Using administrative data to evaluate the effectiveness of the Healthy Families Oregon home visiting program: 2-year impacts on child maltreatment & service utilization

The present study used state administrative databases to examine the 2-year outcomes of a large-scale randomized study of the impact of the Healthy Families Oregon (HFO) home visiting program. 2727 eligible first-time mothers were randomly assigned to either the HFO program or to a community services-as-usual control group. Outcomes for the current study were tracked for 2 years post-random assignment for all study participants through administrative data linkages to Oregon's statewide child welfare system, self-sufficiency services, and substance abuse treatment programs. Results indicated that families assigned to HFO program were no more or less likely to have a substantiated child abuse report than were controls (6.3% vs. 6.0%), but were significantly more likely to have an unsubstantiated report (9.7% vs. 7.9%). Among HFO families who were reported to the child welfare system, 86.2% (94 children) were reported after they had exited the program, while 13.8% (15 children) had a report while enrolled. However, 50.5% of children with unsubstantiated reports were reported while families were receiving HFO services, suggesting a surveillance effect for unsubstantiated reports. HFO families, compared to controls, were also significantly more likely to have been enrolled in Temporary Assistance for Needy Families (TANF) services for the first time, to have received more days of Supplemental Nutrition Assistance Program (SNAP), and to be enrolled in publically-funded substance abuse treatment services. Results suggest that early effects of home visitation on outcomes that can be measured through administrative data are small to modest, and that findings related to documented child welfare systems involvement may require more nuanced data than are typically used and/or available from state agency systems.