Evaluation of Hawaii's Healthy Start Program

Hawaii's Healthy Start Program (HSP) is designed to prevent child abuse and neglect and to promote child health and development in newborns of familie s 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 fam ily program participation and follow-up. After two years of service provision to families, LISP was successful in li nking families with pediatric medical care, improving maternal parenting ef ficacy decreasing maternal parenting stress, promoting the use of nonviolen t discipline, and decreasing injuries resulting from partner violence in th e home. No overall positive program impact emerged after two years of servi ce in terms of the adequacy of well-child health care; maternal life skills , mental health, social support, or substance use; child development; the c hild's home learning environment or parent-child interaction; pediatric hea lth care use for illness or injury; or child maltreatment (according to mat ernal reports and child protective services reports). However, there were a gency-specific positive program effects on several outcomes, including pare nt-child interaction, child development, maternal confidence in adult relat ionships, and partner violence. Significant differences were found in program implementation between the th ree administering agencies included in the evaluation. These differences ha d implications for family participation and involvement levels and, possibl e; for outcomes achieved. The authors conclude that home visiting programs and evaluations should mon itor program implementation for faithfulness to the program model, and shou ld employ comparison groups to determine program impact.