Underserved communities fare better with community-based home visiting

A new report examining home visiting programs finds that community-based models fill critical gaps in care, especially for underserved communities.

First Focus on Children and the advocacy group Start Early have published “Community-Based Home Visiting: Fidelity to Families, Commitment to Outcomes,” a study of 34 home visiting programs in 21 states from coast to coast. The report finds that community-based home visiting programs offer a tailored, uniquely effective approach to aiding young families. These programs, which rarely have access to federal funding, fill gaps in care experienced by people living in rural areas, immigrant and refugee populations, Black and brown families, people speaking languages other than English, families from specific cultures and countries of origin, families experiencing economic disparities and others who face multiple barriers to access.?

“Community-based home visiting programs are developed by and for the communities they serve, with input from people with lived experience in those communities,” said First Focus on Children President Bruce Lesley. “These programs develop meaningful metrics based on the specific needs of children and their caregivers — such as high rates of maternal and infant mortality — and routinely perform rigorous evaluations to determine where they are meeting those needs and where they are falling short. Community-based programs can quickly adjust to community needs as they arise. We must have more funding and more inclusive policies for all home visiting models to ensure more access to care for more of our nation’s moms, babies, and children."

Home visiting connects expectant parents, new caregivers, and their young children with a support person, called a home visitor. The home visitor — an infant and early childhood professional, social worker, peer, doula, nurse, mental health professional, or other trained individual —?meets regularly with the family, develops a relationship with them, and supports them to achieve their goals and meet their needs. Home visiting generates numerous positive outcomes, including improved maternal and caregiver physical and mental health, decreased infant mortality, and greater caregiver confidence, child development, child well-being, and safety.

The United States relies primarily on two types of home visiting models: those developed and researched in alignment with the standards set forth in the statute authorizing the federal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program and its standards for review, the Home Visiting Evidence of Effectiveness (HomVEE) review; and community-based models developed by community organizations, local government, medical systems, or higher education institutions and intentionally designed to center community needs and goals in their measures of success. Despite the proven effectiveness of these community-based programs, only models that meet the federally defined standards of MIECHV are eligible for federal funding.

“Community-Based Home Visiting: Fidelity to Families, Commitment to Outcomes” summarizes listening sessions with 30+ community-based home visiting models from across the country. The report offers policy and funding recommendations to improve support for these models and the families they serve, including increased funding and access to funding to make community-based models more sustainable, changes in the MIECHV program to integrate key practices of community-based models to improve diversity and equity in home visiting, more research that is focused on a broader range of home visiting models, and creating a peer learning cohort for community-based models across the country. ?