Increased Availability of Evidence-Based Home Visiting Models

Definition

The Health and Human Services department has identified several criteria1 to determine whether a home visiting model is “evidence-based.” The model must meet one of the following criteria:

  • At least one high- or moderate-quality impact study of the model finds favorable, statistically significant impacts in two or more of the eight outcome domains
  • At least two high- or moderate-quality impact studies of the model using non-overlapping analytic study samples, with one or more favorable, statistically significant impacts in the same domain

Currently, 20 home visiting models meet the specified criteria for an evidence-based model. For more information see HomVEE, which includes a range of home visiting programs both universal to targeted and differing in level of intensity.

This indicator can be assessed initially by examining a set of indicators related to implementation progress. Once implementation is in process, regular monitoring of the annual number of children and families served can be initiated.

  • 1. https://homvee.acf.hhs.gov/document.aspx?rid=4&sid=19&mid=6

Resources

According to the National Home Visiting Resource Center’s 2017 Home Visiting Yearbook,1 in 2015, there were approximately 269,206 families and 311,976 children served nationwide through evidence-based home visiting.

Several national organizations compile information about home visiting in states and territories:

  • 1. National Home Visiting Resource Center. (2017). 2017 Home Visiting Yearbook. Arlington, VA: James Bell Associates and the Urban Institute.
  • Conduct landscape review to identify which home visiting models are currently in your community.
  • Determine which models would best provide ongoing support to newborns and their families (either existing or new models).
  • Establish leadership support and capacity-building for increased availability.
  • Secure new and maintain existing funding (e.g., legislative, public-private partnerships, etc.); coordinate with current home visiting models and providers in your community to expand their reach.
  • Strategic advocacy to highlight the need for increased access to families with specific risk factors;
  • Determine which sub-populations to target (e.g., families with risk factors such as first-time mothers, mothers who smoke, drink or use illegal drugs, or children otherwise identified to be at risk for abuse and neglect) or target services to a specific geographic region, or racial/ethnic group(s) that are under-served and have been shown to be at risk for certain factors;
  • Track the number of home visiting models in the community and how many children/families are being served by each model.

Increased access can be defined by the number of new programs implemented in a community, as well as by the of the number of additional children and families served in current home visiting programs.

Depending on how communities are increasing the availability of home visiting services, data can be collected to track the number of children and families being served in the program(s) as well as the number of available models and services. Additionally, communities can set short- and long-term target goals for increasing the availability of home visiting services geared toward families and children who have been identified as having specific risk factors. For instance, data could be collected on the following:

  • The number of locations/programs that are offering each of the home visiting models in the community
  • The number of children and/or families who are receiving home visiting services from each model
  • In later stages of implementation, communities can build a community-wide data system* to track the number of eligible families being served by all home visiting models and obtain a count of the number of unique children/families served by one or more home visiting models. Those indicators could then be tracked to ensure access is increasing to serve all targeted children and families.

*Note: Please refer to the Data Systems Progress Indicator for more information

Research Rationale

In the U.S., home visiting programs are increasingly part of communities’ efforts to improve outcomes for the most disadvantaged families. When well implemented, home visiting programs have been shown to reduce rates of infant low birth-weight, child maltreatment, and childhood injuries; increase access to health care, and lengthen the interval between a young mother’s births; improve parenting practices and children’s learning and behavior.1

  • 1. Kahn, J. & Moore, K. A. (2010). What works for home visiting programs: Lessons from experimental evaluations of programs and interventions. Child Trends Fact Sheet. Retrieved from http://www.childtrends.org/Files/ Child_Trends-2010_7_1_FS_WWHomeVisitpdf.pdf