Black or African American
4%
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): Healthy Families America (HFA)®
Study design characteristics contributing to rating
| 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 |
Not assessed in manuscripts reviewed under Handbook of Procedures and Standards, Version 1 |
Notes from the review of this manuscript
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.
Child Health
| 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 | |
| Immunizations | 12 months | Moderate | 0.02 | Not statistically significant, p= 0.23 | 165 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 | |
| Well-baby checks | 12 months | Moderate | 0.15 | Not statistically significant, p= 0.15 | 165 children | HFA vs. comparison group, Arizona, full sample |
Family Economic Self-Sufficiency
| 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 |
Linkages and Referrals
| 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 |
Maternal Health
| 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 | |
| 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 | |
| Mental health index | 6 months | Moderate | 0.35 | Statistically significant, p= 0.02 | 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 | ||
| Subsequent pregnancy | 12 months | Moderate | 0.25 | Not statistically significant, p=0.10 | 165 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 |
Positive Parenting Practices
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description |
|---|---|---|---|---|---|---|---|
| Depression | 6 months | High | 0.00 | Not statistically significant, p= 0.85 | 199 mothers | 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 | |
| Home environment | 6 months | High | 0.47 | Statistically significant, p= 0.00 | 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 | |
| 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 - Affective processes | 12 months | Moderate | 0.08 | Not statistically significant, p= 0.67 | 165 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 - Anger | 12 months | Moderate | 0.04 | Not statistically significant, p= 0.84 | 165 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 - Cause | 12 months | Moderate | 0.50 | Statistically significant, p= 0.01 | 165 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 - Certainty | 12 months | Moderate | 0.26 | Statistically significant, p= 0.03 | 165 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 - Cognitive mechanism | 12 months | Moderate | 0.42 | Statistically significant, p= 0.02 | 165 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 - Feeling expression | 12 months | Moderate | 0.39 | Statistically significant, p= 0.02 | 165 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 - First person | 12 months | Moderate | 0.34 | Statistically significant, p= 0.00 | 165 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 - Future | 12 months | Moderate | 0.12 | Not statistically significant, p= 0.55 | 165 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 - Insight | 12 months | Moderate | 0.28 | Not statistically significant, p= 0.12 | 165 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 - Negative valanced | 12 months | Moderate | 0.54 | Statistically significant, p= 0.03 | 165 mothers | 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 - Past | 12 months | Moderate | 0.02 | Not statistically significant, p= 0.87 | 165 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 - Perceptual process | 12 months | Moderate | 0.10 | Not statistically significant, p= 0.50 | 165 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 - Positive valanced | 12 months | Moderate | 0.08 | Not statistically significant, p= 0.63 | 165 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 - Present | 12 months | Moderate | 0.15 | Not statistically significant, p= 0.37 | 165 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 - Sad | 12 months | Moderate | 0.08 | Not statistically significant, p= 0.64 | 165 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 -Anxiety | 12 months | Moderate | 0.15 | Not statistically significant, p= 0.44 | 165 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 | |
| Mother's reading to child | 6 months | High | 0.38 | Statistically significant, p= 0.01 | 199 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 | |
| Parent efficacy | 6 months | High | 0.11 | Not statistically significant, p= 0.47 | 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/child behavior | 12 months | Moderate | 0.21 | Not statistically significant, p= 0.21 | 165 mother/child dyads | 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 | |
| Problem solving | 6 months | Moderate | 0.20 | Not statistically significant, p= 0.20 | 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 | |
| Reduced chaotic household | 12 months | Moderate | 0.00 | Not statistically significant, p= 0.95 | 165 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 | |
| Regular routines | 12 months | Moderate | 0.25 | Not statistically significant, p= 0.18 | 165 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 | |
| Safety practices | 6 months | Moderate | 0.17 | Statistically significant, p= 0.01 | 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 |
Reductions In Child Maltreatment
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description |
|---|---|---|---|---|---|---|---|
| Spanked child | 12 months | Moderate | 0.23 | Not statistically significant, p ≥ 0.05 | 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 | |
| Total violence | 12 months | Moderate | 0.31 | Statistically significant, p< 0.04 | 165 mothers | HFA vs. comparison group, Arizona, full sample |
This study included participants from the following locations:
- Arizona
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
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 in the comparison group received information about their children’s developmental progress and referrals to services as needed.
Funding Sources
Rigorous Evaluation of Existing Child Abuse Prevention Programs, Children’s Bureau, Award 90CA178.