Healthy Families America

Healthy Families America is a voluntary home visitation program designed to promote healthy families and children through a variety of services, including child development, access to health care, and parent education. The program targets families identified as at risk, with children ages 0 to 5. All Healthy Families America sites must adhere to the following program elements:

(1) Initiating Services Prenatally or at Birth

- The sites use a standardized assessment tool to systematically identify families who most need services.
- Families voluntarily participate in the program. Caseworkers use positive outreach efforts to build family trust in the caseworker and the program.

(2) Providing Services

- Home visitors offer participating families long-term services (usually 3 to 5 years), beginning intensively (at least one visit per week), and use well-defined criteria for determining whether the intensity of service should be increased or decreased.
- Services are culturally sensitive.
- Comprehensive services support parents, parent-child interaction, and child development.
- Families are linked to a medical provider (for timely inoculations and well-child care) and, if needed, financial assistance, food and housing assistance programs, school readiness programs, child care, job training programs, family support centers, substance abuse treatment programs, and domestic violence shelters.
- Home visitors carry a light caseload; the caseload varies from fewer than 10 families to as many as 15.

(3) Selecting and Training Home Visitors

- Caseworkers are chosen based on their ability to establish trusting relationships with participating families.
- All service providers receive basic training in cultural competency, substance abuse, child abuse reporting, domestic violence, drug-exposed infants, and available services in their community.
- Service providers are trained so they understand the components of family assessment and home visitation.

Program goals include prevention of negative birth outcomes (low birth weight, substance abuse, criminal activity, child abuse, and neglect), increased parenting skills, healthy pregnancy practices, and the use of social systems.

A summary of all the evaluations of Healthy Families America indicates that the program produces measurable benefits for participants in areas such as parent-child interaction and parental capacity. Most families receiving these services appear better able to care for their children, to access and effectively use health care services, to avoid reports of child abuse or neglect, and to resolve many personal and familial problems common among low-income, single-parent families. While many of these findings have emerged from the quasi-experimental designs, the randomized trials have produced similar findings.