Evaluation of Hawaii's Healthy Start Program

Abstract

Hawaii's Healthy Start Program (HSP) is designed to prevent child abuse and neglect and to promote child health and development in newborns of families at risk for poor child outcomes. The program operates statewide in Hawaii and has inspired national and international adaptations, including Healthy Families America. This article describes HSP, its ongoing evaluation study, and evaluation findings at the end of two of a planned three years of family program participation and follow-up. After two years of service provision to families, HSP was successful in linking families with pediatric medical care, improving maternal parenting efficacy, decreasing maternal parenting stress, promoting the use of nonviolent discipline, and decreasing injuries resulting from partner violence in the home. No overall positive program impact emerged after two years of service in terms of the adequacy of well-child health care; maternal life skills, mental health, social support, or substance use; child development; the child's home learning environment or parent-child interaction; pediatric health care use for illness or injury; or child maltreatment (according to maternal reports and child protective services reports). However, there were agency-specific positive program effects on several outcomes, including parent-child interaction, child development, maternal confidence in adult relationships, and partner violence. Significant differences were found in program implementation between the three administering agencies included in the evaluation. These differences had implications for family participation and involvement levels and, possibly, for outcomes achieved. The authors conclude that home visiting programs and evaluations should monitor program implementation for faithfulness to the program model, and should employ comparison groups to determine program impact.

The Role of Preschool Home-Visiting Programs in Improving Children's Developmental and Health Outcomes

“…An ambitious evaluation in 1999 of a statewide home visiting program in Hawaii failed to demonstrate any substantial improvements in either maternal or child development and health outcomes. 18 Although these findings contradicted previous smaller studies and evaluations of earlier pilot programs, the comprehensiveness of this evaluation led to further examination of the evidence base for home visiting. In considering these apparent inconsistencies, it is best to remember that home-visiting programs are heterogeneous in their makeup, thereby compounding the difficulties associated with their evaluation.…”

Parenting Education in Indonesia: Review and Recommendations to Strengthen Programs and Systems

“…• Reduce domestic abuse and replace violent discipline techniques with effective nonphysical approaches (Barlow et al 2006;Bugental and Schwartz 2009;Duggan et al 1999;Webster-Stratton and Reid 2010). Researchers suggest that parenting interventions are instrumental in preventing child maltreatment in low-and middle-income countries (Knerr, Gardner, and Cluver 2013 Black et al 1994;Duggan et al 1999;Gelfand et al 1996;Love et al 2005).…”

“…Researchers suggest that parenting interventions are instrumental in preventing child maltreatment in low-and middle-income countries (Knerr, Gardner, and Cluver 2013 Black et al 1994;Duggan et al 1999;Gelfand et al 1996;Love et al 2005). …”

Disparities in Use of Mental Health and Substance Abuse Services by Asian and Native Hawaiian/Other Pacific Islander Women

“…Per the usual protocol, the HSP staff screened all new mothers' medical records at the obstetrical unit for family risk for child abuse. 26 The families provided informed consent for the review of medical records at hospital registration. 25 The 15 areas that were used to measure family risk included:…”