HEALTHY FAMILIES
OVERVIEW
Healthy Families New York (HFNY) is a home visitation program for mothers who are at risk for developing abusive or neglectful behaviors toward their children. The goals of HFNY are to promote positive parenting, prevent child abuse and/or neglect, support prenatal care and child health and development, and improve parental self-sufficiency. An experimental evaluation of HFNY found that the program was effective in reducing the amount of child abuse and neglect in the experimental group. Also, among parents in "prevention" and "psychologically vulnerable" subgroups, those parents in the experimental condition were less likely to report severe abuse and/or neglect than mothers in the control group.
DESCRIPTION OF PROGRAM
Target population: Pregnant women or mothers with newborns younger than 3 months who are at risk for engaging in child abuse and neglect
Healthy Families New York was developed as a prevention effort against child abuse and neglect. The program is geared specifically towards young, first-time mothers who join the program before the birth of their children. The program is centered on home visitation services from trained paraprofessionals and home visitors from the community who help promote positive parenting, prevent child abuse or neglect, support prenatal care and child health and development, and improve parent self-sufficiency. Parents who are evaluated as being potentially eligible for the program are given a brief screening to determine final eligibility for the program. Once eligibility is determined, the women in the program receive home visits every other week during the mother's pregnancy. Once the child is born, visits are conducted weekly until the newborn is six months old. Then, the visitation schedule is slowly decreased until the child enrolls in a school program, Head Start, or reaches the age of 5 years. The home visits are designed to improve the parent-child relationship, teach about child development, encouraging optimal growth, address family problems, and develop individual family plans for self-sufficiency and functioning. Visits are individually suited to the child and use varied curricula selected by staff (example curricula used include "Partners for a Healthy Baby" and "Parents as Teachers"). Children are also screened using instruments that measure developmental progress and referrals to other programs are available and recommended to parents as needed. The cost per family of the HFNY program ranged from $3000-3500 per year.
EVALUATION(S) OF PROGRAM
Evaluated population: 1173 women from 3 sites who
were determined eligible for participation in the program based on scores from
a screener, the Family Stress Checklist. To be eligible, women had
to score above 25 points which defined those who were at risk of engaging in
child abuse and neglect. 1254 women were deemed eligible through the
screener and baseline interviews were conducted with 1173 of those women.
This study adopted an Intent To Treat (ITT) analysis
whereby these 1173 women were included in final analyses even if they dropped
out of the program. 34% of mothers in the study were white, 45% were
African-American, and 18% were
Methods: Mothers were identified using an initial screening as being potential study participants. A Family Assessment Worker (FAW) then visited the home of potential participants and described the program and evaluation. After agreeing to take part in the program, the FAW administered the Family Stress Checklist (FSC) to determine if the woman was eligible to participate in the study. Those deemed eligible (>25 points on the FSC) were randomly assigned to either an experimental condition (N=579) which received all of the HFNY services or a control condition (N=594) which received referrals to other programs based on a needs assessment given at the beginning of the interview.
Baseline measures were taken 2 weeks after the intake interview. Then, women were assessed again when their child was born and on the child's first and second birthdays.
Mothers were given a self-report measure of abusive and neglectful parenting and data was taken from OCFS, which keeps records of child abuse and neglect. Mothers were paid $40 for participation at each of the three waves of data collection.
For analysis, two subgroups were designed to measure the program's impacts on different populations. The first subgroup, the "prevention subgroup", consisted of 170 first-time mothers under the age of 19 years who had been assigned to the evaluation at a gestational age of 30 weeks or less. The second subgroup consisted of 122 mothers determined to be "psychologically vulnerable" based on the presence of depressive symptoms and mastery, measured respectively by the Center for Epidemiologic Studies - Depression scale and the Mastery of Psychological Coping Resources Scale. These variables were combined into an index of psychological vulnerability and women scoring in the top 10% were categorized as psychologically vulnerable.
To measure parenting behaviors, parents were given the Conflict-Tactics Scale (Parent-Child) to determine how often in the past year mothers engaged in abusive or neglectful behaviors. The researchers also included substantiated reports from Child Protective Services (CPS) as a measure of child abuse and neglect.
Results: At the first birthday follow-up, mothers in the HFNY program reported fewer acts of very serious physical abuse compared with mothers in the control group. Mothers in the HFNY program also reported fewer cases of minor physical aggression, psychological aggression and harsh parenting behaviors compared with mothers in the control group. At year 2, mothers in the HFNY program reported fewer cases of serious physical abuse compared with mothers in the control condition. There were no differences found between groups at any of the follow-up assessments with respect to substantiated reports from CPS.
Within the "prevention subgroup", mothers in the HFNY program were less likely to report minor physical aggression compared to their counterparts in the control condition (51 compared with 70 percent). Likewise, "prevention subgroup" mothers in HFNY were less likely to report harsh parenting behaviors than "prevention subgroup" mothers in the control condition (41 vs. 62 percent).
Within the "psychologically vulnerable subgroup", mothers in the experimental program reported fewer acts of serious abuse or neglect at year one compared with their counterparts in the control group (1.95 vs. 8.57 incidents of abuse or neglect). At year one follow up, "psychologically vulnerable" mothers reported less psychological aggression and, at year two, fewer instances of serious abuse and neglect than mothers in the control condition (.02 vs. .62 incidents).
SOURCES FOR MORE INFORMATION
Link to program curriculum: http://healthyfamiliesnewyork.org/admin_docs.cfm
References
http://healthyfamiliesnewyork.org/research_reports_papers.cfm
Program categorized in this guide according to the following:
Evaluated participant ages: 16-19 / Program age ranges in the Guide: Youth
Program components: child care/early childhood education; clinic-based, provider-based, or miscellaneous; home visiting; parent or family component;
Measured outcomes: social and emotional health and development; physical health
KEYWORDS: Adolescence (12-17), Youth (16+), Young Adulthood (17-24), Early Childhood (0-5), High-Risk, Adolescent Mothers, Gender-specific (female only), White or Caucasian, Black or African American, Hispanic or Latino, Home-based, Clinic-based, Child Care, Early Childhood Education, Mentoring, Case Management, Public Assistance, Family Conflict, Child Maltreatment, Mental Health, Social and Emotional Health, Parent-management Skills, Physical Health
Program information last updated 12/7/07
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© Child Trends 2003 |
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