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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
Johns Hopkins University
Anchorage, Alaska, United States
Child Abuse and Neglect
Substantiated and unsubstantiated reports of abuse; maternal self-report of harsh discipline
Time frame: From child's birth (baseline) to 24 months of age
Child Development
Child cognitive, motor and psychosocial development
Time frame: 24 months
Child Health
Hospitalizations, ED use, injuries requiring medical care, adequate well child care, immunizations
Time frame: From child's birth (baseline) to 24 months of age
Maternal Life Course
Educational attainment, employment, social support, rapid repeat birth
Time frame: At time of study follow-up (child 24 months of age)
Maternal Psychosocial Functioning
Mental health, substance use, intimate partner violence
Time frame: At time of study follow-up (child 24 months of age)
Parenting Knowledge
Knowledge of child development; recognition of child delay
Time frame: At time of study follow-up (child 24 months of age)
Parenting Attitudes
Use of corporal punishment, infant caregiving, expectations of children, empathy towards child's needs
Time frame: At time of study follow-up (child 24 months of age)
Parenting Behavior
Observational measures of parent/child interaction and quality of the home environment, use of corporal punishment, use of nonviolent discipline
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NONE
Enrollment
380
Time frame: At time of study follow-up (child 24 months of age)