Program Planning

Research on Home Visiting Programs

Keeping up with current research can support your work as a supervisor and your home visitors in their work with families. (See Research on Home Visiting in the Home Visitor’s Online Handbook.)

"The research question about home visiting is not 'does it work?' but 'for whom does it work, under what circumstances?" – Jones Harden et al.[1]

Child under adult supervision using a rolling pin to flatten dough.Research on home visiting programs and the home-based program option shows that home visiting is a complex endeavor. Positive outcomes of child development, family well-being, positive parenting, health, school success, and economic stability appear in different degrees, in different program models, for different populations. Evidence-based home visiting models, such as the Head Start and Early Head Start home-based program option, provide ongoing positive partnerships with parents and coordinated services to support children’s growth.[2] Numerous rigorous evaluation studies have proven home visiting to be an effective form of early intervention and parenting support.

In 1996, the U.S. Department of Health and Human Services (HHS) launched a large-scale evaluation of the new Early Head Start program. HHS randomly chose families at 17 sites nationally and looked at their social, psychological, developmental, and academic outcomes, compared with those of a matched control group. Families in the control group were able to receive any community services available to them. The evaluation followed families over five time points, according to the child's age: 14 months, 24 months, 36 months, pre-kindergarten, and fifth grade. Below are some of their findings.[3]

Family Demographics and Family Engagement

"Mental health was related to general and specific engagement, suggesting that home visitation may be effective in addressing underlying mental health issues of parents but also illustrating that the operative component is whether the home visitor is able to successfully engage the mother." – Raikes et al.[4]

Family characteristics predicted family engagement in home visiting programs [4]:

  • Teens and single mothers got somewhat fewer services.
  • Mobile families had a shorter duration in the program.
  • Families of a child with a disability stayed longer and were more engaged.
  • Non-English-speaking Hispanic families were more engaged.
  • African American families received fewer child-focused experiences.
  • White families received more services but were not more engaged.
  • Families with more risk factors received fewer child-focused experiences.

Child Outcome Findings

Child-focused experiences are the best indicators of positive school readiness outcomes.

"Certainly, quality of engagement and child focus in the visit are inextricably bound to quantity of visits and these features can only occur within the context of regular home visits." – Jones Harden et al.[1]

For Early Head Start children at 36 months, the home-based model had positive effects on:

  • Child engagement with the parent in semi-structured play
  • The likelihood of an Individualized Education Plan (IEP)
  • Standardized cognitive test scores
  • Emergency room visits due to accident or injury
  • Cognitive and language development
  • Parental support for cognitive and language development
  • Home environments, which were robustly related to the extent of child-focused activity during the home visit
  • Compliance with immunization and well-child visits
  • Ongoing contact with the medical home
  • Ongoing follow-up and support with children with special needs [1]

For Early Head Start children in pre-kindergarten, the home-based model had positive effects on:

  • Child engagement during parent-child play
  • Social behavior problems
  • Positive approaches toward learning
  • Standardized test scores on problem-solving
  • Attending a formal preschool program [2]

Learn More

Connecting Research to Practice: Tips for Working with Infants, Toddlers, and Their Families

This series of research-to-practice briefs covers a variety of topics related to early learning and child development. The briefs were developed to support home visitors in their work with children and families. They provide an accessible overview of recent research, as well as resources for families. In addition to home visitors, teachers and family child care providers can use these briefs to learn more about recent research on early childhood development.

Office of Planning, Research & Evaluation (OPRE): Home Visiting

In collaboration with the Health Resources and Services Administration, OPRE manages a number of evaluation activities. Major projects include the Tribal Research Center on Early Childhood and Tribal Home Visiting Evaluation Institute, the Home Visiting Evidence of Effectiveness project, and The Maternal, Infant, and Early Childhood Home Visiting Evaluation.

 

1 B. Jones Harden, R. Chazan-Cohen, R. Raikes, and C. Vogel. "Early Head Start Home Visitation: The Role of Implementation in Bolstering Program Benefits," Journal of Community Psychology 40, no. 2 (2012): 438–455.

2 T. Adirim and L. Supplee. “Overview of the Federal Home Visiting Program.” Pediatrics: Official Journal of the American Academy of Pediatrics 132 (2013): S59-S64.

3 Early Head Start Research and Evaluation Project (EHSRE), 1996–2010: Project Overview, at http://www.acf.hhs.gov/programs/opre/research/project/early-head-start-research-and-evaluation-project-ehsre-1996-2010 

4 H. Raikes, B. Green, J. Atwater, E. Kisker, J. Constantine, and R. Chazan-Cohen. "Involvement in Early Head Start Home Visiting Services: Demographic Predictors and Relations to Child and Parent Outcomes," Early Childhood Research Quarterly 21 (2006): 2–24.