This study examined the effects of a Healthy Families America (HFA) credentialed home visitation program on the parenting attitudes and practices of a sample of at-risk parents. It also examined the social and emotional competence of children whose parents successfully completed the program. The HFA model is an intensive early intervention program that targets at-risk families through home visitation services. Successful completion of the program is a process that takes between 3 and 5 years. Results indicate that, relative to the baseline, parents who completed the program showed significant positive change in parenting attitudes and practices. In addition, relative to other children their age, the children of families who successfully completed the program exhibited significantly higher levels of performance on measures of social and emotional competence.

The prevention of Rapid Repeat Births (RRBs) and Teen Repeat Births (TRBs) is an important indicator of the effectiveness of home visitation programs that serve mothers who are at-risk for child maltreatment. This study examined the effects on RRBs and TRBs of a rural/small town home visitation program based on the Healthy Families America (HFA) model. The participants in this study were referred between 1999 and 2007 and included a Treatment Group of 140 at-risk mothers who met minimum engagement criteria and a Comparison Group of 241 atrisk mothers who were referred for services but not enrolled due to limits on program capacity. In addition, county-wide TRB data was used as the basis for a static group comparison. With regard to RRBs, the rates for the Treatment (18%) and Comparison (30%) groups were compared using a Chi-Square test of homogeneity. The null hypothesis that there would be no difference between the rates for the two groups was rejected at the .05 level. Similarly, with regard to TRBs, the null hypothesis that there would be no difference between the rates for the Treatment (9%) and Comparison (27%) groups was rejected at that .01 level. Furthermore, using a Chi-Square test of independence, this investigation tested the null hypothesis that the rates for the two groups would not differ from the county-wide rate (24%). This hypothesis was also rejected at the .01 level. Overall, these results of this inquiry support the conclusion that participants in a rigorously implemented HFA program show significantly lower rates of RRB and TRB when compared to a comparable group of at-risk nonparticipants. They also appear to have a significantly lower incidence of TRB than teen mothers in the general population.