Association for Public Policy Analysis & Management

Panel: Home Visiting Innovations for Research and Practice

(Family and Child Policy)

Early childhood is a critical time in which environmental experiences influence brain development and can have last­ing consequences across the life course.  Many families need effective prevention and early intervention services to address challenges in providing a safe, secure, and nurturing environment for their children. 

Early childhood home visiting is a service strategy aimed at supporting positive parenting by building on family strengths to overcome challenges.  Services are targeted to pregnant women and families with young children, and primarily focus on screening for risk factors, providing parents with education and support, and referring parents to necessary service providers.  

In 2010, the U.S. expanded investment in the scale-up of evidence-based home visiting through the federal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program and will continue this investment through 2022.  Today, every U.S. state and territory provides home visiting services reaching more than 300,000 families annually.

However, home visiting has modest overall impacts on family functioning, parenting, and child well-being, in part due to the varied strengths, needs, and interests of families who enroll in home visiting.  In order to deliver high-quality services, home visiting programs must have a strong implementation system to support staff in addressing families’ needs, particularly when those needs touch on complex topics such as mental health.  Further, strategies for improving implementation systems, such as the use of central intake (CI) and continuous quality improvement (CQI), are imperative for moving the field forward. This panel will present findings from three innovative research initiatives which provide insights on how home visiting practice can be improved at a time when home visiting continually evolves in an effort to better serve families.

The first presentation will highlight the Home Visiting Applied Research Collaborative (HARC)’s new initiative, Innovation toward Precision Home Visiting. This initiative brings home visiting stakeholders together to build knowledge by promoting the field’s use of innovative research methods to achieve precision home visiting—the identification of what works best, for which families, under what conditions. 

The second presentation will present findings from the Mother and Infant Home Visiting Program Evaluation (MIHOPE) implementation research report. Specifically, it will capitalize on MIHOPE’s innovative multi-level, multi-informant research design, conducted with 88 home visiting programs, by highlighting not only the strengths of the implementation system in addressing mental health issues, but also areas of the system that can be improved.

The third presentation will present recent work from the state-led MIECHV evaluation in New Jersey to improve family engagement through CI and CQI practices. This approach uses CQI dashboards as an innovative tool to inform Plan-Do-Study-Act (PDSA) cycles, which allow supervisors to track their agency’s progress on select indicators compared to their past performance and the performance of their peer programs.

Taken together, the three presentations will highlight the use of innovative research to improve home visiting research and practice. The panel will also underline how the translation of research findings and development of program-level dashboards can be used as tools for home visiting programs to strengthen their implementation system supports.