Black or African American
20%
Source
Landsverk, J., Carrilio, T., Connelly, C. D., Ganger, W., Slymen, D., Newton, R., et al. (2002). Healthy Families San Diego clinical trial: Technical report. San Diego, CA: The Stuart Foundation, California Wellness Foundation, State of California Department of Social Services: Office of Child Abuse Prevention.
Model(s) Reviewed
Funding Sources
The Stuart Foundation; California Wellness Foundation; State of California Department of Social Services: Office of Child Abuse Prevention
Study Design
| Design | Attrition | Baseline equivalence | Confounding factors | Valid, reliable measures? |
|---|---|---|---|---|
| Randomized controlled trial | Low | Established on race/ethnicity and SES. | None |
Notes
In 2020, HomVEE updated this review to move "Child has insurance coverage" from the Child Health domain to the Family Economic Self-Sufficiency domain because ACF determined that health insurance coverage belongs in that domain.
High rating applies to year 1 and year 3 findings. Insurance findings receive a moderate rating because of baseline differences on health insurance at birth.
Study Participants
Using computerized hospital records, the records of all births were screened for eligibility criteria including (1) residence in the target area, (2) being a non-military family, and (3) speaking English or Spanish. Families meeting these criteria were screened for risk factors for child abuse and neglect. Mothers who screened positive for risk or for whom there was not sufficient information to screen them out, were screened further using the Kempe Family Stress Checklist (FSC). Families in which either parent received a score of 25 or greater on the FSC were randomly assigned to the treatment or control group using a deck of cards. 515 families agreed to participate in the study and were randomly assigned (255 to the control group and 260 to the treatment group). Participant enrollment took place between February 1, 1996, and March 31, 1997. 247 program group families and 241 comparison group families completed a baseline interview. At baseline, 32.8% of all mothers were under age 20. 26.8% of participating mothers were Hispanic (English-speaking), 19.3% were Hispanic (Spanish-speaking), 24.2% were Caucasian, 19.5% were African American, and 10.2% were Asian or of another race/ethnicity. 53.4% of participants did not have a high school diploma, 52.3% were receiving food stamps, 55.7% were receiving TANF, and 52.3% were unemployed. This study reports results from three years of follow-up of the Healthy Families San Diego clinical trial. The analytic samples for the control group were 214, 207, and 207 for years 1, 2, and 3, respectively. For the program group, the corresponding analytic samples were 221, 196, and 205 for years 1, 2, and 3 .
Setting
San Diego County, a primarily urban county that includes suburban and rural regions.
Home Visiting Services
Home visitors were randomly assigned to families and attempted to visit them at the hospital following the birth of the child. Initial assessments were conducted in a home visit to gauge family needs and develop an Individualized Family Service Plan. In addition to home visits, families were encouraged to attend group meetings for parents and/or children. Visits continued until children reached age 3.
Comparison Conditions
Families in the comparison group were given a list of community resources at the time of the baseline interview.
Subgroups examined
• Race/ethnicity (Hispanic, White, or African American)
Study Participants
Using computerized hospital records, the records of all births were screened for eligibility criteria including (1) residence in the target area, (2) being a non-military family, and (3) speaking English or Spanish. Families meeting these criteria were screened for risk factors for child abuse and neglect. Mothers who screened positive for risk or for whom there was not sufficient information to screen them out, were screened further using the Kempe Family Stress Checklist (FSC). Families in which either parent received a score of 25 or greater on the FSC were randomly assigned to the treatment or control group using a deck of cards. 515 families agreed to participate in the study and were randomly assigned (255 to the control group and 260 to the treatment group). Participant enrollment took place between February 1, 1996, and March 31, 1997. 247 program group families and 241 comparison group families completed a baseline interview. At baseline, 32.8% of all mothers were under age 20. 26.8% of participating mothers were Hispanic (English-speaking), 19.3% were Hispanic (Spanish-speaking), 24.2% were Caucasian, 19.5% were African American, and 10.2% were Asian or of another race/ethnicity. 53.4% of participants did not have a high school diploma, 52.3% were receiving food stamps, 55.7% were receiving TANF, and 52.3% were unemployed. This study reports results from three years of follow-up of the Healthy Families San Diego clinical trial. The analytic samples for the control group were 214, 207, and 207 for years 1, 2, and 3, respectively. For the program group, the corresponding analytic samples were 221, 196, and 205 for years 1, 2, and 3 .
