Black or African American
4%
Source
LeCroy, C. W., & Lopez, D. (2020). A randomized controlled trial of healthy families: 6-month and 1-year follow-up. Prevention science, 21(1), 25-35. https://doi:10.1007/s11121-018-0931-4
Model(s) Reviewed
Funding Sources
Rigorous Evaluation of Existing Child Abuse Prevention Programs, Children’s Bureau, Award 90CA178.
Study Design
| Design | Attrition | Baseline equivalence | Confounding factors | Valid, reliable measures? |
|---|---|---|---|---|
| Randomized controlled trial | Low | Established on race/ethnicity, SES, and baseline measures of the outcomes | None |
Notes
Information on baseline equivalence for race and ethnicity, socioeconomic status, and baseline measures of the outcomes relied on correspondence with the author. In addition to the 32 findings that received a high rating, 8 findings assessed at the six-month follow-up period received a moderate rating because the outcomes were assessable at baseline and the authors did not establish baseline equivalence or include a statistical control. At the 12-month follow-up period, 26 findings about outcomes that were not assessable at baseline received a moderate rating. Another 15 were assessable at baseline, but the authors did not establish baseline equivalence or include a statistical control; these findings received a low rating.
Study Participants
The study randomly assigned 245 families, 98 families to receive the Healthy Families program and 147 families to the comparison group. Two-thirds of the sample were Hispanic, 15 percent were mixed race, 11 percent were White, and 4 percent were Black. On average mothers were 26 years old, 25 percent were employed, and 42 percent did not graduate high school or have a GED. Local hospitals in Arizona referred families to the study at the time of the children’s birth. They were eligible to participate if they were at moderate or high risk for child abuse based on standard risk screening instruments.
Setting
Arizona
Home Visiting Services
Families assigned to the treatment group received services from the Healthy Families Arizona program. This included a focus on four areas: (1) promoting positive child development, (2) facilitating child health and adherence to well-child visits, (3) improving the parent–child dynamic and promoting positive parent–child interactions, and (4) and promoting the physical and mental health of the mother. The program used the Growing Great Kids curriculum, which aims to strengthen protective factors, enhance parental attachment and resiliency, and strengthen child development. Families in the treatment group received weekly home visits during the first 6 months, after which visits tapered in frequency. Most of the families in the study received at least six home visits, with the average family receiving 13.3 visits by the 6-month follow-up and 23.6 visits by the 12-month follow-up.
Comparison Conditions
Families in the comparison group received information about their children’s developmental progress and referrals to services as needed.
Were any subgroups examined?
No
Study Participants
The study randomly assigned 245 families, 98 families to receive the Healthy Families program and 147 families to the comparison group. Two-thirds of the sample were Hispanic, 15 percent were mixed race, 11 percent were White, and 4 percent were Black. On average mothers were 26 years old, 25 percent were employed, and 42 percent did not graduate high school or have a GED. Local hospitals in Arizona referred families to the study at the time of the children’s birth. They were eligible to participate if they were at moderate or high risk for child abuse based on standard risk screening instruments.
Setting
Arizona
Home Visiting Services
Families assigned to the treatment group received services from the Healthy Families Arizona program. This included a focus on four areas: (1) promoting positive child development, (2) facilitating child health and adherence to well-child visits, (3) improving the parent–child dynamic and promoting positive parent–child interactions, and (4) and promoting the physical and mental health of the mother. The program used the Growing Great Kids curriculum, which aims to strengthen protective factors, enhance parental attachment and resiliency, and strengthen child development. Families in the treatment group received weekly home visits during the first 6 months, after which visits tapered in frequency. Most of the families in the study received at least six home visits, with the average family receiving 13.3 visits by the 6-month follow-up and 23.6 visits by the 12-month follow-up.
Comparison Conditions
Families in the comparison group received information about their children’s developmental progress and referrals to services as needed.
Were any subgroups examined?
