Key findings from this study indicate that HFI services are associated with promotion of optimal parent-child outcomes during the first two years of life.

For example, caregivers receiving HFI services exhibit significant improvement in their ability to promote their children's social, emotional, and cognitive growth during the first six months of life.  Parents receiving all other usual services who were not able to receive HFI services because of limited availability did not exhibit these early improvements in their caregiving skills.

As expected, at one year, HFI parents, relative to parents receiving all other usual services, displayed greater acceptance and tolerance of their growing children's challenging behaviors.

At two years, families receiving HFI services, compared to those receiving all other usual services, offered their children a wider array of materials to stimulate intellectual development.

Perhaps most importantly, findings from this evaluation demonstrate that HFI programs are successful at engaging and retaining parents at high risk for problems in parenting.  Further, families with the highest risk for problems in parenting demonstrated the greatest benefit across time from HFI's prevention services.

As with any evaluation, certain limitations should be considered when interpreting this study's findings.  Although the present study included a comparison group of families, which were equivalent to HFI families in terms of risk and motivation to receive services, placement of families into service groups was not random.  Any bias in the manner in which families were assigned to HFI services versus the comparison condition may have impacted this study's findings.

It also may be noted that participation in the evaluation project was voluntary.  As one would expect, not all families receiving HFI services volunteered to participate.  Thus, the extent to which the present findings generalize to families who did not volunteer remains unknown.  Further, some families who volunteered did not complete the two year study.  Attrition analyses in the present study revealed that the number of data collection sessions completed was not meaningfully associated with demographic characteristics, such as race, education or employment.  Thus, families that completed the two year project were demographically similar to those that did not complete the study.

With these limitations in mind, findings from this large-scale, longitudinal evaluation may be interpreted as evidence that HFI's services are associated with improved parent-child outcomes, including reduced risk for child abuse and associated problems in parenting.