Assessing Healthy Families America’s Parenting Outcomes

POSTED BY: PHIL GORDON ON THU, APR 18, 2013

April is National Child Abuse Prevention Month.  Prevent Child Abuse America is one of the leaders in working to reduce child abuse and neglect.  Their Pinwheels for Prevention Campaign does much to raise awareness.  In this post we will focus on Healthy Families America, one of six departments of Prevent Child Abuse America.  We first became associated with Healthy Families America through Healthy Families Virginia. While we were still working on the validation of the Keys to Interactive Parenting Scale (KIPS), Healthy Families Virginia asked to see the preliminary work. As they reviewed our approach to assessing parenting, they found a great fit with the Healthy Families Virginia program, and requested training to certify their staff right away.  In 2004 Healthy Families Virginia began assessing parenting using KIPS.  Eleven Healthy Families Virginia sites went even further and collaborated on the validation of the parenting assessment.   

Healthy Families America

Healthy Families America’s mission is to promote child well-being and prevent the abuse and neglect of our nation’s children through home visiting services. Healthy Families America programs serve families with increased risk for child maltreatment, neglect, or other adverse childhood experiences. Services are initiated either during the prenatal period or shortly after the baby’s birth. Healthy Families America is a national initiative to support parents in providing a healthy start for children up to 5 years of age.  Healthy Families America is one of the home visiting models that currently meets the proven efficacy criteria of the U.S. Department of Health and Human Services and therefore is one of the commonly used models in the Maternal, Infant, Early Childhood Home Visiting Program (MIECHV).

Healthy Families America Goals:

  1. Build and sustain community partnerships to systematically engage overburdened families in home visiting services prenatally or at birth.

  2. Cultivate & strengthen nurturing parent-child relationships.

  3. Promote healthy childhood growth and development.

  4. Enhance family functioning by reducing risk and building protective factors.

Healthy Families America (HFA) home visitors meet with families weekly.  The HFA logic model delineates the following activities to build nurturing parent-child relationships:

  • Create trusting, nurturing relationships with families.

  • Assess, address, and promote positive parent-child interaction.

  • Utilize the parent-child curriculum to promote attachment.

  • Nurture parents by maintaining healthy relationships.

  • Educate parents about infant capacities, baby cues, attachment, & empathy.

  • Assist parents in connecting current interaction to future development.

  • Reinforce positive discipline techniques.

  • Encourage fathers to become active in the lives of their children.

 Assesssing Healthy Families America Parenting Outcomes

The 2011 HFA logic model defines a series of short, intermediate and long-term outcomes for each of their 4 program goals (see more on outcomes, obtaining funding, and assessing parenting). 

The 7 intermediate parent outcomes include: 

  • Increase Parental Competency

  • Increase Parental Sensitivity & Responsiveness to Child’s Needs & Cues

  • Increase Connectedness & Affective Mutuality

  • Increase Promotion of Child’s Attentional & Behavioral Strategies

  • Increase Cognitive Stimulation

  • Increase Appropriate Discipline & Limit Setting

  • Decrease Harsh, Aggressive Parenting Practices

Let’s see how well KIPS links to these parenting outcomes.  The first goal, Increase Parenting Competency, is a global goal, and matches the overall KIPS scale in assessing parenting quality. So let’s look at the more specific outcomes.  The slide show below explores how 6 of the Healthy Families America intermediate outcomes match the 12 KIPS items. [Click on the arrows beneath the slides to advance to the next slide].

  • HFA outcome:  Increasing Parental Sensitivity and Responsiveness to Child’s Needs and Cues closely matches the first 2 items on the KIPS parenting assessment: Sensitivity of Responses and Supports Emotions. 

  • HFA outcome:  Increase Connectedness & Affective Mutuality maps to 4 KIPS items:  Supports Emotions, Physical Interaction, Involvement in Child’s Activities and Encouragement. 

  • HFA outcome:  Increase Promotion of Child’s Attentional & Behavioral Strategies connects to 6 relevant KIPS parenting assessment items:  Open to Child’s Agenda, Reasonable Expectations, Adapts Strategies to Child, Supportive Directions, Encouragement, and Promotes Exploration/Curiosity. 

  • HFA outcome:  Increase Cognitive Stimulation matches 5 KIPS items:  Language Experiences, Reasonable Expectations, Adapts Strategies to Child, Supportive Directions and Encouragement. 

  • HFA outcome:  Decreasing Harsh and Aggressive Parenting maps to 4 KIPS parenting assessment items:  Supports Emotions, Physical Interaction, Reasonable Expectations and Limits & Consequences.  

The last figure in the slides combines all 21 arrows to show that the Healthy Families America intermediate parent outcomes are all assessed by KIPS.  Also, note that each of the HFA parent outcomes is addressed multiple times by KIPS, reinforcing the strong alignment of this parenting assessment with HFA.  Furthermore, as shown in the final figure, KIPS doesn’t assess aspects of parenting that are unrelated to an HFA parent outcome.  Thus, KIPS assesses all of HFA’s parent outcomes, yet is a brief and efficient parenting assessment. 

Assessing parenting can have a wide range of benefits for your program.  Two major benefits are documenting outcomes and guiding family services.  First, by aggregating parents’ KIPS scores over time, programs can produce evidence that they are making a difference on a key program goal, supporting nurturing parenting behavior and parent-child relationships.  The figure below shows the results obtained from the Kentucky HANDS home visiting program, which was modeled after Healthy Families America and Healthy Start.

assessing parenting outcomes HFA

Second, assessing parenting to guide family services is another major benefit.   When serving as a TA/QA Specialist with Prevent Child Abuse Virginia, Lynn Kosanovich commented, “This tool is not designed to be a judgment on good parent or not a good parent.  And I have heard some home visitors worry about that.  Rather it’s a way to point out where their behaviors are really in sync with what their child needs, and then opportunities they have to grow in other areas.”  I think Lynn said it very well.  Assessing parenting allows you to discover opportunities for parents to grow.  Together, parents and family service providers can build on strengths and explore opportunities for learning more nurturing parenting skills that meet their children’s needs.

Personally, I felt that my early schooling in the 1960s and 1970s worked very hard to stifle my curiosity.  So it is my distinct pleasure to serve as the evaluator of an inquiry math and science program, a collaboration of the Allentown School District and the Da Vinci Science Center.  Observing K-8 classrooms using inquiry based instruction that supports exploration and curiosity is extremely rewarding. I know I am seeing quality instruction when I feel jealous of the students being well-supported in their exploration and curiosity. Learning math and science can be fun!  Not only are the children learning science and math, but the important trait of curiosity is being nourished.  The skills we look for in a good inquiry-based teacher and a parent are remarkably similar.  The goal of both is for the child to develop the habits of mind that eventually allow them to be thoughtful, resilient, and productive members of society.