Setting
San Diego County, a primarily urban county that includes suburban and rural regions.
Home Visiting Services
Home visitors were randomly assigned to families and attempted to visit them at the hospital following the birth of the child. Initial assessments were conducted in a home visit to gauge family needs and develop an Individualized Family Service Plan. In addition to home visits, families were encouraged to attend group meetings for parents and/or children. Visits continued until children reached age 3.
Comparison Conditions
Families in the comparison group were given a list of community resources at the time of the baseline interview.
Subgroups examined
• Race/ethnicity (Hispanic, White, or African American)
Findings that rate moderate or high in this manuscript
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| CBCL Internalizing problems T score | Year 3 | High | 0.17 | Not statistically significant, p ≥ 0.05 | 382 children | Full sample, San Diego trial | ||
| BSID, Mental Development Index (MDI) | Year 1 | High | 0.23 | Statistically significant, p < 0.05 |
422 children | Full sample, San Diego trial | ||
| BSID, Motor MDI | Year 1 | High | 0.04 | Not statistically significant, p ≥ 0.05 | 422 children | Full sample, San Diego trial | ||
| Stanford Binet Short Term Memory SAS | Year 3 | High | 0.08 | Not statistically significant, p ≥ 0.05 | 412 children | Full sample, San Diego trial | ||
| Stanford Binet Abstract/Visual Reasoning SAS | Year 3 | High | 0.01 | Not statistically significant, p ≥ 0.05 | 412 children | Full sample, San Diego trial | ||
| Stanford Binet Verbal Reasoning Memory SAS | Year 3 | High | 0.07 | Not statistically significant, p ≥ 0.05 | 412 children | Full sample, San Diego trial | ||
| Stanford Binet Sum of Area SAS | Year 3 | High | 0.06 | Not statistically significant, p ≥ 0.05 | 412 children | Full sample, San Diego trial | ||
| Stanford Binet Partial Composite | Year 3 | High | 0.00 | Not statistically significant, p ≥ 0.05 | 412 children | Full sample, San Diego trial | ||
| Stanford Binet Communication Survey | Year 3 | High | 0.01 | Not statistically significant, p ≥ 0.05 | 412 children | Full sample, San Diego trial | ||
| CBCL Anxious/Depressed T score | Year 3 | High | 0.14 | Not statistically significant, p ≥ 0.05 | 382 children | Full sample, San Diego trial | ||
| CBCL Withdrawn T score | Year 3 | High | 0.13 | Not statistically significant, p ≥ 0.05 | 382 children | Full sample, San Diego trial | ||
| CBCL Sleep problems T score | Year 3 | High | 0.09 | Not statistically significant, p ≥ 0.05 | 382 children | Full sample, San Diego trial | ||
| CBCL Somatic problems T score | Year 3 | High | 0.24 | Statistically significant, p < 0.05 |
382 children | Full sample, San Diego trial | ||
| CBCL Aggressive T score | Year 3 | High | 0.02 | Not statistically significant, p ≥ 0.05 | 382 children | Full sample, San Diego trial | ||
| CBCL Destructive T score | Year 3 | High | 0.05 | Not statistically significant, p ≥ 0.05 | 382 children | Full sample, San Diego trial | ||
| CBCL Behavior Problems | Year 3 | High | 0.15 | Not statistically significant, p ≥ 0.05 | 382 children | Full sample, San Diego trial | ||
| CBCL Externalizing problems T score | Year 3 | High | 0.06 | Not statistically significant, p ≥ 0.05 | 382 children | Full sample, San Diego trial |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Any neglect (CTS-PC) | Year 1 | High | 0.07 | Not statistically significant, p ≥ 0.05 | 422 families | Full sample, San Diego trial | ||
