Preventing Child Abuse and Neglect Through Home Visitation: A Randomized Controlled Trial

Healthy Families Arizona is a voluntary, home visitation program aimed at preventing child abuse and neglect. This study sought to examine the impact of the Healthy Families Arizona program on (a) reducing the risk of child abuse and neglect, (b) child health and development, and (c) parent/child relationships. To examine program impact in these three areas a longitudinal randomized controlled trial (RCT) was implemented and latent growth model analysis was used to take advantage of the repeated measures design. The RCT includes 98 families assigned to the Healthy Families Arizona program and 97 families assigned to a control group. All 195 participating families voluntarily agreed to be involved in the study for a period of five years, with the option to withdraw at any time without consequence. The data were gathered in the participants' homes and all of the measures were administered verbally by one of two trained research assistants. The participant interviews were conducted in English or Spanish, according to participant's preferences. This paper utilizes data collected at three points in time, baseline, 6, and 12 months. The retention rate at 12 months was 89% and did not differ by group. Data quality was very good, negating the need for imputation methods to replace missing data. The psychometric qualities of all scaled measures were examined and when necessary adjustments were made to insure adequate internal consistency. The purpose of this paper is to describe between group differences in severity and change overtime on outcomes framed within a risk and resiliency model. Several findings favored the Healthy Families Arizona program participants. These include, for instance, less use of violent discipline techniques by caretakers from 6 to 12 months; differences in strong parental beliefs in corporal punishment, satisfaction with parenting, acceptance of normative infant behavior; emotional loneliness of the mother; hope-related agency, i.e., the belief that the mother herself is capable of pursuing her goals successfully, use of community resources, and perceptions of material hardship. Healthy Families Arizona home visitors are trained to promote nonviolent discipline practices, teach families coping and stress reduction techniques, provide social support, connect families with community resources, and are a source of child development and child safety information. The outcomes demonstrated in this study are consistent with the intent and practices of the Healthy Families Arizona program, and bode well for the three prevention goals of decreased child abuse and neglect, improved parent/child relationships, and enhanced child health and development. Although this paper is restricted to one year of data, implications are made for social work practice and policy in the area of child abuse and neglect prevention.