Assessing Effectiveness of Early Childhood Home Visiting Models Implemented with Tribal Populations

The Tribal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program aims to support the development of tribal children and families through implementing high quality, culturally relevant early childhood home visiting models that have demonstrated evidence of effectiveness or are considered promising approaches.

The Office of Planning. Research, and Evaluation at the Administration for Children and Families, U.S. Department of Health and Human Services (HHS) contracts with Mathematica to conduct the HomVEE review. HomVEE conducted its initial systematic review focusing specifically on research relevant to tribal communities in fall 2010. As the research literature on early childhood home visiting models studied with tribal populations grows, HomVEE updates the review.

HomVEE’s 2022 review of research with tribal populations includes 77 manuscripts that spanned 32 early childhood home visiting models.

• Two-thirds of the models (21 models) had research that reported results from an impact study that was eligible for inclusion in HomVEE’s 2022 review. Eligible research on the remaining 11 models examined a tribal population with implementation research only.
• Eligible impact research consisted of 48 manuscripts. Among those, 14 manuscripts (29 percent) reported findings from a well-designed impact study. Eight of those manuscripts specifically examined the effect of a model with a 100 percent tribal population or sample.
• One early childhood home visiting model, Family Spirit, met HHS criteria for an “evidence-based early childhood home visiting service delivery model” for tribal populations.
• The review includes two detailed appendices, presented in a separate volume from these findings in the main report. Appendix A describes the review process HomVEE used to identify, screen, and assess the research literature on early childhood home visiting models implemented with tribal populations. Appendix B provides information on each model (as indicated in Box 1 in this report). Appendix B also includes models that had only implementation research (and no impact studies) available about tribal populations.

HomVEE’s review of research with tribal populations involved the following steps:

• Conducting a broad literature search, including database searches and a call for research, to identify research on early childhood home visiting models implemented in tribal communities or studies that included a sizable share (30 percent or more) of tribal participants. This search included literature on early childhood home visiting models implemented among tribal populations in high income or upper middle income countries outside the United States.
• Screening manuscripts for relevance.
• Rating the quality of manuscripts about impact studies with eligible designs based on their ability to produce unbiased estimates of a model’s effects. Reviewers that had no conflict of interest assessed, using a standard protocol, the research design and methodology of the impact study described in each manuscript and assigned each manuscript a rating of high, moderate, or low. HomVEE’s published standards assign a rating of moderate or high to a well-designed impact study.
• Assessing the evidence of effectiveness for each model to determine whether the model met the HHS criteria for “an evidence-based early childhood home visiting service delivery model” in tribal populations. (More information on the criteria is available here: https://homvee.acf.hhs.gov/about-us/hhs-criteria.)
• Reviewing implementation information for each model with well-designed impact studies (those with manuscripts that earned a rating of moderate or high) and models that have only implementation research. (Implementation information is not discussed in detail in this report.)
• Updating this report with new information.

Bleiweiss-Sande, R., Sama-Miller, E., Chavez, C., Coughlin, R., & Mraz Esposito, A. (2022). Assessing effectiveness of early childhood home visiting models implemented with tribal populations, OPRE Report #2022-268. Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.