Introduction to the Special Issue on Taking Home Visiting to Scale: Findings from the Maternal, Infant, and Early Childhood Home Visiting Program State-Led Evaluations

Denmark, Nicole; Peplinski, Kyle; Sparr, Mariel; Labiner-Wolfe, Judy; Zaid, Susan; Gupta, Pooja; Miller, Kassie Mae

doi:10.1007/s10995-018-2539-5

Cited by 7 publications

(7 citation statements)

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“…3 These state-led evaluations have allowed awardees to (1) answer questions that are important to their program and solve local problems, (2) show how homevisiting implementation and outcomes may be replicated and scaled up in diverse contexts, and (3) contribute new knowledge, both individually and collectively, by identifying trends across similar studies (Zaid & Till, 2016). Findings from completed studies highlight factors contributing to participant engagement, the influence of professional development on job satisfaction, barriers to service utilization, effectiveness of a coordinated intake system, development of early childhood coalitions, and the benefits of continuous quality improvement and have been featured in the MIECHV Special Issue: Taking Home Visiting to Scale: Findings from the Maternal, Infant, Early Childhood Home Visiting Program State-Led Evaluations (Denmark et al, 2018).…”

Section: Areas Of Successmentioning

confidence: 99%

Using a Developmental Approach to Evaluation Capacity Building in Home Visiting

et al. 2021

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The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program, administered by the Health Resources and Service Administration in collaboration with the Administration for Children and Families, provides evidence-based home visiting services across 50 states, the District of Columbia, and five U.S. territories. MIECHV invests in comprehensive technical assistance (TA) to support and build the capacity of awardees to conduct rigorous evaluations of their programs. Throughout the course of the evaluation process, awardees received TA from the Design Options for Home Visiting Evaluation project. Between 2011 and 2020, over 173 state-led evaluations have been conducted. Individual technical assistance (TA) modalities included conference calls, emails, interactive and individualized webinars, developing and sharing resources, and involvement of content experts. When issues and challenges were identified across multiple awardees, Design Options for Home Visiting Evaluation (DOHVE) delivered targeted group TA to awardees with common needs that may benefit from peer-to-peer learning. When cross-cutting issues and challenges were identified, DOHVE used universal approaches such as webinars and guidance documents that were made available to all awardees.Through the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program, efforts have been taken to promote awardee capacity by targeting all phases of the evaluation process, including planning, implementing, and disseminating findings and providing TA that is responsive and tailored to meet awardee-specific needs. This approach enabled DOHVE to support MIECHV awardees in expanding knowledge of their programs and the evidence base on home visiting. Lessons learned from TA provision highlight the importance of developing feasible plans and providing ongoing support during implementation.

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Section: Areas Of Successmentioning

confidence: 99%

Using a Developmental Approach to Evaluation Capacity Building in Home Visiting

et al. 2021

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“…In many cases, when these programs are scaled to larger populations, the effects evaporate [ 5 ]. Similarly, the evaluations of national programs have also found mixed results [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

The effect of supervision on community health workers’ effectiveness with households in rural South Africa: A cluster randomized controlled trial

Rotheram¹,

Roux

Norwood³

et al. 2023

PLoS Med

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Background Community health workers (CHWs) can supplement professional medical providers, especially in rural settings where resources are particularly scarce. Yet, outcomes of studies evaluating CHWs effectiveness have been highly variable and lack impact when scaled nationally. This study examines if child and maternal outcomes are better when existing government CHWs, who are perinatal home visitors, receive ongoing enhanced supervision and monitoring, compared to standard care. Methods and findings A cluster randomized controlled effectiveness trial was conducted comparing outcomes over 2 years when different supervision and support are provided. Primary health clinics were randomized by clinic to receive monitoring and supervision from either (1) existing supervisors (Standard Care (SC); n = 4 clinics, 23 CHWs, 392 mothers); or (2) supervisors from a nongovernmental organization that provided enhanced monitoring and supervision (Accountable Care [AC]; n = 4 clinic areas, 20 CHWs, 423 mothers). Assessments were conducted during pregnancy and at 3, 6, 15, and 24 months post-birth with high retention rates (76% to 86%). The primary outcome was the number of statistically significant intervention effects among 13 outcomes of interest; this approach allowed us to evaluate the intervention holistically while accounting for correlation among the 13 outcomes and considering multiple comparisons. The observed benefits were not statistically significant and did not show the AC’s efficacy over the SC. Only the antiretroviral (ARV) adherence effect met the significance threshold established a priori (SC mean 2.3, AC mean 2.9, p < 0.025; 95% CI = [0.157, 1.576]). However, for 11 of the 13 outcomes, we observed an improvement in the AC compared to the SC. While the observed outcomes were not statistically significant, benefits were observed for 4 outcomes: increasing breastfeeding for 6 months, reducing malnutrition, increasing ARV adherence, and improving developmental milestones. The major study limitation was utilizing existing CHWs and being limited to a sample of 8 clinics. There were no major study-related adverse events. Conclusions Supervision and monitoring were insufficient to improve CHWs’ impact on maternal and child outcomes. Alternative strategies for staff recruitment and narrowing the intervention outcomes to the specific local community problems are needed for consistently high impact. Trial registration Clinicaltrials.gov, NCT02957799.

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“…§ 18001 et seq. ( 2010)), and home visiting programs currently operate in all U.S. states, five US territories and many tribal communities (Denmark et al, 2018). Hundreds of thousands of families in the United States are served annually by home visiting programs.…”

Section: Introductionmentioning

confidence: 99%

Young mother risk-taking moderates doula home visiting impacts on parenting and toddler social-emotional development

Edwards

Hans

2022

Dev Psychopathol

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This longitudinal randomized controlled trial examined the impact of a doula home visiting intervention for young, low-income mothers on parenting and toddler social-emotional development and tested whether intervention effects were moderated by maternal emotional and behavioral health characteristics. 156 mothers were offered home visits from a home visitor starting in mid-pregnancy through several years postpartum, with a community doula also working with the mother during pregnancy and after the birth. 156 received case management. Interviews, video recordings of mother-child interactions, and toddler assessments were conducted at 3 weeks, 3 months, 13 months, and 30 months of age. Intent-to-treat analyses conducted with the full sample showed some intervention effects. Moderation analyses, however, showed that most effects were concentrated among mothers engaged in high levels of risk-taking (delinquent behaviors, school suspensions, smoking, alcohol use, sexual risk-taking). Among higher risk-taking mothers, the intervention was related to less intrusiveness during early infancy, less psychological and physical aggression during toddlerhood, more sensitive parenting attitudes, and greater toddler social relatedness. Maternal depressive symptoms were only a moderator for toddler behavior problems. These findings suggest that doula home visiting may be a particularly effective model for enhancing sensitive, non-aggressive parenting among young mothers with a history of risk-taking behavior.

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Introduction to the Special Issue on Taking Home Visiting to Scale: Findings from the Maternal, Infant, and Early Childhood Home Visiting Program State-Led Evaluations

Cited by 7 publications

References 0 publications

Using a Developmental Approach to Evaluation Capacity Building in Home Visiting

Using a Developmental Approach to Evaluation Capacity Building in Home Visiting

The effect of supervision on community health workers’ effectiveness with households in rural South Africa: A cluster randomized controlled trial

Young mother risk-taking moderates doula home visiting impacts on parenting and toddler social-emotional development

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