Parental risks were common at baseline, and one-sixth of families had a substantiated child protective services report in the child’s first 2 years of life. There was no overall program effect on maltreatment reports, and most measures of potential maltreatment. Home visited mothers reported using mild forms of physical discipline less often than control mothers. The groups were similar in their use of more severe forms of physical discipline. There was no program impact on parental risks. There was no impact on outcomes for families with a high dose of home visiting. Home visitors often failed to address parental risks and seldom linked families with community resources. Contradictions in the model compromised effectiveness. Based on the promising results of early research, influential reports in the early 1990s endorsed home visiting to prevent child maltreatment. National initiatives grew to assist communities wishing to implement home visiting. Healthy Families America (HFA) is perhaps the most prominent. HFA recommends voluntary home visiting targeted to those identified at-risk families. This study assessed the impact of a statewide HFA program in preventing child abuse. It examines outcomes, compares actual services to the program model, and related impact to the model and implementation system. The study is designed to estimate effectiveness and explain how the implementation system influenced service delivery. The focus of the study was on 6 Healthy Families Alaska (HFAK) programs; 325 families were enrolled in 2000-2001, randomized to intervention and control groups, and interviewed to measure baseline attributes. Tables, references