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

Project Overview

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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 includes 2,900 families from 66 local home visiting programs across 17 states. Programs participating in the study are using one of two national 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 initiative, and is the result of a collaboration between ACF, the Health Resources and Services Administration (HRSA), and CMS.

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

The MIHOPE-Strong Start analysis includes 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 final report with results from the implementation and impact analyses, three annual reports, a qualitative report examining state efforts for promoting prenatal health and positive birth outcomes, and a design report.

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 Health Resources and Services Administration and the Centers for Medicare and Medicaid Services.

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

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