No
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 | |
|---|---|---|---|---|---|---|---|---|
Safety practices |
6 months |
Moderate | 0.17 | Statistically significant, p= 0.01 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Mobilizing resources |
6 months |
Moderate | 0.43 | Statistically significant, p= 0.01 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Home environment |
6 months |
High | 0.47 | Statistically significant, p= 0.00 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Role satisfaction |
6 months |
High | 0.33 | Not statistically significant, p= 0.06 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Parent/child behavior |
6 months |
High | 0.24 | Not statistically significant, p= 0.13 |
199 mother/child dyads | HFA vs. comparison group, Arizona, full sample |
||
Parent efficacy |
6 months |
High | 0.11 | Not statistically significant, p= 0.47 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Regular routines |
6 months |
High | 0.36 | Statistically significant, p= 0.02 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Reduced chaotic household |
6 months |
High | 0.29 | Statistically significant, p= 0.04 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Depression |
6 months |
High | 0.00 | Not statistically significant, p= 0.85 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Social support |
6 months |
Moderate | 0.17 | Not statistically significant, p= 0.26 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Problem solving |
6 months |
Moderate | 0.20 | Not statistically significant, p= 0.20 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Personal care |
6 months |
Moderate | 0.14 | Not statistically significant, p= 0.38 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Mother's reading to child |
6 months |
High | 0.38 | Statistically significant, p= 0.01 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Home environment |
12 months |
Moderate | 0.32 | Statistically significant, p= 0.04 |
165 mothers | HFA vs. comparison group, Arizona, full sample |
||
Parent/child behavior |
12 months |
Moderate | 0.21 | Not statistically significant, p= 0.21 |
165 mother/child dyads | HFA vs. comparison group, Arizona, full sample |
||
Regular routines |
12 months |
Moderate | 0.25 | Not statistically significant, p= 0.18 |
165 mothers | HFA vs. comparison group, Arizona, full sample |
||
Reduced chaotic household |
12 months |
Moderate | 0.00 | Not statistically significant, p= 0.95 |
165 mothers | HFA vs. comparison group, Arizona, full sample |
||
Mother's reading to child |
12 months |
Moderate | 0.09 | Not statistically significant, p= 0.53 |
165 children | HFA vs. comparison group, Arizona, full sample |
||
Father contact with child |
12 months |
Moderate | 0.02 | Not statistically significant, p= 0.86 |
165 children | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Past |
6 months |
High | 0.27 | Not statistically significant, p= 0.10 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Present |
6 months |
High | 0.34 | Statistically significant, p= 0.01 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Future |
6 months |
High | 0.02 | Not statistically significant, p= 0.81 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - First person |
6 months |
High | 0.10 | Not statistically significant, p= 0.60 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Affective processes |
6 months |
High | 0.24 | Not statistically significant, p= 0.15 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Positive valanced |
6 months |
High | 0.37 | Statistically significant, p= 0.02 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Negative valanced |
6 months |
High | 0.29 | Not statistically significant, p= 0.08 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension -Anxiety |
6 months |
High | 0.15 | Not statistically significant, p= 0.35 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Anger |
6 months |
High | 0.06 | Not statistically significant, p= 0.70 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Sad |
6 months |
High | 0.42 | Statistically significant, p= 0.01 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Perceptual process |
6 months |
High | 0.33 | Statistically significant, p= 0.04 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Feeling expression |
6 months |
High | 0.50 | Statistically significant, p= 0.00 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Cognitive mechanism |
6 months |
High | 0.44 | Statistically significant, p= 0.01 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Insight |
6 months |
High | 0.33 | Statistically significant, p= 0.05 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Cause |
6 months |
High | 0.39 | Statistically significant, p= 0.01 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Certainty |
6 months |
High | 0.27 | Not statistically significant, p= 0.08 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Past |
12 months |
Moderate | 0.02 | Not statistically significant, p= 0.87 |
165 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Present |
12 months |
Moderate | 0.15 | Not statistically significant, p= 0.37 |
