American Indian or Alaska Native
22%
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.
Model(s): Healthy Families America (HFA)®
Study design characteristics contributing to rating
| Design | Attrition | Baseline equivalence | Confounding factors? | Valid, reliable measures? |
|---|---|---|---|---|
| Randomized controlled trial | High |
Established on race and SES. Baseline equivalence on outcomes not feasible. |
None |
Not assessed in manuscripts reviewed under Handbook of Procedures and Standards, Version 1 |
Notes from the review of this manuscript
Moderate rating applies to the following outcomes: rapid repeat birth, income above the poverty level, and employment. Community life skills and social support outcomes receive a low rating because establishing baseline equivalence on these outcomes is feasible but not demonstrated. Analyses of other outcomes are not rated for this report because they are represented in other studies.
Family Economic Self-Sufficiency
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description |
|---|---|---|---|---|---|---|---|
| Household income above poverty level | Year 2 | Moderate | 0.02 | Not statistically significant, p ≥ 0.05 | 249 mothers | Biological mothers with custody of index child at interview, Alaska trial | |
| Household member employed | Year 2 | Moderate | 0.05 | Not statistically significant, p ≥ 0.05 | 249 mothers | Biological mothers with custody of index child at interview, Alaska trial |
Maternal Health
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description |
|---|---|---|---|---|---|---|---|
| Rapid repeat birth | Child age 2 | Moderate | 0.04 | Not statistically significant, p ≥ 0.05 | 325 mothers | Full sample, Alaska trial |
This study included participants from the following locations:
- Alaska
Study Participants
Between January 2000 and July 2001, 388 families who screened positive on a Healthy Families Alaska (HFAK) protocol for risk factors associated with poor health and social outcomes and received scores of 25 or higher on the Kempe Family Stress Checklist were recruited during pregnancy or at the time of birth (Duggan et al., 2007). Of these families, 364 consented to participate and were randomly assigned to the program group (n = 179) or the comparison group (n = 185). 325 families completed a baseline interview. The sample was 22% Alaska native, 55% Caucasian, 8% multiracial, and 15% were of other race. 58% of families were below poverty level, 58% of mothers had graduated from high school, and 73% had worked in the year prior to enrollment (Johns Hopkins University, 2005). The average age of mothers at baseline was 23.5 years. This study reports the second-year follow-up results of the HFA K evaluation, with a sample size of 138 program group primary caregivers and 140 comparison group primary caregivers. Most of the analyses of interview data reported by the authors are limited to biological mothers with custody of the index child at follow-up (249 families). Additional outcomes are reported from medical records (268 families), child protective services reports (309 families), and observational data (~237 families).
Note: Information on sample size was received through communication with the author.
Setting
This study included six Healthy Families Alaska sites, two in Anchorage and one each in Wasilla, Fairbanks, Juneau, and Kenai.
Intervention condition
Note: Navigate to the model page for more information about the home visiting model. See the source manuscript for more information about how the model was implemented in this study.
Comparison Conditions
Families assigned to the comparison condition received referrals to other community services.
Subgroups examined
• Parity (multiparous) • Intimate partner violence (any incident of physical assault in past year) • Risk of child maltreatment (mother screens positive for high risk of child abuse)
Funding Sources
Alaska Mental Health Trust Authority; Alaska State Department of Health and Social Services