Skip Navigation

Healthy Start-Home Visiting

In Brief

Last Updated

July 2013

Top

Evidence of Model Effectiveness

This model does not meet the criteria established by the Department of Health and Human Services (HHS) for an “evidence-based early childhood home visiting service delivery model” for the general population or for tribal populations.

Top

Model Description

The Healthy Start Initiative (Healthy Start) provides funds to local agencies to promote health education and interconception care for women who are at risk for poor perinatal outcomes. At-risk women include racial or ethnic minorities, immigrants, or those with limited education or income. Healthy Start requires local programs to provide women with support and education on smoking, sexually transmitted diseases, preterm labor, child sleeping positions, substance abuse prevention, and other risk factors or behaviors. Services are provided to women prenatally and are intended to continue for two years following delivery. This report focuses on Healthy Start programs that deliver services through home visiting (Healthy Start-Home Visiting).

This report includes a study that compared the results for mothers using more and less intensive versions of Healthy Start-Home Visiting. In the higher-intensity version, mothers were offered more intensive and frequent home visits than mothers visited by typical Healthy Start-Home Visiting nurse case managers. For more information, please read the Model Overview.

Top

Extent of Evidence

Results of Search and ReviewNumber of Studies for Healthy Start-Home VisitingNumber of Studies for Healthy Start-Home Visiting High-Intensity Enhancement
Released from 1979 to 2012 481
Eligible for review 61
     Rated high 00
     Rated moderate 01
     Rated low 60
     Additional sourcesa 00

aAdditional sources overlap with another study and are not rated.

For more information, see the study database. For more information on the criteria used to determine the study ratings, please read Producing Study Ratings.

Top

Summary of Findings



Outcomes Primary Outcome Measures Secondary Outcome Measures
Child Development and School Readiness Not measured Not measured
Child Health Not measured Not measured
Family Economic Self-Sufficiency Not measured Not measured
Linkages and Referrals Not measured Not measured
Maternal Health Not measured Not measured
Positive Parenting Practices Not measured Not measured
Reductions in Child Maltreatment Not measured Not measured
Reductions in Juvenile Delinquency, Family Violence, and Crime Not measured Not measured

Healthy Start-Home Visiting High-Intensity Enhancement
Outcomes Primary Outcome Measures Secondary Outcome Measures
Child Development and School Readiness Not measured Not measured
Child Health

Favorable: 0
No effect: 3
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Family Economic Self-Sufficiency Not measured Not measured
Linkages and Referrals Not measured Not measured
Maternal Health Not measured Not measured
Positive Parenting Practices Not measured Not measured
Reductions in Child Maltreatment Not measured Not measured
Reductions in Juvenile Delinquency, Family Violence, and Crime Not measured Not measured
Table Help
CLOSE

This table summarizes the effects found in research across outcome domains. Outcomes with a favorable impact are listed in green and outcomes with an unfavorable or ambiguous impact are listed in red. Outcomes that have high attrition or lack of baseline equivalence are excluded from this report.

Favorable Impact: A statistically significant impact on an outcome measure in a direction that is beneficial for children and parents. This impact could statistically be positive or negative, and is determined “favorable” based on the end result. For example, a favorable impact could be an increase in children’s vocabulary or daily reading to children by parents, or a reduction in harsh parenting practices or maternal depression.

Unfavorable or Ambiguous Impact: A statistically significant impact on an outcome measure in a direction that may indicate potential harm to children and/or parents. This impact could statistically be positive or negative, and is determined “unfavorable or ambiguous” based on the end result. NOTE: While some outcomes are clearly unfavorable, for other outcomes it is not as clear which direction is desirable. For example, an increase in children’s behavior problems is clearly unfavorable, while an increase in number of days mothers are hospitalized is more ambiguous. This may be viewed as an unfavorable impact because it indicates that mothers have more health problems, but it could also indicate that mothers have increased access to needed health care due to their participation in a home visiting program.

Primary Outcome Measure: For the HomVEE review, an outcome measured through direct observation, direct assessment, or administrative data; or self-reported data collected using a standardized (normed) instrument.

Secondary Outcome Measure: For the HomVEE review, most self-reported data, excluding self-reports based on a standardized (normed) instrument.

Please read Describing Effects for more information on these categories. Only results from studies that meet the standards for the high or moderate ratings are included above.

Top

Criteria Established by the Department of Health and Human Services

 Healthy Start-Home VisitingHealthy Start-Home Visiting High-Intensity Enhancement
Information Based on Comprehensive Review of All High- and Moderate-Impact Studies for this Model
High- or moderate-quality impact study? NoYes
Across high- or moderate-quality studies, favorable impacts in…
 
   at least two outcome domains within one sample
 
   OR
 
   the same domain for at least two non-overlapping samples?
NANo
Favorable impacts on full sample? NANo
Any favorable impacts on outcome measures sustained at least 12 months after program enrollment?a NANA
One or more favorable, statistically significant impact reported in a peer-reviewed journal?a NANA

NA = not applicable.

aThis information is reported for all models, but the requirements for sustained findings and inclusion in a peer-reviewed journal only apply to models for which all findings are from randomized controlled trials.

Please read the HHS Criteria for Evidence-Based Programs for more information.

Top