An Evaluation of Hawaii’s Healthy Start Program Using Child Abuse Hospitalization Data

This retrospective study had a twofold focus: (1) to assess the utility of a perinatal screening and assessment protocol for identifying families with an elevated child maltreatment risk and (2) to assess the effectiveness of an intensive home visitation program designed to prevent severe maltreatment. Among 15,864 families screened and assessed for child maltreatment risk, elevated risk was identified in 4,464 families, 1,738 of whom received intensive home visiting services and 2,728 who did not. Subsequently, data on hospitalizations with a child maltreatment diagnosis were used as outcome measures. Among the 1,738 served by home visitors, there were five hospitalized cases of child maltreatment; among the 2,278 families not served, there were 34 cases. The results of chi squared analyses suggest that the screening and assessment protocol successfully differentiates between families with greater and lesser degrees of risk for maltreatment and that hospitalization occurred significantly more often among unserved families (p = <.001).