Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Purpose: In this era of evidence-based practice, whether or not a program is judged effective is based entirely on the results of an experiment, with randomized controlled studies being the gold standard. Rarely considered in this assessment is that to a large extent the findings are dependent on the outcome measures that are used. This suggests that outcome measurement is absolutely critical to documenting positive program effects. Although the numbers of controlled studies of home visitation to prevent child maltreatment are few, several have found little to no positive effects. Typically, these null findings are explained by a lack of program theory and poor fidelity. Not addressed is the fact that the outcome measures may not have been sensitive to the progress made by program participants. Upon further review, we found that many of the standardized measures commonly used in the evaluation of home visitation programs were not specifically developed to capture change. As a result of these concerns, a systematic effort was undertaken to create an instrument that would be sensitive to the changes intended to be affected in home visitation programs. This newly developed instrument is called the Healthy Families Parenting Inventory (HFPI). Methods: This paper describes the entire course of development of the HFPI, from development of an item pool through empirical validation. Initially, focus groups were held with home visitors, supervisors, and program participants to determine how these groups conceptualized the impact of home visitation. These data were used to specify the factors that should be considered in the measurement of program outcomes. Items were then developed, pretested, and administered to two separate populations. This was followed by an empirical study of construct validity to guide the fine tuning of the instrument. Results: Reliability analysis found the HFPI subscales have alpha coefficients ranging from .76 to .86, indicating excellent internal consistency. Factor analysis supported the existence of nine distinct subscales. The subscale items correlate poorly with measures with which they should not correlate, and low to moderately with other total subscale scores on the instrument. Implications for practice: The HFPI is an easy to administer, 63-item instrument that measures important aspects of behavior, attitudes, and perceptions related to parenting. The instrument has nine subscales that are organized as follows: social support, problem-solving, depression, personal care, mobilizing resources, role satisfaction, parent/child interaction, home environment, and parenting efficacy. The HFPI was developed specifically for use in evaluating home visitation programs for populations of at-risk children from birth to five years of age. The HFPI can be used to identify critical areas of need, target concerns, build on strengths, and to develop individualized case plans.