| Psychological aggression prevalence (CTS-PC) | Year 1 | High | 0.10 | Not statistically significant, p ≥ 0.05 | 422 families | Full sample, San Diego trial | ||
| Psychological aggression frequency (CTS-PC) | Year 1 | High | 0.14 | Not statistically significant, p ≥ 0.05 | 422 families | Full sample, San Diego trial | ||
| Mild physical assault prevalence (CTS-PC) | Year 1 | High | 0.07 | Not statistically significant, p ≥ 0.05 | 422 families | Full sample, San Diego trial | ||
| Mild physical assault frequency (CTS-PC) | Year 1 | High | 0.07 | Not statistically significant, p ≥ 0.05 | 422 families | Full sample, San Diego trial | ||
| Physical abuse prevalence (CTS-PC) | Year 1 | High | 0.34 | Not statistically significant, p ≥ 0.05 | 422 families | Full sample, San Diego trial | ||
| Physical abuse frequency (CTS-PC) | Year 1 | High | 0.08 | Not statistically significant, p ≥ 0.05 | 422 families | Full sample, San Diego trial | ||
| Any neglect (CTS-PC) | Year 3 | High | 0.12 | Not statistically significant, p ≥ 0.05 | 382 families | Full sample, San Diego trial | ||
| Psychological aggression prevalence (CTS-PC) | Year 3 | High | 0.25 | Not statistically significant, p ≥ 0.05 | 382 families | Full sample, San Diego trial | ||
| Psychological aggression frequency (CTS-PC) | Year 3 | High | 0.27 | Statistically significant, p < 0.05 |
382 families | Full sample, San Diego trial | ||
| Mild physical assault prevalence (CTS-PC) | Year 3 | High | 0.25 | Not statistically significant, p ≥ 0.05 | 382 families | Full sample, San Diego trial | ||
| Mild physical assault frequency (CTS-PC) | Year 3 | High | 0.29 | Statistically significant, p < 0.05 |
382 families | Full sample, San Diego trial | ||
| Physical abuse prevalence (CTS-PC) | Year 3 | High | 0.45 | Not statistically significant, p ≥ 0.05 | 382 families | Full sample, San Diego trial | ||
| Physical abuse frequency (CTS-PC) | Year 3 | High | 0.20 | Not statistically significant, p ≥ 0.05 | 382 families | Full sample, San Diego trial |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Partner violence resulting in injury (CTS) | Year 1 | High | 0.00 | Not statistically significant, p ≥ 0.05 | 422 families | Full sample, San Diego trial | ||
| Incident of physical assault, prevalence (CTS) | Year 1 | High | 0.08 | Not statistically significant, p ≥ 0.05 | 422 families | Full sample, San Diego trial | ||
| Incident of physical assault, frequency (CTS) | Year 1 | High | 0.04 | Not statistically significant, p ≥ 0.05 | 422 families | Full sample, San Diego trial | ||
| Restraining order | Year 1 | High | 0.00 | Not statistically significant, p ≥ 0.05 | 422 families | Full sample, San Diego trial | ||
| Family court | Year 1 | High | 0.06 | Not statistically significant, p ≥ 0.05 | 422 families | Full sample, San Diego trial | ||
| Partner violence resulting in injury (CTS) | Year 3 | High | 0.19 | Not statistically significant, p ≥ 0.05 | 382 families | Full sample, San Diego trial | ||
| Incident of physical assault, prevalence (CTS) | Year 3 | High | 0.04 | Not statistically significant, p ≥ 0.05 | 382 families | Full sample, San Diego trial | ||
| Incident of physical assault, frequency (CTS) | Year 3 | High | 0.02 | Not statistically significant, p ≥ 0.05 | 382 families | Full sample, San Diego trial | ||
| Restraining order | Year 3 | High | 0.26 | Not statistically significant, p ≥ 0.05 | 382 families | Full sample, San Diego trial | ||
