Maternal health

In brief

Overview

Improving maternal health is a goal of some early childhood home visiting models in the HomVEE review. To achieve this goal, models provide mothers with health information and guidance during pregnancy and after the child’s birth. Some also link mothers to prenatal and postpartum health care providers. In addition, some programs link mothers to treatment facilities for mental health and substance issues, or may directly provide preventive mental health intervention or other services that promote their psychological well-being.

Measurement considerations

Maternal health involves both the mother’s health status (during or after pregnancy), including mental and behavioral health, stress, and health-related habits such as nutrition and sexual health, and measures of social support and other protective factors. Outcome measures in this domain include health care service receipt outcomes extracted from medical records, as well as standardized and unstandardized parent self-report measures.

Maternal health involves the mother’s health status (during or after pregnancy), including mental and behavioral health, stress, and health-related habits such as nutrition and sexual health. Receipt of health services is in this domain; the mother’s health insurance status is in the family economic self-sufficiency domain.

Social/emotional support to the mother belongs in this domain, whereas in-kind support that the primary caregiver received is in the family economic self-sufficiency domain. HomVEE characterizes more support as favorable. (The favorability of positive or negative findings in this area may be dependent on context or other factors. In some cases, the HomVEE team will confer with subject matter experts to make determinations about whether a finding is favorable, or unfavorable or ambiguous.)

Review of research

The HomVEE review examined the research on 50 early childhood home visiting models with studies published in 1979 through 2019. (HomVEE counts related versions, commonly referred to as adaptations, together in this section and in the table below. More information is available in the procedures and standards handbook.) Of the 26 models with manuscripts about high- or moderate-quality studies that measured outcomes in this domain, 17 had favorable effects.

Summary of findings

The effects shown in the research are grouped into four categories: (1) favorable, (2) no effect, (3) unfavorable or ambiguous, and (4) not measured. Results for models that only have low-rated research are listed as “not applicable.” For more information on these categories please read the procedures and standards handbook. Only results from manuscripts that receive a moderate or high rating are considered below. This table includes manuscripts links to more information on the model’s effectiveness, implementation, and details on findings in this domain.

