensselaer and Latino population in Ulster. |
| Intervention services | Participants in the program group were assigned to an HFNY home visitor. Home visitors were scheduled to visit families biweekly during pregnancy (if they enrolled prior to the birth of the child) and at least weekly immediately following the birth of the child. The frequency of visits was gradually decreased based on family needs, and visits continued until the child turned 5 or began Head Start or kindergarten. Home visitors emphasized activities to improve the parent-child relationship, help parents understand child development and improve child growth, improve access to health care, and improve family functioning through the development and use of a Family Support Plan. |
| Comparison conditions | Members of the control group received information about and referrals to other community services, though they were not referred to home visiting services that were similar to HFNY (DuMont et al., 2008). |
| 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). • Parity (primiparous) • Maternal age (less than 18 years or 18 and older) • Maternal depression (low, moderate, or high based on screening) • Intimate partner violence (reported violence in year prior to enrollment or did not report violence) • Mother reports being victim of maltreatment during own childhood (yes or no) |
| Funding sources | New York State Office of Children and Families Services, Bureau of Evaluation and Research |
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Child ever without needed medical care | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 children | % = 2.20 | % = 1.40 | Not reported | HomVEE calculated = 0.28 | Not statistically significant, p ≥ 0.05 | |
| Moderate | Child has primary care provider | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 children | % = 98.40 | % = 98.60 | = -0.20 | HomVEE calculated = -0.08 | Not statistically significant, p ≥ 0.05 | |
| Moderate | Mother breastfed baby | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,060 mothers | % = 45.90 | % = 44.70 | = 1.20 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Number of months breastfed | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,060 mothers | Adjusted mean = 1.01 | Adjusted mean = 1.04 | Mean difference = -0.03 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Number of well-baby visits | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 children | Adjusted mean = 4.54 | Adjusted mean = 4.61 | Mean difference = -0.07 | Not available | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Child has health insurance | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 children | % = 93.90 | % = 90.40 | = 3.50 | HomVEE calculated = 0.30 | Statistically significant, p < 0.05 |
|
| Moderate | Education appropriate for age | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY trial | Year 1 | 1,061 families | % = 57.50 | % = 60.30 | = -2.80 | HomVEE calculated = -0.07 | Not statistically significant, p > 0.05 |
|
| Moderate | Family received TANF | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY trial | Year 1 | 1,061 families | % = 35.00 | % = 30.40 | = 4.60 | HomVEE calculated = 0.13 | Not statistically significant, p ≥ 0.05 | |
| Moderate | Family received WIC | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY trial | Year 1 | 1,061 families | % = 74.80 | % = 72.20 | = 2.60 | HomVEE calculated = 0.08 | Not statistically significant, p ≥ 0.05 | |
| Moderate | Family received 50% income from work | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY trial | Year 1 | 1,061 families | % = 51.20 | % = 56.60 | = -5.40 | HomVEE calculated = -0.13 | Not statistically significant, p > 0.05 |
|
| Moderate | Mother employed | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY trial | Year 1 | 1,061 families | % = 40.80 | % = 47.60 | = 6.80 | HomVEE calculated = -0.17 | Statistically significant, p < 0.05 |
|
| Moderate | Mother has health insurance | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 mothers | % (adjusted) = 80.10 | Adjusted mean % = 78.40 | = 1.70 | Not available | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Above alcohol abuse cutoff (AUDIT) | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 mothers | % (adjusted) = 2.00 | Adjusted mean % = 3.80 | = -1.80 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Above depression threshold (CES-D) | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 mothers | % (adjusted) = 29.00 | Adjusted mean % = 31.20 | = -2.20 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Alcohol abuse (AUDIT) | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 mothers | Adjusted mean = 1.14 | Adjusted mean = 1.28 | Mean difference = -0.14 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Depressive symptoms (CES-D) | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 mothers | Adjusted mean = 11.45 | Adjusted mean = 11.61 | Mean difference = -0.16 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Drug use | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 mothers | % (adjusted) = 9.80 | Adjusted mean % = 10.60 | = -0.80 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Mother has primary care physician | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 mothers | % (adjusted) = 86.90 | Adjusted mean % = 85.00 | = 1.90 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Sense of personal mastery (PSM) | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 mothers | Adjusted mean = 23.80 | Adjusted mean = 23.55 | Mean difference = 0.25 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Smoking | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 mothers | % (adjusted) = 41.30 | Adjusted mean % = 43.80 | = -2.50 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Smoking frequency | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 mothers | Adjusted mean = 3.42 | Adjusted mean = 3.93 | Mean difference = -0.51 | Not available | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Attitudes: Empathy (AAPI-2) | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY trial | Year 1 | 1,060 mothers | Adjusted mean = 37.12 | Adjusted mean = 36.64 | Mean difference = 0.48 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Attitudes: Inappropriate expectations (AAPI-2) | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY trial | Year 1 | 1,060 mothers | Adjusted mean = 19.11 | Adjusted mean = 18.83 | Mean difference = 0.28 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Attitudes: Physical punishment (AAPI-2) | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY trial | Year 1 | 1,060 mothers | Adjusted mean = 38.43 | Adjusted mean = 38.01 | Mean difference = 0.42 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Attitudes: Power/independence (AAPI-2) | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY trial | Year 1 | 1,060 mothers | Adjusted mean = 19.39 | Adjusted mean = 19.40 | Mean difference = -0.01 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Attitudes: Role reversal (AAPI-2) | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY trial | Year 1 | 1,060 mothers | Adjusted mean = 23.59 | Adjusted mean = 23.24 | Mean difference = 0.35 | Not available | Not statistically significant, p ≥ 0.05 | |
| Moderate | Child safety checklist | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY trial | Year 1 | 1,060 mothers | % = 86.10 | % = 85.90 | Not reported | Not available | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | ER visits due to injury or ingestion | FavorableUnfavorable or ambiguousNo Effect |
Full sample, NY Trial | Year 1 | 1,061 children | % = 3.80 | % = 6.20 | = -2.40 | HomVEE calculated = -0.31 | Not statistically significant, p ≥ 0.05 |