| Family court | Year 3 | High | 0.24 | Not statistically significant, p ≥ 0.05 | 382 families | Full sample, San Diego trial |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Quality of home environment (HOME) | Year 1 | High | 0.06 | Not statistically significant, p ≥ 0.05 | 435 mothers | Full sample, San Diego trial | ||
| Mother-child interaction, Caregiver total score (NCAST) | Year 1 | High | 0.16 | Not statistically significant, p ≥ 0.05 | 435 mothers | Full sample, San Diego trial | ||
| Mother-child interaction, Child total score (NCAST) | Year 1 | High | 0.15 | Not statistically significant, p ≥ 0.05 | 435 mothers | Full sample, San Diego trial | ||
| Nonviolent discipline (CTS-PC) | Year 1 | High | 0.00 | Not statistically significant, p ≥ 0.05 | 435 mothers | Full sample, San Diego trial | ||
| Quality of home environment (HOME) | Year 3 | High | 0.00 | Not statistically significant, p ≥ 0.05 | 412 mothers | Full sample, San Diego trial | ||
| Mother-child interaction, Caregiver total score (NCAST) | Year 3 | High | 0.09 | Not statistically significant, p ≥ 0.05 | 412 mothers | Full sample, San Diego trial | ||
| Mother-child interaction, Child total score (NCAST) | Year 3 | High | 0.05 | Not statistically significant, p ≥ 0.05 | 412 mothers | Full sample, San Diego trial | ||
| Nonviolent discipline (CTS-PC) | Year 3 | High | 0.00 | Not statistically significant, p ≥ 0.05 | 412 mothers | Full sample, San Diego trial |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Mother attended school | Year 1 | High | 0.07 | Not statistically significant, p ≥ 0.05 | 435 families | Full sample, San Diego trial | ||
| Mother earned HS degree or currently enrolled | Year 1 | High | 0.08 | Not statistically significant, p ≥ 0.05 | 435 families | Full sample, San Diego trial | ||
| Mother worked | Year 1 | High | 0.00 | Not statistically significant, p ≥ 0.05 | 435 families | Full sample, San Diego trial | ||
| Someone in household worked | Year 1 | High | 0.09 | Not statistically significant, p ≥ 0.05 | 435 families | Full sample, San Diego trial | ||
| Welfare receipt | Year 1 | High | 0.03 | Not statistically significant, p ≥ 0.05 | 435 families | Full sample, San Diego trial | ||
| WIC receipt | Year 1 | High | 0.00 | Not statistically significant, p ≥ 0.05 | 435 families | Full sample, San Diego trial | ||
| Food stamps | Year 1 | High | 0.02 | Not statistically significant, p ≥ 0.05 | 435 families | Full sample, San Diego trial | ||
| Emergency food | Year 1 | High | 0.25 | Not statistically significant, p ≥ 0.05 | 435 families | Full sample, San Diego trial | ||
| Section 8 housing | Year 1 | High | 0.21 | Not statistically significant, p ≥ 0.05 | 435 families | Full sample, San Diego trial | ||
| Homeless shelter | Year 1 | High | 0.43 | Not statistically significant, p ≥ 0.05 | 435 families | Full sample, San Diego trial | ||
| Legal aid | Year 1 | High | 0.10 | Not statistically significant, p ≥ 0.05 | 435 families | Full sample, San Diego trial | ||
| Child support enforcement | Year 1 | High | 0.33 | Statistically significant, p < 0.05 |
435 families | Full sample, San Diego trial | ||
| Use of respite care | Year 1 | High | 0.68 | Not statistically significant, p ≥ 0.05 | 435 families | Full sample, San Diego trial | ||
| Adult education | Year 1 | High | 0.07 | Not statistically significant, p ≥ 0.05 | 435 families | Full sample, San Diego trial | ||
