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January 2013
January
2013 Volume 33 No. 3
Strengthening
Home Visiting Through Research
New
Research Strengthens Home Visiting Field: The Pew Home Visiting Campaign
Libby
Doggett
Extensive
research has shown that home visiting parental education programs improve child
and family outcomes, and they save money for states and taxpayers. Now, the
next generation of research is deepening understanding of those program
elements that are essential to success, ways to improve existing models, and
factors to consider in tailoring home visiting to local contexts and particular
target populations. All new parents need good information about their child’s
development to help them through the stress and uncertainty that come with
having a baby. Years of research have shown that this vital support can be
provided, in part, by formal parent-education programs called “home visiting.”
Assessing
Quality in Home Visiting Programs
Jon
Korfmacher, Audrey Laszewski , Mariel Sparr, and Jennifer Hammel
Defining
quality and designing a quality assessment measure for home visitation programs
is a complex and multifaceted undertaking. This article summarizes the process
used to create the Home Visitation Program Quality Rating Tool (HVPQRT) and
identifies next steps for its development. The HVPQRT measures both structural
and dynamic features of program quality and provides a comprehensive look into
how home visiting services are delivered. While additional research is underway
for further testing and refinements, the initial research suggests that the HVPQRT
is a promising instrument for home visiting stakeholders who strive to increase
service quality.
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Toward
Population Impact From Home Visiting
Kenneth
A. Dodge , W. Benjamin Goodman, Robert Murphy, Karen J . O’Donnell , and
Jeannine M. Sato
Although
some home visiting programs have proven effective with the families they serve,
no program has yet demonstrated broader impact on an entire county or state population.
This article describes the Durham Connects program, which aims to achieve broad
county-level effects by coalescing community agencies to serve
early-intervention goals through a Preventive System Of Care and by delivering
universal, short-term, postnatal nurse home visiting services. Evaluation of Durham
Connects occurred through a randomized controlled trial of all 4,777 births in
Durham, NC, over an 18-month period. The results indicated that, by 6 months
old, Durham Connects infants had 18% fewer emergency room visits and 80% fewer overnight
stays in the hospital than did control families. A broad effect is achievable
if a program attends to the challenges of community partnership, universal
reach and assessment, rigorous evaluation, and strategies for sustaining
funding.
Does
Home Visiting Benefit Only First-Time Mothers?: Evidence From Healthy
Families Virginia
Lee
Huntington and Joseph Galano
It is
a common assumption that mothers who have had previous births would participate
less fully and have poorer outcomes from early home visitation programs than
would first-time mothers. The authors conducted a qualitative and quantitative
study to test that assumption by measuring three aspects of participation: time
in the program, the number of home visits, and the intensity of services. The study
also assessed three outcomes: immunizations, the home environment, and
subsequent births. Data from more than 4,000 participants at Healthy Families
Virginia sites indicate that mothers who had had previous births participated
and benefitted similarly to first-time mothers. These findings suggest a need
for future research to better understand the conditions under which home
visiting works, and they have policy implications concerning the value of
universal home visitation.
Effectiveness
of Home Visiting as a Strategy for Promoting Children’s Adjustment to School
Kristen
Kirkland
A
growing body of evidence suggests that involving families in home visiting
services promotes positive experiences during the initial years of a child’s
life; however less is known about whether or not the benefits continue to
accrue after a child enters school. This article describes the results of a
study examining the effectiveness of an evidence-based home visiting program in
promoting children’s academic adjustment. The findings suggest that home
visiting programs can produce positive effects on children’s academic
adjustment and that changes in earlier parenting practices may play an
important role in explaining how home visiting influenced these later outcomes.
Home
Visiting Processes: Relations With Family Characteristics and Outcomes
Carla
A. Peterson, Lori A. Roggman, Beth Green, Rachel Chazan-Cohen, Jon Korfmacher,
Lorraine McKelvey, Dong Zhang, and Jane B. Atwater
Variations
in dosage, content, and family engagement with Early Head Start (EHS) home visiting
services were examined for families participating in the EHS Research and
Evaluation Project. Families were grouped by characteristics of maternal age, maternal
ethnicity, and level of family risk. All home visiting variables were related
differentially to both family characteristics and outcomes but in different
ways for different groups. Results highlight the importance of documenting home
visiting processes across and within families as well as using this information
to guide programming and support home visitors in order to maximize the
effectiveness of home visiting programs.
Also
in This Issue:
- This
Issue and Why It Matters—Stefanie Powers , Monica Herk, and Andrea
Hewitt
- Letters—What
Our Readers Have to Say
- New
Opportunities and Directions in Home Visiting Research and Evaluation—Lauren
H. Supplee , Robin L. Harwood, Nancy Geyelin Margie , and Aleta L. Meyer
The
authors describe the research and evaluation activities connected to the new
Maternal, Infant and Early Childhood Home Visiting program. The goal of these
activities is to provide information on federal, state, and local efforts to
strengthen programs by providing much needed knowledge on the best ways to
support the implementation of home visiting programs at multiple levels—with families,
home visitors, supervisors, organizations, and others. The collection of
research and evaluation activities has a strong emphasis on capacity building,
both for grantees and for the research community as a whole. This article aims
to support the dissemination of research to the practice community by
highlighting the resources currently available and to come.
- Federal
Home Visiting Under the Affordable Care Act—Kathleen Strader, Jacqueline
Counts , and Jill Filene
The
Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program is part of
The Patient Protection and Affordable Care Act and provides $1.5 billion over 5
years to states, territories, and tribes with the goal of delivering
evidence-based home visiting services as part of a high-quality, comprehensive
early childhood system that promotes health and well-being for pregnant women,
parents, caregivers, and children from birth to 5 years old. The authors share
promising results through anecdotal information from families, states, and
tribes on progress made thus far.
- PERSPECTIVES —Maternal Engagement in Home Visiting:
The MOM Program—Jerilynn Radcliffe and Donald F. Schwarz
The
MOM Program is an innovative home visiting program whose aim is to empower
low-income urban mothers to obtain health and early intervention services for
their children. The authors discuss a recent evaluation of the MOM program
which sought to examine maternal involvement in the program. The results raise important
questions and call for larger efforts to more fully understand how to
effectively mitigate the negative effects of poverty on children’s health and
development and to promote the well-being of all children, particularly those
living in poverty.
- PERSPECTIVES
—Reflective Practice: Look, Listen, Wonder, and Respond—Deborah J .
Weatherston
The
author explores the reflective components of observation, listening, wondering,
and response. Together, these components invite parents to discover who their
babies are as well as to understand the importance of nurturing relationships,
past and present, to development, growth, and change. Of equal interest, reflective practice offers
Infant Mental Health home visitors opportunities to explore the meaning and
mystery of early relationship development, to understand early experience, and
to feel again the warmth or promise of relationships, personal and
professional, as they engage and support others through their work
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