Hawaii's Healthy Start Program of Home Visiting for At-Risk Families

Evaluation of Family Identification, Family Engagement, and Service Delivery

Dados Bibliográficos

ID23327002
AutoresAnne Duggan (0000-0003-0263-9505, From Johns Hopkins University School of Medicine), Anne K Duggan (0000-0002-3465-3662, Johns Hopkins University), Amy Windham (From Johns Hopkins University School of Medicine), Elizabeth Mcfarlane (Hawaii Medical Association), Loretta Fuddy (Hawaii Department of Health), MPH LCSW (Hawaii State Department of Health, Honolulu, Hawaii; and), Charles A Rohde (0000-0002-7671-2480, Johns Hopkins University), Charles Rohde (Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland), Sharon B Buchbinder (Towson University), Sharon Buchbinder (Towson University Department of Health Science, Towson, Maryland.), Calvin Sia (Hawaii Medical Association)
Ano2000
Volume105
FascículoSupplement_2
Páginas250-259
Data de publicação2000-01-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoPEDIATRICS (JOURNAL)
Identificadores do periódicoISSN: 0031-4005 • E-ISSN: 1098-4275
EditoraAmerican Academy of Pediatrics (AAP) (PUBLISHER)
DOI10.1542/peds.105.s2.250
PMID10617732
OpenAlexW1926166776
IdiomaEN
Citações recebidas59
Referências citadas28

OBJECTIVE: To describe family identification, family engagement, and service delivery in a statewide home visiting program for at-risk families of newborns. SETTING: Six target communities of Hawaii's Healthy Start Program (HSP), which incorporates 1) early identification of at-risk families of newborns via population-based screening and assessment, and 2) paraprofessional home visiting to improve family functioning, promote child health and development, and prevent child maltreatment. DESIGN: Cross-sectional study: describes early identification process and family characteristics associated with initial enrollment. Longitudinal study: describes home visiting process and characteristics associated with continued participation. SUBJECTS: Cross-sectional study: civilian births in 6 communities (n = 6553). Longitudinal study: at-risk families in the intervention group of a randomized trial of the HSP (n = 373). PROCESS: completeness and timeliness of early identification and home visiting activities; family characteristics: sociodemographics, child abuse risk factors, infant biologic risk. RESULTS: Early identification staff determined risk status for 84% of target families. Families with higher risk scores, young mothers with limited schooling, and families with infants at biologic risk were more likely to enroll in home visiting. Half of those who enrolled were active at 1 year with an average of 22 visits. Families where the father had multiple risk factors and where the mother was substance abusing were more likely to have >/=12 visits; mothers who were unilaterally violent toward the father were less likely. Most families were linked with a medical home; linkage rates for other community resources varied widely by type of service. Half of families overall, but >/=80% of those active at 1 year, received core home visiting services. Performance varied by program site. CONCLUSIONS: It is challenging to engage and retain at-risk families in home visiting. Service monitoring must be an integral part of operations.

Family medicine · Identification (biology) · Service (business) · Child Abuse and Trauma · Marketing · Maternal Mental Health During Pregnancy and Postpartum · Medicine · Nursing · Prenatal Substance Exposure Effects · Gerontology