Healthy Families New York (HFNY) randomized trial: effects on early child abuse and neglect.

OBJECTIVE: To evaluate the effects of a home visiting program modeled after Healthy Families America on parenting behaviors in the first 2 years of life.

METHODS: A sample of 1173 families at risk for child abuse and neglect who met the criteria for Healthy Families New York (HFNY) was randomly assigned to either an intervention group that was offered HFNY or a control group that was given information and referrals to other services. Data were collected through a review of CPS records, and maternal interviews at baseline and the child's first birthday (90% re-interviewed) and second birthday (85% re-interviewed).

RESULTS: HFNY mothers reported committing one-quarter as many acts of serious abuse at age 2 as control mothers (.01 versus .04, p<.05). Two sets of interactions were tested and found to have significant effects (p<.05). At age 2, young, first-time mothers in the HFNY group who were randomly assigned at 30 weeks of pregnancy or less were less likely than counterparts in the control group to engage in minor physical aggression in the past year (51% versus 70%) and harsh parenting in the past week (41% versus 62%). Among women who were "psychologically vulnerable," HFNY mothers were one-quarter as likely to report engaging in serious abuse and neglect as control mothers (5% versus 19%) at age 2.

CONCLUSIONS: These findings suggest that who is offered home visitation may be an important factor in explaining the differential effectiveness of home visitation programs. Improved effects may be realized by prioritizing the populations served or by enhancing the model to meet program objectives for hard-to-serve families.