Mother and Infant Home Visiting Program Evaluation – Strong Start (MIHOPE-Strong Start), 2012-2018

Project Overview






The Mother and Infant Home Visiting Program Evaluation-Strong Start (MIHOPE-Strong Start) was launched in 2012 to evaluate the effectiveness of evidence-based home visiting for improving prenatal and birth outcomes and reducing health care costs for families enrolled in Medicaid or the Children’s Health Insurance Program (CHIP). The study included 2,900 families from 66 local home visiting programs across 17 states. Programs participating in the study used one of two evidence-based home visiting models with some prior evidence of effectiveness at improving birth outcomes: Healthy Families America (HFA) and Nurse-Family Partnership (NFP). The evaluation was part of the Centers for Medicare and Medicaid Services’ (CMS) Center for Medicare and Medicaid Innovation’s Strong Start for Mothers and Newborns Visit disclaimer page initiative, and is the result of a collaboration between ACF, CMS, and the Health Resources and Services Administration (HRSA).

The study included a random assignment impact analysis and a multi-level implementation research analysis. The primary data used in the study were from surveys completed by families and home visiting staff, Medicaid and CHIP data, vital records, and program service records.

The MIHOPE-Strong Start analysis included a subset of families and local programs that were recruited for MIHOPE, the national evaluation of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program. An important distinction between MIHOPE-Strong Start and MIHOPE is that MIHOPE included only programs receiving MIECHV funding, while MIHOPE-Strong Start included both MIECHV and non-MIECHV-funded programs.

Pregnant mothers were enrolled in the study from 2014 until 2015. Data collection was completed in 2017. The project produced:

A Design Report

Annual Reports (3)

A Final Report

A report on state efforts

Data will be archived with the Inter-university Consortium for Political and Social Research (ICPSR) Visit disclaimer page at the University of Michigan through OPRE’s Child and Family Data Archive Visit disclaimer page .

The contract to conduct the evaluation was awarded to MDRC with subcontracts to James Bell Associates, Johns Hopkins University, Mathematica Policy Research, and New York University. This project was led by the Administration for Children and Families in collaboration with the Centers for Medicare and Medicaid Services and the Health Resources and Services Administration.

The points of contact are Nancy Geyelin Margie and Laura Nerenberg.

Related Resources

Given the potentially negative societal, personal, medical and financial ramifications of poor birth outcomes, improving birth outcomes -— especially among socioeconomically disadvantaged women — has been a long-standing policy goal. One potential approach to improving birth outcomes is home visiting, which provides pregnant women and families who have young children with education and support, assessment, and referrals to community services. A few prior studies.....

A healthy birth and positive experiences in early childhood can promote health and development. One approach that has improved outcomes for children and their parents is home visiting, which provides individually tailored support...

Rates of poor birth outcomes remain high in the United States. In 2015, 9.6 percent of U.S. infants were born preterm and 8.1 percent were born with low birth weights...