165 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Future |
12 months |
Moderate | 0.12 | Not statistically significant, p= 0.55 |
165 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - First person |
12 months |
Moderate | 0.34 | Statistically significant, p= 0.00 |
165 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Affective processes |
12 months |
Moderate | 0.08 | Not statistically significant, p= 0.67 |
165 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Positive valanced |
12 months |
Moderate | 0.08 | Not statistically significant, p= 0.63 |
165 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Negative valanced |
12 months |
Moderate | 0.54 | Statistically significant, p= 0.03 |
165 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension -Anxiety |
12 months |
Moderate | 0.15 | Not statistically significant, p= 0.44 |
165 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Anger |
12 months |
Moderate | 0.04 | Not statistically significant, p= 0.84 |
165 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Sad |
12 months |
Moderate | 0.08 | Not statistically significant, p= 0.64 |
165 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Perceptual process |
12 months |
Moderate | 0.10 | Not statistically significant, p= 0.50 |
165 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Feeling expression |
12 months |
Moderate | 0.39 | Statistically significant, p= 0.02 |
165 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Cognitive mechanism |
12 months |
Moderate | 0.42 | Statistically significant, p= 0.02 |
165 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Insight |
12 months |
Moderate | 0.28 | Not statistically significant, p= 0.12 |
165 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Cause |
12 months |
Moderate | 0.50 | Statistically significant, p= 0.01 |
165 mothers | HFA vs. comparison group, Arizona, full sample |
||
Linguistic dimension - Certainty |
12 months |
Moderate | 0.26 | Statistically significant, p= 0.03 |
165 mothers | HFA vs. comparison group, Arizona, full sample |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Use of resources |
6 months |
High | 0.24 | Not statistically significant, p= 0.10 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Use of resources |
12 months |
Moderate | 0.48 | Statistically significant, p= 0.01 |
165 mothers | HFA vs. comparison group, Arizona, full sample |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Breastfeeding |
6 months |
Moderate | 0.29 | Statistically significant, p= 0.04 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Immunizations |
6 months |
High | 0.04 | Not statistically significant, p= 0.79 |
199 children | HFA vs. comparison group, Arizona, full sample |
||
Well-baby checks |
6 months |
High | 0.06 | Not statistically significant, p= 0.70 |
199 children | HFA vs. comparison group, Arizona, full sample |
||
Immunizations |
12 months |
Moderate | 0.02 | Not statistically significant, p= 0.23 |
165 children | HFA vs. comparison group, Arizona, full sample |
||
Well-baby checks |
12 months |
Moderate | 0.15 | Not statistically significant, p= 0.15 |
165 children | HFA vs. comparison group, Arizona, full sample |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Contraception use |
6 months |
Moderate | 0.21 | Not statistically significant, p= 0.14 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Subsequent pregnancy |
6 months |
High | Not statistically significant, p ≥ 0.05 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
|||
Substance abuse treatment |
6 months |
High | 0.26 | Not statistically significant, p = 0.07 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Mental health index |
6 months |
Moderate | 0.35 | Statistically significant, p= 0.02 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Emotional loneliness |
6 months |
High | 0.03 | Not statistically significant, p= 0.94 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Hope |
6 months |
High | 0.15 | Not statistically significant, p= 0.31 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
||
Subsequent pregnancy |
12 months |
Moderate | 0.25 | Not statistically significant, p=0.10 |
165 mothers | HFA vs. comparison group, Arizona, full sample |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Job training or employment |
6 months |
High | 0.09 | Not statistically significant, p= 0.54 |
199 mothers | HFA vs. comparison group, Arizona, full sample |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Total violence | 12 months | Moderate | 0.31 | Statistically significant, p< 0.04 | 165 mothers | HFA vs. comparison group, Arizona, full sample | ||
| Threatened child | 12 months | Moderate | 0.21 | Not statistically significant, p ≥ 0.05 | 165 mothers | HFA vs. comparison group, Arizona, full sample | ||
| Spanked child | 12 months | Moderate | 0.23 | Not statistically significant, p ≥ 0.05 | 165 mothers | HFA vs. comparison group, Arizona, full sample |
This study included participants with the following characteristics at enrollment:
Race/Ethnicity
Maternal Education
Other Characteristics
This study included participants from the following locations:
- Arizona