Most home visiting programs conduct developmental screenings to identify children at risk for delays and refer children for additional diagnostic assessments, evaluations, and treatment when screening uncovers possible problems.
Although the designs and eligibility criteria vary,
most home visiting programs» primary objectives are to:
Most home visiting programs are voluntary, and states and communities encourage participation by families with risk for maltreatment (for example, families where parents have low levels of education, live in poverty, single - parent households, and parents who themselves were involved in the child welfare system).
Although
most home visiting programs are voluntary, some states and communities highly encourage participation by families with risk of maltreatment.
Most home visiting programs are voluntary, and states and communities encourage participation by families with risk for maltreatment (for example, families where parents have low levels of education, live in poverty, single - parent households, and parents who themselves were involved in the child welfare system).
Not exact matches
The
most widespread
home -
visiting program in the country today is one that focuses primarily on health: the Nurse - Family Partnership, which sends trained nurses into the
homes of low - income expecting mothers, mostly unmarried teenagers.
The
most effective intervention we have is a focus on parental attachment, through a public policy of
home visit programs, starting in the first days of a child's life.
This was part of what I found
most poignant, the idea that with
home visit programs and other types of coaching, even poor, and very stressed parents can be motivated to change how they treat infants and toddlers.
Research shows that families typically receive roughly half of the number of
home visits expected.16, 17 For example, across three randomized controlled trials conducted of Nurse Family Partnership, average dosage of
visits ranged from 45 to 62 percent.18 Research also shows that many, perhaps
most, families enrolled in
home visiting programs drop out before their eligibility ends.16, 19,20 Some
home visiting studies have varied the dosage that families were offered and found that fewer
home visits produced outcomes similar to higher levels of exposure.21
Most trials of prenatal
home visiting have produced disappointing effects on pregnancy outcomes such as birth weight and gestational age, 9,16,17 although one
program of prenatal and infancy
home visiting by nurses has reduced prenatal tobacco use in two trials18, 19 and has reduced pregnancy - induced hypertension in a large sample of African - Americans.20
As we learn more about the mechanisms for these impacts, both direct and indirect, research will demonstrate the
most effective approach to link
home visiting services and early childhood education and child care
programs to more fully realize positive outcomes.
HHS's maternal, infant, and early childhood
home visiting program: Which
program models identified by HHS as «Evidence - Based» are
most likely to produce important improvements in the lives of children and parents?
In New Jersey's regional central intake system, providers use uniform referral and screening forms to link families to community supports, including the
most appropriate
home visiting program.
Carol Raphael, President and CEO of the
Visiting Nurse Service of New York, the state's oldest and largest
home care agency, said, «The
Visiting Nurse Service of New York applauds Governor Cuomo's call for a thoughtful, collaborative approach to restructuring the State's Medicaid
program; we are prepared to work with him and his Administration toward the enactment of policies that focus on coordinating care to the State's
most vulnerable patients, who often suffer from multiple complex conditions.»
The
most recent research on the
program showed that, after being
visited frequently by a nurse during their child's first two years of life, the mothers were less likely to abuse or neglect their children, have another child, and abuse drugs or alcohol than mothers who did not receive
home visits.
Teachers in the CPC
program have at least a bachelor's degree along with a certification in early childhood education.18 Staff compensation is relatively high compared to
most preschool staff, mirroring the salary schedule of the Chicago Public School system, which reduces teacher turnover.19 In addition to teachers and classroom aides, students also are monitored by parent volunteers,
home visit representatives, clerks, nurses, speech therapists, and other administrative staff who are associated with the public school
program.
The
program is designed for people who can keep a dog or cat in their
home during the week and place it up for adoption at CAP on the weekend, a time when
most potential adopters
visit the shelter.
His
most recent work focuses on the field of
home visiting, as he is co-leading two national studies of
home visiting programs for disadvantaged mothers.
There are several different models for coordinated intake: in
most cases, coordinated intake workers conduct outreach to families and complete the Coordinated Intake Assessment Tool (CIAT), which collects
program eligibility information before referring families to an appropriate
home visiting program, or other community services.
