Evaluation of the Healthy Families Alaska Program

Johns Hopkins University

Status: Completed

Conditions: Child Abuse

Treatments: Behavioral: Home Visiting

Study type: Interventional

Funder types: Other

Identifiers

NCT00216710

Contract Number 067727

99-0155

Details and patient eligibility

About

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.

Full description

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.

Enrollment: 380 patients

Sex: Female

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Family resides in a community served by one of six HFAK programs participating in the study
• Family identified as at-risk by HFAK staff following the usual HFAK protocol

Exclusion criteria

• Family was previously enrolled in HFAK
• Mother unable to speak English well enough to complete study activities.
• Family unwilling to enroll in the HFAK program.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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380 participants in 2 patient groups

Home Visited Mothers

Experimental group

Description:

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

Treatment:

Behavioral: Home Visiting

Control Mothers

No Intervention group

Description:

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.