This final report provides an executive summary highlighting key elements of the Massachusetts Healthy Families Evaluation (MHFE-2) to set the background for the findings and implications that are presented, in detail, in the report; the document is divided into 13 chapters and three appendices with supporting technical documents; and the chapters present an in-depth description of MHFE-2, participant characteristics, program operations, impacts, and implications.
This document is a final report of the Massachusetts Healthy Families Evaluation (MHFE-2), which followed approximately 700 mothers and their children from 2008 through 2012 and employed a randomized controlled trial (RCT) design for its impact component, collecting and analyzing data from two comparable samples of those 700 families: one sample was offered Healthy Family Massachusetts (HFM) home visiting services, and the second sample group was not. The MHFE-2 evaluation sought to answer the following key research questions: how those mothers enrolled in HFM utilized program services; to what extent the programs operated, and if participants utilized services as intended by the HFM model; if program dosage was associated with outcomes; what the nature of the home visitor-mother relationship was; and if participation in HFM yielded positive effects in the five HFM goal areas. The report lays out the details of the MHFE-2 evaluation design; the researchers’ analytic approach, which was comprised of a five-tier evaluation; a breakdown of tiers two and three, with in-depth discussion of participant characteristics, program operations, the links among aspects of program operations, and the links between maternal characteristics and program operations; an in-depth discussion of tiers four and five, such as overall program impacts, how to understand the pathway to program impacts, how to understand differential goal achievement by subgroups, the links between utilization and outcomes, and the links between fidelity and outcomes; as well as a discussion of outcomes, methodology, and impacts, as well as implications for policy within communities and across sectors. The appendices provide a further look at the five-tiered approach to evaluation, study design measures and outcome analysis, and a list of publications and other evaluation products.
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