Healthy Families America (HFA)

There is some evidence that Healthy Families America (HFA) improves parenting practices and attitudes^{2, 3}. HFA may also reduce child abuse and neglect^{2, 3, 4, 5, 6, 7}. 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 the most successful programs.

HFA parents appear to use positive parenting skills (e.g., stimulate, reassure, or praise a child) and engage in developmentally supportive activities more than non-participating parents^{8, 9}. HFA has been shown to decrease self-reported cases of abuse and neglect in some circumstances^{3, 4, 5, 10} and increase use of non-violent discipline⁴, especially among first time mothers and families with substantiated instances of abuse or neglect⁴. However, HFA does not appear to affect substantiated official reports of child abuse and neglect, potentially due to surveillance bias^{3, 4, 6, 11}.  

HFA has been shown to improve child well-being and safety⁷. HFA mothers are more likely to receive a developmental screening and practice safety behaviors (e.g., using car seats, keeping poison out of reach, etc.) than non-participants^{2, 8}. Breastfeeding rates appear higher³ and alcohol use appears lower^{2, 3} for mothers who participate in HFA programs than for mothers who do not.

Mothers participating in Healthy Families New York (HFNY) are less likely to deliver low birthweight (LBW) babies than non-participants; positive effects are more likely for mothers who participate in the program earlier in their pregnancies. Decreases in LBW babies have also been shown in Virginia, Florida, and Washington, D.C. implementations of HFA³.

HFA may improve children’s cognitive development in some circumstances³. By age seven, children whose mothers participated in HFNY are more likely to be in gifted programs and less likely to be enrolled in special education classes than children whose mothers did not participate⁴. Participants’ children also demonstrate more learning-promoting behaviors and less grade retention than comparison children; effects on academic performance have been demonstrated for daughters of HFNY participants, but not for sons¹². 

There are nearly 400 affiliated HFA program sites in 40 States, DC, and the U.S. territories¹.