Healthy Families Evaluation Update
2014-15 Key Outcome and Service Findings
Best Beginnings Meeting
March 10, 2016
Informing policy,
Improving programs
Beth L. Green, Ph.D.
Jerod Tarte, M.A.
[email protected]
[email protected]
www.npcresearch.com
Presentation Overview
• HFO Family
Characteristics
• Key Outcome Findings
• Service Delivery Findings
• Looking Ahead
3/10/2016
2
Families Served FY 2014-15 Are
Demographics
of ISOutcomes
Families
at High Risk for Negative
HFO home visited families are at high risk, compared
to general Oregon population
100%
85%
90%
75%
80%
70%
60%
50%
35%
40%
34%
30%
20%
10%
20%
20%
11%
3%
0%
% teen parents
% single parents
HFO
3/10/2016
% less than HS
% below FPL
Oregon General Pop.
3
Healthy Families Oregon:
Demographics
of
IS
Families
Parent History and Other Risks
100%
90%
79%
80%
70%
70%
60%
51%
50%
45%
44%
40%
30%
20%
10%
10%
0%
% substance % previous or
abuse
current CW
% lacked
nurturing
parents
% multiple
stressors
% scored High % 4+ NBQ risks
Stress
More screened families scored at high risk this year:
68% vs. 42% in 2011-12
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4
Status Report Outcomes
Families Served FY2014-15
3/10/2016
5
Parenting Outcomes at 12 Months
• Reading to children
decreased slightly—
– only 83% of parents
nationally read to their
young child 3 or more
times per week - 67%
for low income families.
• HOME scores
improving generally
• Fewer families had
complete HOMEs
• Slightly fewer families
reported improved
parenting skills
100%
95%
90%
85%
80%
75%
70%
65%
2004-05 2005-06 2006-07 2007-08 2012-13 2014-15
% Improved Parenting Skills
%Good/Better HOME
%Reads 3x/Week or more
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6
Daily Reading Outcomes
•
•
•
HFO parents
much more
likely to
report
reading daily
to young
children
100%
90%
80%
Especially
true for
Hispanic
parents
70%
Randomized
study found
that HFO
parents were
significantly
more likely to
read daily
compared to
controls.
50%
3/10/2016
72%
67%
63%
60%
52%
40%
40%
30%
25%
20%
HFO
Natl. Avg HFO Natl. Avg. HFO (RTC) HFO
Low SES Hispanic Hispanic
(Control)
parents
7
Health Outcomes
100%
• Overall health
outcomes very
strong, meet
HFA standards
95%
90%
• Only 68-74% of
Oregon 2-year
olds fully
immunized
85%
• Insurance
coverage has
continually
increased.
75%
80%
70%
2005-06 2006-07 2007-08 2012-13 2014-15
% Immunized by age 2
% Regular Well-Child
% Children w/Insurance
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8
Outcomes for Families Served
Prenatally
• Statewide, only about 100%
255 mothers screened 90%
AND served prenatally
• These mothers were
more likely to be
breastfeeding at 6
months.
• May be less likely to
have premature birth
• Families served
prenatally also remain
in the program longer
80%
70%
79%
69%
60%
50%
40%
30%
20%
6%
10%
11%
0%
% Breastfed
Served Prenatally
3/10/2016
% Premature
Served Postnatally
9
Child Development
• Most children are
developing
normally,
although trend
towards more 100%
delays indicated.
90%
• Staff take
appropriate
action when
delay indicated. 80%
• % of children
70%
receiving ASQ
screening has
been decreasing
(HFA standard) 60%
% Normal Development
% w/delay referred or appropriate
action
% screened within past year
50%
3/10/2016
2005-06
2006-07
2007-08 2012-2013 2014-15
10
Service Delivery Findings
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11
Eligibility Screening: Numbers
Screened Continues to Decline
10000
9500
9750
9443
9052
9000
8500
8814
8000
7681
7500
7000
6500
6000
5500
5000
2007-08
3/10/2016
2010-11
2011-12
2013-14
2014-15
12
New Screening Target Population as of
2014-15: All Births
•
•
•
•
45,620 births last year statewide
17% (7,681) screened by HFO
92% of screens within 2 weeks of birth
90% of home visits within 3 months of
birth
 Service improvement note:
262 families were not offered
services because of incorrect NBQ
scoring
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13
Program Acceptance Rates
•
•
70% of screened=eligible +
interested
78% of those offered HFO
– 545 could not be located
– 98 “caseloads full”
•
38% of offered received
first HV (e.g., “Accept”)
– 78% of these (1,151) did not
have a reason for no visit
•
60%
Families more likely to get
1st HV if:
50%
40%
30%
– Spanish speaking,
Hispanic
20%
– Married
10%
– Regional variability in
other factors
0%
2006-07
2007-08
2012-13
2014-15
% Accept Home Visiting
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14
Intensive Home Visiting Component
Enrollment Decreased Slightly
3500
3000
3235
2958
2857
2549
2500
1812
2000
1500
1273
793
898
2007-08
2012-2013
2014-15
Total Enrolled
New Enrollments
1000
500
0
2006-07
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15
Program Retention Rates
•
•
•
•
Overall, retention
patterns are similar
for last 3 cohorts
100%
12-month retention
varies by program
(44%-81%)
80%
Spanish-speaking
families have highest
retention—77% at 12
months vs. 50% for
English speaking.
90%
3/10/2016
72%
70%
54%
60%
50%
40%
30%
Older, married moms 20%
also somewhat higher
10%
retention
0%
– 39% of teens
retained at 12
months
86%
% retained 3 % retained 6 % retained
months
months
12 months
% retained
18 months
Enrolled 2010-11
Enrolled 2011-12
Enrolled 2012-13
Enrolled 2013-14
16
Why do Families Leave?
• 33% decline further service
• 22% age out
• 20% move out of county
• 14% “other”
• 11% cannot locate
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17
Program Strengths
1. Engaging higher risk
families and families of
color (especially
Hispanic/Latino)
2. Parents reading to children
3. Family HOME environment
4. Health outcomes generally
5. Outcomes for prenatally
served moms
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18
Suggestions for Improvement
1. Consider more prenatal
screening & services
2. Increase on-time ASQs
3. Work on site-specific
performance indicators
4. Ensure accurate NBQ scoring,
HOME completion, data
systems improvements
5. Monitor new service
population
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19
Questions?
Thoughts?
Recommendations?
3/10/2016
20