| Mother attended school | Year 3 | High | 0.25 | Statistically significant, p < 0.05 |
412 families | Full sample, San Diego trial | ||
| Mother earned HS degree or currently enrolled | Year 3 | High | 0.02 | Not statistically significant, p ≥ 0.05 | 412 families | Full sample, San Diego trial | ||
| Mother worked | Year 3 | High | 0.03 | Not statistically significant, p ≥ 0.05 | 412 families | Full sample, San Diego trial | ||
| Someone in household worked | Year 3 | High | 0.04 | Not statistically significant, p ≥ 0.05 | 412 families | Full sample, San Diego trial | ||
| Welfare receipt | Year 3 | High | 0.07 | Not statistically significant, p ≥ 0.05 | 412 families | Full sample, San Diego trial | ||
| WIC receipt | Year 3 | High | 0.09 | Not statistically significant, p ≥ 0.05 | 412 families | Full sample, San Diego trial | ||
| Food stamps | Year 3 | High | 0.02 | Not statistically significant, p ≥ 0.05 | 412 families | Full sample, San Diego trial | ||
| Emergency food | Year 3 | High | 0.21 | Not statistically significant, p ≥ 0.05 | 412 families | Full sample, San Diego trial | ||
| Section 8 housing | Year 3 | High | 0.24 | Not statistically significant, p ≥ 0.05 | 412 families | Full sample, San Diego trial | ||
| Homeless shelter | Year 3 | High | 0.00 | Not statistically significant, p ≥ 0.05 | 412 families | Full sample, San Diego trial | ||
| Legal aid | Year 3 | High | 0.36 | Not statistically significant, p ≥ 0.05 | 412 families | Full sample, San Diego trial | ||
| Child support enforcement | Year 3 | High | 0.11 | Not statistically significant, p ≥ 0.05 | 412 families | Full sample, San Diego trial | ||
| Use of respite care | Year 3 | High | 0.43 | Not statistically significant, p ≥ 0.05 | 412 families | Full sample, San Diego trial | ||
| Adult education | Year 3 | High | 0.04 | Not statistically significant, p ≥ 0.05 | 412 families | Full sample, San Diego trial | ||
| Child has insurance coverage | Year 1 | High | 0.15 | Not statistically significant, p ≥ 0.05 | 435 children | Full sample, San Diego trial | ||
| Child has insurance coverage | Year 3 | High | 0.07 | Not statistically significant, p ≥ 0.05 | 412 children | Full sample, San Diego trial |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Maternal social support (MHI) | Year 1 follow-up | High | 0.00 | Not statistically significant, p ≥ 0.05 | 435 mothers | Full sample, San Diego trial | ||
| Confidence in adult relationships | Year 1 follow-up | High | 0.08 | Not statistically significant, p ≥ 0.05 | 435 mothers | Full sample, San Diego trial | ||
| Problem substance use (CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE) | Year 1 follow-up | High | 0.54 | Not statistically significant, p ≥ 0.05 | 435 mothers | Full sample, San Diego trial | ||
| Drinks per day | Year 1 follow-up | High | 0.08 | Not statistically significant, p ≥ 0.05 | 435 mothers | Full sample, San Diego trial | ||
| Depressive symptoms (CES-D) | Year 1 follow-up | High | 0.10 | Not statistically significant, p ≥ 0.05 | 435 mothers | Full sample, San Diego trial | ||
| Above threshold for depression (CES-D = 16) | Year 1 follow-up | High | 0.08 | Not statistically significant, p ≥ 0.05 | 435 mothers | Full sample, San Diego trial | ||
| Mental Health (MHI) | Year 1 follow-up | High | 0.15 | Not statistically significant, p ≥ 0.05 | 435 mothers | Full sample, San Diego trial | ||
| Parenting Stress (PSI) | Year 1 | High | 0.06 | Not statistically significant, p ≥ 0.05 | 435 mothers | Full sample, San Diego trial | ||