Participants in voluntary
home visiting programs are typically new and expectant mothers, many of whom are single, low - income teenagers who need these supports the
most.
In general, the research shows that
home visiting programs have the greatest, albeit still modest, effect on parents» support for children's learning and in reducing the prevalence of child maltreatment, but that these effects are strongest for the
most disadvantaged
program participants.
Thus CFRP is studying how, when, and why families leave
home visiting programs; which families are the
most likely to leave; and how father involvement in the
programs relates to family retention.
Unlike the proposed House reauthorization bill — Increasing Opportunity through Evidence - Based
Home Visiting Act (H.R. 2824)-- the Senate version does not include a state match requirement — viewed as harmful to the
program by
most advocacy groups.
Those sectors of society that are
most likely to accrue benefit in future cost savings from the social and educational effects of
home visiting should contribute to the funding of
programs.
The wide variability in
programs makes it difficult to draw solid conclusions about the conditions under which
home visiting is
most effective.
Most notably,
home -
visited families participating in Early Head Start reported experiencing significantly less stress in their parenting roles than did control families.95 The same pattern occurred in Queensland: mothers who received
home -
visiting services reported less stress in the parenting role than did mothers in the control group.96 Healthy Families
programs in Alaska, San Diego, and Hawaii also examined parenting stress in their evaluations.
For example, substantial evidence exists that families
most plagued by domestic violence are least likely to respond to
home -
visiting support.23 Other factors that hamper success of
home visiting include limited family resources, family mental illness, and families not motivated to participate in the
programs.24 Thus, the very risk factors that make children vulnerable interfere with the effectiveness of the
programs that are designed to help them.
They can enhance developmentally oriented anticipatory guidance with individualized content that meets families» individual needs.42
Home - visiting programs include a «degree of social support that is difficult to provide in most clinical settings; outreach and liaison between the pediatrician, the family, and the community; involvement with socioeconomic issues that directly affect the well - being of the child and family; reinforcement and follow - up of preventive care, peer helper support, as well as encouragement by the home health visitor who has the advantage of being with the family in its own home, a more accepting, less threatening setting for the fami
Home -
visiting programs include a «degree of social support that is difficult to provide in
most clinical settings; outreach and liaison between the pediatrician, the family, and the community; involvement with socioeconomic issues that directly affect the well - being of the child and family; reinforcement and follow - up of preventive care, peer helper support, as well as encouragement by the
home health visitor who has the advantage of being with the family in its own home, a more accepting, less threatening setting for the fami
home health visitor who has the advantage of being with the family in its own
home, a more accepting, less threatening setting for the fami
home, a more accepting, less threatening setting for the family.7
Although
most outcomes were reviewed at
program completion to observe the effects of a high - intensity comprehensive treatment
program for low - birth - weight infants, 39 certain outcomes were examined after the first year and provide a test of the
home -
visiting component on its own.40
Nurse Family Partnership (NFP) is one of the
most rigorously evaluated
home visiting programs in existing literature.
While
Home Visiting programs are not the only option for reducing the occurrence of ACEs, they are one of the
most feasible.
However, for both child abuse and parent stress, the average effect sizes were not different from zero, suggesting a lack of evidence for effects in these areas.108 Earlier meta - analytic reviews have also noted the lack of sizable effects in preventing child maltreatment — again citing the different intensity of surveillance of families in the treatment versus control groups as an explanation (though the authors did report that
home visiting was associated with an approximately 25 percent reduction in the rate of childhood injuries).109 Another review focusing on the quality of the
home environment also found evidence for a significant overall effect of
home -
visiting programs.110 More recently, Harriet MacMillan and colleagues published a review of interventions to prevent child maltreatment, and identified the Nurse - Family Partnership and Early Start
programs as the
most effective with regard to preventing maltreatment and childhood injuries.
