In This Issue - THE NEW SOCIAL WORKER Online

e developed that could adequately address
the key issues associated with this
evolving national concern. In 1991, the
United States Advisory Board on Child
Abuse and Neglect proposed the implementation
of a new national child abuse
prevention initiative, which soon became
known as Healthy Families America. The
program was launched in 1992 under the
auspices of the National Committee to
Prevent Child Abuse, in partnership with
Ronald McDonald House Charities and
the Freddie Mac Foundation.
The initial concept for the Healthy
Families America strategic intervention
program was based on the outcome
results of several large scale evaluation
studies of federally funded child abuse
preventive service programs conducted
by Daro and Cohn in the 1970s and
1980s. The studies compared the efficacy
and cost effectiveness of a number of different
types of service interventions designed
to prevent child abuse and neglect
among high risk client populations. One
study compared clients receiving basic
child abuse prevention services with
those receiving enhanced home visitation
and other supportive services. Outcome
results indicated that the behaviors that
lead to child abuse and neglect showed
a significant statistical reduction among
those clients receiving enhanced preventive
and supportive services, such as
home visits and group therapy, compared
to those who received basic services
alone (Cohn & Daro, 1988). Similar
results were obtained from controlled
studies conducted by Lutzker and Rice
(1984, 1987), Olds, Chamberlin, and
Tadebaum (1986), and Seitz, Rosenbaum,
and Apfel (1985). Data from follow-up
studies documented substantial improvements
in parenting behaviors and family
life among clients who received enhanced
child abuse prevention services
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compared to those clients who did not
receive such intensive intervention.
Healthy Families America was modeled
after a pilot program that was originally
started in Hawaii in the mid 1980s
called Hawaii Healthy Start, a voluntary
initiative that offered home visits by
paraprofessionals to new parents identified
as being at high risk for child abuse.
The program has grown steadily across
the nation since its inception in 1992.
Healthy Families America home visitor
programs currently exist in 440 communities
across 36 states in the United
States and in several of the Canadian
provinces.
The primary goal of the national
program is to assist expectant and new
mothers to give their children a healthy
start in life through the promotion of
positive parenting skills that will enhance
a child’s development and sense
of well being and prevent behaviors that
contribute to child abuse and neglect.
Healthy Families America strongly
believes that, for the program to be effective
in preventing behaviors that lead to
child abuse, services need to be implemented
on a case-by-case basis in accordance
with the specific needs of individual
families. The program encourages
service professionals to assist families at
risk to develop and maintain strong supportive
ties with the health care system.
Preventive services are provided in an
atmosphere that fosters bonds of friendship,
trust, and social support among
program participants, service professionals,
and community health care and child
welfare agencies.
One of the key components that
make the Healthy Families America
program so successful is early intervention.
Supportive services begin at the
time of the child’s birth and continue for
a specified time period lasting between
three and five years. Every new parent
that becomes a participant in a Healthy
Families America program has access to
some intervention services based on his
or her level of need. Level of need for
service intervention is determined by
caseworkers who utilize a standardized
assessment tool to systematically identify
families at risk for behaviors that can
lead to the onset of child abuse.
Healthy Families America provides
overburdened parents with supportive
services that can assist them in coping
with everyday stressful situations that
often accompany the process of becoming
a parent for the first time. Professional
family support caseworkers utilize
positive community outreach strategies
to build the trust of participating families
in both the caseworker and the program.
Family participation in the program is on
a strictly voluntary basis.
All comprehensive preventive
services provided to families at risk
participating in Healthy Families
America programs across the nation
are culturally sensitive and support the
establishment of healthy parent-child
interactions that lead to positive physical
and emotional growth and development
among children. In addition to providing
direct supportive services to high risk
families, Healthy Families America
family support caseworkers also provide
their clients with referral links to other
community based organizations and
service professionals who can offer
them additional healthcare and social
services that can help these clients to give
their child a healthy start in life. These
services include financial assistance,
food and housing assistance, child care
and school readiness programs, job
training programs, substance abuse
treatment programs, domestic violence
shelters, and medical care services from
community physicians.
Research has shown that in the
communities where Healthy Families
America programs have been implemented,
90% of families that were invited
to participate accepted the supportive
services that were offered to them.
Healthy Families America—
What do the results of
evaluations tell us about the
success of the program?
Since their inception in the early
1990s, Healthy Families America