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Helping to Prevent Child Abuse--and Future Criminal Consequences: Hawai'i Healthy Start

NCJ Number
Ralph B. Earle Ph.D.
Date Published
12 pages
Hawaii's Healthy Start program uses home visitors from the community to provide services to at-risk families and to specifically reduce family stress, improve family functioning and parenting skills, enhance child health and development, and prevent child abuse and neglect.
Unlike other similar programs, Hawaii's program follows the child from birth to 5 years of age with a range of services and assists and supports other family members. To ensure systematic enrollment, Healthy Start signs up most families right after the delivery of the child, although about 10 percent of families are enrolled prenatally. Healthy Start has formal agreements with all hospitals in Hawaii to enable the program to perform postpartum screening through a review of the mother's medical record or a brief interview. Fewer than 1 percent of mothers refuse to be interviewed, 4 to 8 percent later refuse service offers, and about 7 percent cannot be relocated after release from the hospital. Paraprofessional home visitors call on families weekly for the first 6 to 12 months. Early in the relationship, the home visitor helps parents develop an individual support plan, specifying the kinds of services they want and need and the means by which to receive them. As part of its oversight, Hawaii's Maternal Child Health Branch requires the completion of a series of infant/child monitoring questionnaires to identify problems in child development at 4, 12, 20, and 30 months. If these show developmental delays, further assessments are performed and appropriate services are offered. In 1994, a confirmed child care abuse and neglect case cost the Hawaii family welfare system $25,000 for investigation, related services, and foster care. In contrast, Healthy Start officials estimate an annual average cost of $2,800 per home visitor case. Preliminary evaluation findings indicate that Healthy Start families have lower child abuse and neglect rates and children are developing appropriately for their ages. 20 notes and 2 photographs