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Mother and Infant Home Visiting Program Evaluation (MIHOPE), 2011-2017

Project Overview

The Mother and Infant Home Visiting Evaluation (MIHOPE) is the legislatively mandated evaluation of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program.

MIHOPE includes:

  • a random assignment impact study that will examine the effects home visiting programs have on the at-risk families they serve, focusing on areas like prenatal, maternal, and newborn health, child development, parenting, domestic violence, and referrals and service coordination;
  • an implementation study that will (1) describe the services received by families in MIECHV-funded home visiting programs, (2) identify factors that help explain observed variation in service delivery for families; and (3) explore home visiting program staff members' perspectives on the reasons for variation in services to families.
  • a cost analysis and effectiveness study that will examine the financial costs of operating the programs; and how those costs are related to impacts.
  • an analysis of the needs assessments that were provided by states and territories in their initial MIECHV applications and plans in 2010 and 2011.

A special goal of this study is the linking of implementation strategies to program impacts, thus informing the field about the types of program features or strategies that might lead to even greater impacts on families. For example, understanding how, and at what level, the average family participates in the program will provide context to any variation in impacts we find in the health of families.

Sites in the evaluation operate one of four models that meet HHS’ criteria for evidence of effectiveness (see HomVEE) and were chosen by at least 10 states for their MIECHV programs in their initial plans: Early Head Start – Home-Based Option, Healthy Families America, Nurse-Family Partnership, and Parents as Teachers. The study includes over 4,000 families from 88 sites across 12 states. The primary data used in the study comes from surveys of families and home visiting staff; review of programs’ administrative records; interviews with staff, supervisors, model developers, and state administrators; direct observations of parents, children, and home visitors; staff logs; and state administrative data (child welfare, Medicaid, and vital records).

Study enrollment and data collection began in 2012; study enrollment ended in 2015, and data collection will end in 2017. The MIHOPE Report to Congress, which included the analysis of the states’ and territories’ needs assessments and baseline data on the families, staff and programs participating in MIHOPE, was delivered to Congress in February 2015. Three final reports – one on implementation, one on cost, and one on impact and impact variation – will be released in 2018.

The contract was awarded to MDRC with subcontracts to James Bell Associates, Johns Hopkins University, Mathematica Policy Research, University of Georgia and a number of academic consultants. This project is being led by the Administration for Children and Families in collaboration with the Health Resources and Services Administration.

The point of contact is Nancy Geyelin Margie.

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