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- What are the characteristics of families, home visitors, and local home visiting programs included in the two studies, and what services did families receive?
- What are the effects of home visiting programs for families from pregnancy through the time children are 15 months old?
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, resources, and information to expectant parents and families with young children. This brief summarizes recently published reports from two national studies of evidence-based early childhood home visiting: the Mother and Infant Home Visiting Program Evaluation (MIHOPE) and the Mother and Infant Home Visiting Program Evaluation - Strong Start (MIHOPE-Strong Start).
MIHOPE is the legislatively mandated evaluation of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program, which assessed program effects on a wide range of the family outcomes home visiting is intended to affect. MIHOPE-Strong Start was part of the Strong Start for Mothers and Newborns Initiative and examined the effectiveness of evidence-based home visiting on prenatal care, birth outcomes, and health care use in infancy. Both studies included implementation and impact analyses, highlights of which are presented in this brief. An important distinction between MIHOPE and MIHOPE-Strong Start is that MIHOPE included only programs receiving MIECHV funding, while MIHOPE-Strong Start included both MIECHV- and non-MIECHV-funded programs.
The information in this brief will provide stakeholders such as funders, states, home visiting model developers, and local programs with detailed information on how home visiting programs were implemented and the effects they had on family outcomes.
Key Findings and Highlights
Key findings include the following:
- The home visiting programs in the studies were generally well implemented, with appropriate support in place to help home visitors administer the intended services. This support included training for home visitors, supervision, structured parenting curricula, consultants to address specific family needs, and protocols for risk screening and referrals. However, the studies identified several ways that this support could be strengthened.
- MIHOPE found positive effects on some family outcomes but MIHOPE-Strong Start found little effect on birth outcomes and prenatal behaviors. MIHOPE found positive effects across multiple outcome areas through the time children were about 15 months old. In contrast, MIHOPE-Strong Start found that the two evidence-based models that were examined had little effect on birth outcomes and prenatal behaviors. The findings from both studies are broadly consistent with results from previous studies of the evidence-based models of home visiting.
Both MIHOPE and MIHOPE-Strong Start used a rigorous research design to assess the effectiveness of home visiting services and to examine how programs were implemented.
- 12 States
- 88 local programs
- 4,229 families
- 4 evidence-based models (EHS, HFA, NFP, and PAT)
- Participants were pregnant women or families with children less than 6 months of age, recruited from local programs funded through the MIECHV program
MIHOPE-Strong Start included:
- 17 states
- 66 local programs
- 2,900 families
- 2 evidence-based models (HFA and NFP)
- Participants were pregnant women in the first 32 weeks of their pregnancies, recruited from local programs that served primarily Medicaid beneficiaries
In both studies, families were randomly assigned either to an evidence-based home visiting program or to a control group who was given information on other services available in the community. The MIHOPE-Strong Start impact analysis included information on 46 local home visiting programs and 1,845 families that were initially recruited for MIHOPE but met the MIHOPE-Strong Start eligibility criteria.
Charles Michalopoulos, Sarah Shea Crowne, Ximena A. Portilla, Helen Lee, Jill H. Filene, Anne Duggan, and Virginia Knox. (2019). A Summary of Results from the MIHOPE and MIHOPE-Strong Start Studies of Evidence-Based Home Visiting. OPRE Report 2019-09. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.
- Early Head Start — Home-based option
- Healthy Families America (HFA)
- Maternal, Infant, and Early Childhood Home Visiting program
- MIHOPE-Strong Start:
- Mother and Infant Home Visiting Program Evaluation – Strong Start
- Mother and Infant Home Visiting Program Evaluation
- Nurse-Family Partnership (NFP)
- Parents as Teachers