| Confidence in adult relationships | Year 3 follow-up | High | 0.02 | Not statistically significant, p ≥ 0.05 | 412 mothers | Full sample, San Diego trial | ||
| Problem substance use (CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE Alcohol Screening">CAGE) | Year 3 follow-up | High | 0.07 | Not statistically significant, p ≥ 0.05 | 412 mothers | Full sample, San Diego trial | ||
| Drinks per day | Year 3 follow-up | High | 0.15 | Not statistically significant, p ≥ 0.05 | 412 mothers | Full sample, San Diego trial | ||
| Depressive symptoms (CES-D) | Year 3 follow-up | High | 0.04 | Not statistically significant, p ≥ 0.05 | 412 mothers | Full sample, San Diego trial | ||
| Above threshold for depression (CES-D = 16) | Year 3 follow-up | High | 0.11 | Not statistically significant, p ≥ 0.05 | 412 mothers | Full sample, San Diego trial | ||
| Mental Health (MHI) | Year 3 follow-up | High | 0.02 | Not statistically significant, p ≥ 0.05 | 412 mothers | Full sample, San Diego trial | ||
| Repeat pregnancy within 36 months of index birth | Year 3 follow-up | High | 0.15 | Not statistically significant, p ≥ 0.05 | 412 mothers | Full sample, San Diego trial | ||
| Repeat birth within 36 months of index birth | Year 3 follow-up | High | 0.16 | Not statistically significant, p ≥ 0.05 | 412 mothers | Full sample, San Diego trial | ||
| Parenting Stress (PSI) | Year 3 | High | 0.08 | Not statistically significant, p ≥ 0.05 | 412 mothers | Full sample, San Diego trial |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Child has regular health care site | Year 1 | High | 0.12 | Not statistically significant, p ≥ 0.05 | 435 children | Full sample, San Diego trial | ||
| Child has specific health care provider | Year 1 | High | 0.27 | Not statistically significant, p ≥ 0.05 | 435 children | Full sample, San Diego trial | ||
| Number of well-child visits | Year 1 | High | 0.05 | Not statistically significant, p ≥ 0.05 | 435 children | Full sample, San Diego trial | ||
| Compliance with recommended number of well-child visits | Year 1 | High | 0.03 | Not statistically significant, p ≥ 0.05 | 435 children | Full sample, San Diego trial | ||
| Number of sick visits | Year 1 | High | Not statistically significant, p ≥ 0.05 | 435 children | Full sample, San Diego trial | |||
| Child has regular health care site | Year 3 | High | 0.18 | Not statistically significant, p ≥ 0.05 | 412 children | Full sample, San Diego trial | ||
| Child has specific health care provider | Year 3 | High | 0.24 | Not statistically significant, p ≥ 0.05 | 412 children | Full sample, San Diego trial | ||
| Number of well-child visits | Year 3 | High | 0.22 | Statistically significant, p < 0.05 |
412 children | Full sample, San Diego trial | ||
| Compliance with recommended number of well-child visits | Year 3 | High | 0.09 | Not statistically significant, p ≥ 0.05 | 412 children | Full sample, San Diego trial | ||
| Number of sick visits | Year 3 | High | Not statistically significant, p ≥ 0.05 | 412 children | Full sample, San Diego trial | |||
| Immunizations up-to-date | Year 3 | High | 0.18 | Not statistically significant, p ≥ 0.05 | 412 children | Full sample, San Diego trial |
This study included participants with the following characteristics at enrollment:
Race/Ethnicity
Maternal Education
Other Characteristics
This study included participants from the following locations:
- California