A Summary of Results from the MIHOPE and MIHOPE-Strong Start Studies Of Evidence-Based Home Visiting

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 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.

MIHOPE included:

• 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.