Lee, E., Kirkland, K., Miranda-Julian, C., & Greene, R. (2018). Reducing maltreatment recurrence through home visitation: a promising intervention for child welfare involved families. Child abuse & neglect, 86, 55-66.
Used in Implementation Reports
Study Participants
Families were referred to the Healthy Families New York (HFNY) randomized controlled trial if they met the following criteria: 1) families were expectant or had an infant less than three months old, 2) families were considered to be at risk for child abuse or neglect, and 3) families lived in areas with high rates of teen pregnancy, infant mortality, welfare, and limited uptake of prenatal care. Families were then deemed eligible to participate if parents scored 25 or above on the Kempe Family Stress Checklist, which assesses parental risk for child abuse or neglect. Over an 18-month recruitment period, 1,297 families were recruited and randomly assigned to the treatment or comparison group, and 1,254 of these families were deemed eligible to participate in the study. This study focuses on a subgroup of mothers who participated in this larger randomized controlled trial: mothers who had at least one substantiated child protective services (CPS) report in the five years prior to random assignment (N=104; 52 in each group). About two-thirds were pregnant at random assignment. About half (54 percent) were African-American (non-Latina), 34 percent were White (non-Latina), and 13 percent were Latina. At baseline, around half (53 percent) had at least a high school diploma or GED and 70 percent were receiving public assistance.
New York state
Home Visiting Services
The treatment group participated in Healthy Families New York. Home visitors made biweekly visits during pregnancy, weekly visits after birth until the child was 6 months old, and then made less frequent visits until the child enrolled in Head Start or turned 5 or started kindergarten. While Healthy Families New York did not require a specific curriculum, the home visitors in this trial primarily used one of three evidence-based curricula. The home visitors aimed to promote parent-child attachment, positive parenting practices, and safe home environments. They also linked families with resources and healthcare, assessed children for developmental delays, and helped families address other issues such as substance abuse or maternal depression.
Comparison Conditions
The comparison group received referrals and information based on their needs. They were not referred to home visiting models that were similar to the Healthy Families New York program.
Staff Characteristics and Training
Home visits were conducted by Family Support Workers, who were paraprofessionals who lived in the same communities and were linguistically and culturally similar to participants. Home visitors were not required to have post-secondary education, although a third were college graduates. Home visitors needed to attend a one-week core training to conduct home visits. They also shadowed a veteran home visitor before beginning work. They were observed on one home visit per quarter and met with their supervisors at least 1.5 hour each week.
Author Affiliation
The authors report no conflicts of interest.
Funding Sources
National Institute of Justice Grant 2006-Mu-Mu-0002 and NYS Office of Children and Family Services grant number 1058555-1-41144.
Study Reg
Clinicaltrials.gov Identifier: None found. Study registration was assessed by HomVEE beginning with the 2014 review.
Confounding Factors


Baseline Equivalence

Established on race/ethnicity and SES; outcome(s) not feasible to assess at baseline

Screening Decision

Passes screens