Evaluation of the Healthy Families Alaska Program
This study will assess the effectiveness of early home visitation by a professional in preventing child maltreatment, promoting healthy family functioning, and promoting child health and development.
The investigators will test the following hypotheses regarding the effectiveness of early paraprofessional home visiting for at-risk families
- Actual home visiting services adhere to HFAK standards.
- HFAK promotes healthy family functioning, promotes child health and development, and prevents child abuse and neglect.
- Adherence to HFAK process standards is positively associated with achievement of outcomes.
|Study Design:||Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
|Official Title:||Evaluation of the Healthy Families Alaska Program|
- Child Abuse and Neglect [ Time Frame: From child's birth (baseline) to 24 months of age ]Substantiated and unsubstantiated reports of abuse; maternal self-report of harsh discipline
- Child Development [ Time Frame: 24 months ]Child cognitive, motor and psychosocial development
- Child Health [ Time Frame: From child's birth (baseline) to 24 months of age ]Hospitalizations, ED use, injuries requiring medical care, adequate well child care, immunizations
- Maternal Life Course [ Time Frame: At time of study follow-up (child 24 months of age) ]Educational attainment, employment, social support, rapid repeat birth
- Maternal Psychosocial Functioning [ Time Frame: At time of study follow-up (child 24 months of age) ]Mental health, substance use, intimate partner violence
- Parenting Knowledge [ Time Frame: At time of study follow-up (child 24 months of age) ]Knowledge of child development; recognition of child delay
- Parenting Attitudes [ Time Frame: At time of study follow-up (child 24 months of age) ]Use of corporal punishment, infant caregiving, expectations of children, empathy towards child's needs
- Parenting Behavior [ Time Frame: At time of study follow-up (child 24 months of age) ]Observational measures of parent/child interaction and quality of the home environment, use of corporal punishment, use of nonviolent discipline
|Study Start Date:||July 1999|
|Study Completion Date:||January 21, 2005|
|Primary Completion Date:||February 21, 2004 (Final data collection date for primary outcome measure)|
Experimental: Home Visited Mothers
Mothers randomized to the home visited group received AK State-funded home visiting services. Frequency of home visits was determined by home visiting staff based on mothers' needs. Mothers could receive home visiting services until their child turned 3 years old
|Behavioral: Home Visiting|
No Intervention: Control Mothers
Mothers randomized to the control group did not receive home visiting services, but were offered referrals to other community-based services, as was usual protocol with home visiting agencies were operating at capacity.
Healthy Families Alaska (HFAK) is a well-established child abuse prevention program targeted to at-risk families. HFAK is based on the Healthy Families America initiative promoted by Prevent Child Abuse America. The State Department of Health and Social Services (DHSS) administers the HFAK program.
In 1998, the Alaska State Legislature requested a controlled study of HFAK to determine its effectiveness in preventing child maltreatment, promoting healthy family functioning, and promoting child health and development. DHSS awarded the Johns Hopkins University School of Medicine a contract to conduct the study from July 1999 through June 2004.
The study is a randomized trial of six HFAK sites throughout Alaska. It aims to compare services actually provided to HFAK standards, assess program success in achieving intended outcomes, and relate program impact to service delivery.
Families are enrolled over 21 months beginning in January 2000. Families are randomized to either the HFAk group or the control group. Baseline data on family attributes are collected from HFAK files and maternal interviews. HFAK service data are collected from the program's management information system, record reviews, surveys of staff, and staff focus groups. Outcome data are collected when the children were two years old through maternal interview, home-based observations, child developmental testing, review of medical records, and review of OCS child welfare records.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00216710
|United States, Alaska|
|Johns Hopkins University|
|Anchorage, Alaska, United States, 99503|
|Principal Investigator:||Anne K Duggan, ScD||Johns Hopkins University|