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Healthy Families America (HFA)

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Description

Healthy Families America (HFA) is a home visiting program model designed to work with overburdened families who are at-risk for adverse childhood experiences. Developed in 1992 by Prevent Child Abuse America, the program is based on 12 Critical Elements operationalized through best practice standards that provide a quality structure while offering flexibility in implementation. HFA services begin prenatally or right after birth and are offered by family support workers for 3 to 5 years (HFA).

Expected Beneficial Outcomes

Improved child well-being
Improved child safety
Improved parenting practices and attitudes

Evidence of Effectiveness

There is some evidence that Healthy Families America (HFA) improves child well-being (CEBC, PPN, Harding 2007) as well as parenting practices and attitudes (PPN, LeCroy 2011, Harding 2007). HFA appears less likely to reduce child abuse and neglect (DuMont 2008, Harding 2007, Duggan 2007, LeCroy 2011, CEBC). Flexibility in implementation, inherent in the program's design, is likely to contribute to variable effects. Additional evidence is needed to confirm effects and determine the characteristics of successful programs. 

HFA has been shown to positively affect child well-being and safety (CEBC). Mothers participating in Healthy Families New York (HFNY) are less likely to deliver low birthweight babies than non-participants (PPN). Positive effects on the number of low birthweight babies have also been shown in Virginia, Florida, and Washington DC implementations of HFA (Harding 2007).

Overall, HFNY mothers are less likely to engage in abusive, neglectful, or harsh parenting practices, and more likely to use positive parenting skills than non-participants (PPN). An Arizona-based study finds positive effects on parents' expectations and home safety practices in the short-term only (LeCroy 2011). A multi-state assessment finds variation but concludes that, overall, HFA has a largely positive effect on parenting attitudes and home environments (Harding 2007). 

HFA does not appear to affect the prevalence or frequency of substantiated reports of child abuse and neglect, potentially due to surveillance bias (DuMont 2008, Harding 2007, Duggan 2007). The program has been shown to decrease self-reported cases of abuse and neglect in some circumstances (Harding 2007, DuMont 2008).

Implementation Examples

United States

There are nearly 400 affiliated HFA program sites in 40 States, DC, and the US territories (HFA).

Implementation Resources

Citations - Description

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Citations - Implementation Examples

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