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Implementing Healthy Start-Home Visiting

Model Overview

Last Updated

March 2010


The information in this profile reflects feedback from this model’s developer as of the above date. The description of the implementation of the model here, including any adaptations, may differ from how it was implemented in the studies reviewed to determine this model’s evidence of effectiveness. Inclusion in the implementation report does not mean the practices described meet the DHHS criteria for evidence of effectiveness.


Implementation Support

Healthy Start-Home Visiting is authorized under Title III, Part D, Section 330H of thePublicHealthService Act; (42 USC 254 c-8). The Healthy Start-Home Visiting Program is administered by the U.S. Department of Health and Human Services’ Health Resources and Services Administration (HRSA) through the Maternal and Child Health Bureau’s (MCHB’s) Division of Healthy Start and Perinatal Services (DHSPS).

The National Healthy Start Association (NHSA) is a nationwide membership association and primarily serves the federally funded Healthy Start projects. NHSA aims to promote the development of community-based maternal and child health programs, particularly those addressing the issues of infant mortality, low birth weight and racial disparities in perinatal outcomes. As part of its mission, NHSA supports the expansion of a wide range of activities and efforts that are rooted in the community and actively involve community residents in their design and implementation.

The availability of state-level support for implementation varies by grantee.


Theoretical Model

In the United States, women and infants living in high-risk situations experience high rates of infant mortality, low birth weight, and other poor perinatal outcomes. To address these disparities and the factors contributing to them, the Healthy Start Initiative provides program funds to local agencies committed to community-driven strategies to mitigate the causes of infant mortality, low birth weight, and other poor perinatal outcomes. Healthy Start-Home Visiting projects provide services that cover the pregnancy and interconception phases for women and infants.


Target Population

Healthy Start-Home Visiting targets at-risk groups such as racial or ethnic minorities, immigrant populations, or individuals who are considered vulnerable because of limited education, age of mother, low income, disability, or residence in rural or isolated areas.


Targeted Outcomes

The purpose of Healthy Start-Home Visiting is to address significant disparities in perinatal health, especially disparities experienced by at-risk populations. The model also aims to enhance the capacity of a community’s perinatal and women’s health service system.


Model Components

Healthy Start programs include (1) outreach and client recruitment, (2) case management (including home visitation), (3) health education, (4) interconception care, and (5) depression screening and referrals. Healthy Start programs also work on activities to promote community-level collaboration, sustainability, and system improvement and change.


Model Intensity and Length

How often and for how long services are provided varies by grantees.

Healthy Start-Home Visiting programs begin to provide services prenatally and continue for two years following delivery.



Healthy Start programs are located in 36 states, the District of Columbia, and Puerto Rico (Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia, and Wisconsin).


Adaptations and Enhancements

Healthy Start-Home Visiting projects work with a community consortium to provide a variety of support services for families, including programs that focus on fatherhood and male involvement, centering pregnancy, group prenatal care, Promotoras, and Doulas. These services may be offered as enhancements to the Healthy Start-Home Visiting model.



Theinformation contained onthis page was lastupdated in March 2010. Recommended Further Reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by theHealthResources and Services Administration (HRSA) on January 28, 2010 and the National Healthy Start Association on February 24, 2010. HomVEE reserves the right to edit the profile for clarity and consistency.