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Home Visitation: Building Parental Ability for Better Child Health and Development

By Katy Sides

Used for prevention or intervention, home visiting (HV) is a service delivery instrument that has been used across many disciplines. Home visiting programs typically use either a professional or paraprofessional trained worker to provide services, guidance and information in an innovative way that eliminates many of the traditional barriers to service delivery.

In the case of early childhood, home visitation is a service delivery strategy that reaches families as early as the prenatal stage, at the birth of a child, or prior to school entry. Many early childhood home visiting programs target families and caregivers at high risk for poor health, development or economic outcomes; while some programs are universal, reaching all new parents. Most HV programs are able to address child health and development by reaching mothers, fathers, and caregivers. There are a range of home visiting categories within the early childhood sector that include maternal, infant, and early childhood HV; home visitation for children in at-risk families; and home visits as an integral part of child care or school-based educational programs.

Although it is important to note that home visiting is not a cure-all, the available empirical evidence suggests that home visitation programs show promise to reach families in need and affect positive change for children and their parents. HV must be one of several service strategies included in a comprehensive, high-quality early childhood system that promotes maternal, infant and early childhood health, safety, and development; strong parent-child relationships; and responsible parenting.

While home visiting has been a tool since the 1800s, maternal and child home visitation services have become a prominent part of the national policy conversation for the past five years. In 2009, the American Academy of Pediatrics (AAP) released a policy statement reaffirming home visiting as an intervention to enhance developmental, health, and safety outcomes for children and states. In 2010, a grant award funded by the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) was used to help create the foundation for a more responsive and effective national system of high quality healthcare for children. In March 2010 the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program was created as part of the Patient Protection and Affordable Care Act of 2010 (ACA). Under the ACA, home visitation must be part of an early childhood system of care.

There are many benefits of home visitations programs that target pregnant women and/or families with children from birth to age five. Most HV models had favorable impacts on child development, school readiness and positive parenting practices. Research has also shown that HV models produce cost savings longitudinally, with the greatest savings realized among those visited who were at greatest risk.

To learn more about home visitation and how it can be one element of a comprehensive early childhood system, see our recent case study, or our related issue brief.

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