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Child Abuse Prevention

FINAL REPORT: A Randomized Trial of Healthy Families New York (HFNY):

Does Home Visiting Prevent Child Maltreatment?
NIJ Grant 2006-MU-MU-0002 October 31, 2010

Study Summary

This study utilizes a seven-year randomized controlled trial to evaluate the effectiveness of a state-administered home visitation program, Healthy Families New York (HFNY), in preventing child maltreatment and risks for delinquency.  Based on the Healthy Families America model, HFNY strives to promote positive parent-child interactions, prevent child maltreatment, support optimal child development, and improve parents’ self-sufficiency. 

In 2000, eligible families were randomly assigned to either an intervention group that was offered HFNY services or to a control group that received referrals to appropriate services.  Baseline interviews were conducted with 1173 of the eligible women, with follow-up interviews at birth, and Ages 1, 2 and 3.  At Age 7, interviews were completed with 942 of the original study participants and 800 of their children. The researchers also obtained administrative data on Child Protective Services (CPS) reports, foster care placements, federal and state-supported benefits, and program costs and services.

HFNY produced markedly lower rates of confirmed CPS reports and initiation of child welfare services for a subgroup of mothers who had confirmed CPS involvement prior to random assignment, referred to as the Recurrence Reduction Opportunity (RRO) subgroup.  There were no differences between the intervention and control groups in rates of confirmed CPS reports for the sample overall.  However, consistent with prior findings, HFNY mothers reported engaging in serious physical abuse less frequently than mothers in the control group.  HFNY children were also less likely to report that their mothers used minor physical aggression.  In addition, sustained reductions in psychological and minor physical aggression were observed for a subgroup of young, first-time mothers, who enrolled in HFNY during pregnancy (the High Prevention Opportunity or HPO subgroup).  

HFNY also directly benefited children: Compared to children in the control group, HFNY children were more likely to participate in a gifted program, and less likely to receive special education services and to skip school.  In addition, HFNY children in the HPO subgroup were less likely to score below average on a standardized vocabulary assessment and to repeat a grade.   No differences were detected for problem behaviors.

By age seven, participant earnings and savings from monetized benefits such as receipt of welfare and use of the child welfare system generated a return of more than $3.00 for every dollar invested in RRO families, but only partially recovered program expenditures for the HPO subgroup and sample as a whole. 

Home visiting presents a unique opportunity to forge enduring relationships with families at a time when parents are vulnerable and the developmental path of the newborn is particularly malleable.  Findings from the current study demonstrate the benefits of providing HFNY services to families early in life

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