Next we turn to a discussion of the outcomes of
home -
visiting programs, with a focus on those outcomes that are
most relevant to preventing child abuse and neglect.
This brief synthesizes the findings of the research to highlight which outcomes
home visiting programs are the
most likely to improve and for whom.
Because the
most at - risk families may also be the
most difficult to reach in center - based settings,
home visiting programs are at an advantage in that the very same high - risk families they need to target are the same families they may be better suited to reach.
Many
home visiting programs aim to educate parents about the importance of supporting children's early learning through frequent reading and a stimulating
home environment and provide parents with the tools to support their children's early learning.15 In general, evaluations of
home visiting programs show fairly positive impacts on parents» support for children's learning, though the evidence is strongest for the
most disadvantaged
program participants (e.g., poor, unmarried teens; very - low income participants).
Home visiting programs should have the greatest and most immediate impact on parenting outcomes relative to child outcomes because home visiting programs target parenting directly as a mechanism of change in child
Home visiting programs should have the greatest and
most immediate impact on parenting outcomes relative to child outcomes because
home visiting programs target parenting directly as a mechanism of change in child
home visiting programs target parenting directly as a mechanism of change in children.
Most trials of prenatal
home visiting have produced disappointing effects on pregnancy outcomes such as birth weight and gestational age, 9,16,17 although one
program of prenatal and infancy
home visiting by nurses has reduced prenatal tobacco use in two trials18, 19 and has reduced pregnancy - induced hypertension in a large sample of African - Americans.20
For the
most part,
home visiting programs have largely been shown to be ineffective at increasing rates of well - child
visits and immunizations (Table 2).
If
home visiting programs target the
most at - risk families (i.e., young and poor parents, parents with a history of child maltreatment), the research suggests that these
programs may positively influence parents» support of their children's learning and reduce rates of child maltreatment.
Finally,
home visiting programs that promote high quality parent - child relationships and combined with high - quality early education
programs are
most likely to result in better school readiness outcomes for children.
In general, the research shows that
home visiting programs have the greatest, albeit modest, effect on parents» support for children's learning and in reducing the prevalence of child maltreatment, but that these effects are strongest for the
most disadvantaged
program participants.
HHS's maternal, infant, and early childhood
home visiting program: Which
program models identified by HHS as «Evidence - Based» are
most likely to produce important improvements in the lives of children and parents?
One of the
most extensively conducted randomised controlled trials of an early childhood intervention
program in Europe has shown that a home visiting program combined with the Triple P — Positive Parenting Program improved children's cognitive devel
program in Europe has shown that a
home visiting program combined with the Triple P — Positive Parenting Program improved children's cognitive devel
program combined with the Triple P — Positive Parenting
Program improved children's cognitive devel
Program improved children's cognitive development.
Although
most states were already implementing
home visiting programs, MIECHV increased the use of evidence - based models to deliver care to high - risk families.
New Early Childhood Comprehensive Systems grant...
home visiting programs respond to Zika crisis... the impact of perinatal depression and steps we are taking to build capacity to address the
most common risk factor in pregnancy and more!
«
Home visiting programs are pro-family, voluntary, and
most importantly, they work,» said James M. Hmurovich, President & CEO of Prevent Child Abuse America.
First, parent support
programs improve parental competence / confidence and parental beliefs that child - initiated interactions are
most important in parent - child interactions.7, 8 Second, although general parent support
programs support social - emotional development of children, parent support that is directed at parental emotional and educational / economic development has an enhanced impact on child social - emotional development.9 Third, participatory help - giving practices contribute the
most to parents» judgment of their children's emotional competence.7 Fourth, group approaches to parental support have a more powerful effect on child social - emotional competence than
home -
visiting approaches.9
In 2014 - 2015, the
program provided information and referral services to 7,700 Oregon families, and intensive
home visiting to more than 2,500 of our
most vulnerable families.
If MIECHV funding isn't continued, our state won't be able to provide high - quality and proven
home visiting programs to hundreds of Washington families with young children who are living in some of the
most challenging situations.