Effects shown in research — Maternal health domain

Summary of findings across models for the maternal health outcome domain
Model	Meets HHS criteria	Findings	For more information
Attachment and Biobehavioral Catch-Up (ABC) -Infant	Meets HHS criteria? Yes	Findings Not measured	For more information Model effectiveness Implementation
Child First	Meets HHS criteria? Yes	Findings Favorable: 11 No effect: 15 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
Child Parent Enrichment Project (CPEP)	Meets HHS criteria? No	Findings Favorable: 1 No effect: 6 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
Childhood Asthma Prevention Study (CAPS)	Meets HHS criteria? No	Findings Favorable: 0 No effect: 1 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
Computer-Assisted Motivational Intervention (CAMI)	Meets HHS criteria? No	Findings Favorable: 1 No effect: 1 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
Early Head Start Home-Based Option	Meets HHS criteria? Yes	Findings Favorable: 5 No effect: 17 Unfavorable or ambiguous: 1	For more information Model effectiveness Implementation Outcome details
Early Intervention Program for Adolescent Mothers Implementation support is not currently available for the model as reviewed.	Meets HHS criteria? Yes	Findings Favorable: 0 No effect: 19 Unfavorable or ambiguous: 1	For more information Model effectiveness Implementation Outcome details
Early Start (New Zealand)	Meets HHS criteria? Yes	Findings Favorable: 0 No effect: 5 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
Early Steps to School Success™—Home Visiting	Meets HHS criteria? No	Findings Not measured	For more information Model effectiveness Implementation
Even Start-Home Visiting (Birth to Age 5) Implementation support is not currently available for the model as reviewed.	Meets HHS criteria? No	Findings Not applicable	For more information Model effectiveness Implementation
Family Check-Up^® For Children	Meets HHS criteria? Yes	Findings Favorable: 7 No effect: 2 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
Family Connections (Birth to Age 5)	Meets HHS criteria? No	Findings Not applicable	For more information Model effectiveness Implementation
Family Connects	Meets HHS criteria? Yes	Findings Favorable: 1 No effect: 2 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
Family Spirit^®	Meets HHS criteria? Yes	Findings Favorable: 5 No effect: 47 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
Following Baby Back Home (FBBH)	Meets HHS criteria? No	Findings Not measured	For more information Model effectiveness Implementation
Health Access Nurturing Development Services (HANDS) Program	Meets HHS criteria? Yes	Findings Favorable: 7 No effect: 1 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
HealthConnect One's^® Community-Based Doula Program	Meets HHS criteria? No	Findings Not measured	For more information Model effectiveness Implementation
Healthy Beginnings	Meets HHS criteria? Yes	Findings Favorable: 3 No effect: 6 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
Healthy Families America (HFA)^®	Meets HHS criteria? Yes	Findings Favorable: 9 No effect: 80 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
Healthy Start-Home Visiting HHS has determined that Healthy Start is not eligible for review by HomVEE because it is a federal grant program and not a home visiting model. Information on Healthy Start has been removed from the website.		Findings Not measured	For more information Model effectiveness Implementation
Healthy Steps (National Evaluation 1996 Protocol) This report focuses on Healthy Steps as implemented in the 1996 evaluation. HHS has determined that home visiting is not the primary service delivery strategy and the model does not meet current requirements for MIECHV program implementation.	Meets HHS criteria? Yes	Findings Favorable: 0 No effect: 10 Unfavorable or ambiguous: 1	For more information Model effectiveness Implementation Outcome details
Home Instruction for Parents of Preschool Youngsters (HIPPY)^®	Meets HHS criteria? Yes	Findings Not measured	For more information Model effectiveness Implementation
Home-Start	Meets HHS criteria? No	Findings Favorable: 0 No effect: 4 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
HOMEBUILDERS (Birth to Age 5)^®	Meets HHS criteria? No	Findings Not applicable	For more information Model effectiveness Implementation
Maternal Early Childhood Sustained Home-Visiting Program (MECSH)	Meets HHS criteria? Yes	Findings Favorable: 1 No effect: 15 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
Maternal Infant Health Outreach Worker (MIHOW)^®	Meets HHS criteria? No	Findings Favorable: 6 No effect: 8 Unfavorable or ambiguous: 1	For more information Model effectiveness Implementation Outcome details
Maternal Infant Health Program (MIHP)	Meets HHS criteria? Yes	Findings Favorable: 3 No effect: 0 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
Minding the Baby^® Home Visiting (MTB-HV)	Meets HHS criteria? Yes	Findings Favorable: 1 No effect: 11 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
MOM Program	Meets HHS criteria? No	Findings Favorable: 0 No effect: 4 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
Mothers’ Advocates in the Community (MOSAIC)	Meets HHS criteria? No	Findings Not measured	For more information Model effectiveness Implementation
North Carolina Baby Love Maternal Outreach Workers Program Implementation support is not currently available for the model as reviewed.	Meets HHS criteria? No	Findings Not measured	For more information Model effectiveness Implementation
Nurse-Family Partnership (NFP)^®	Meets HHS criteria? Yes	Findings Favorable: 29 No effect: 99 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
Nurses for Newborns^®	Meets HHS criteria? No	Findings Not measured	For more information Model effectiveness Implementation
Nurturing Parenting Programs (Birth to Age 5)	Meets HHS criteria? No	Findings Not measured	For more information Model effectiveness Implementation
Oklahoma’s Community-Based Family Resource and Support (CBFRS) Program Implementation support is not currently available for the model as reviewed.	Meets HHS criteria? Yes	Findings Favorable: 3 No effect: 0 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
Parent-Child Assistance Program (P-CAP)	Meets HHS criteria? No	Findings Not measured	For more information Model effectiveness Implementation
ParentChild+^® Core Model	Meets HHS criteria? No	Findings Not measured	For more information Model effectiveness Implementation
Parents as Teachers (PAT)^®	Meets HHS criteria? Yes	Findings Favorable: 0 No effect: 3 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
Philani Outreach Programme	Meets HHS criteria? No	Findings Not measured	For more information Model effectiveness Implementation
Play and Learning Strategies (PALS) Entries in this row combine information across all versions of PALS. Only PALS Infant meets HHS criteria for an evidence-based home visiting model. Some other versions of PALS have at least one manuscript about a high- or moderate-quality impact study, but no version of the model other than PALS Infant meets HHS criteria for an evidence-based home visiting model.	Meets HHS criteria? No	Findings Not measured	For more information Model effectiveness Implementation
Play and Learning Strategies (PALS) Infant	Meets HHS criteria? Yes	Findings Not measured	For more information Model effectiveness Implementation
Pride in Parenting (PIP) Implementation support is not currently available for the model as reviewed.	Meets HHS criteria? No	Findings Not measured	For more information Model effectiveness Implementation
Promoting First Relationships^®—Home Visiting Option	Meets HHS criteria? No	Findings Not measured	For more information Model effectiveness Implementation
Promoting Parental Skills and Enhancing Attachment in Early Childhood (CAPEDP) Trial Implementation support is not currently available for the model as reviewed.	Meets HHS criteria? No	Findings Favorable: 0 No effect: 1 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
Resource Mothers Program Implementation support is not currently available for the model as reviewed.	Meets HHS criteria? No	Findings Not measured	For more information Model effectiveness Implementation
Resources, Education, and Care in the Home (REACH)	Meets HHS criteria? No	Findings Not measured	For more information Model effectiveness Implementation
REST Routine Implementation support is not currently available for the model as reviewed.	Meets HHS criteria? No	Findings Favorable: 0 No effect: 1 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
SafeCare^® Entries in this row combine information across all versions of SafeCare. Only SafeCare Augmented meets HHS criteria for an evidence-based home visiting model. For SafeCare itself, there are no manuscripts about high- or moderate-quality impact studies. Some other versions of SafeCare have at least one such manuscripts. Planned Activities Training (a SafeCare module) and Cellular Phone Enhanced Planned Activities Training (a SafeCare module with an add-on) show evidence of effectiveness.	Meets HHS criteria? No	Findings Favorable: 4 No effect: 6 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
SafeCare Augmented	Meets HHS criteria? Yes	Findings Favorable: 0 No effect: 8 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
Seattle-King County Healthy Homes Project	Meets HHS criteria? No	Findings Not applicable	For more information Model effectiveness Implementation
Triple P - Positive Parenting Program^®—Variants suitable for home visiting No Triple P intervention is exclusively delivered in the home with families with children from birth through age 5. This profile is based on (1) studies of programs that provided Triple P services in the home to families with children from birth through age 5, and (2) developer input on the Triple P interventions suitable for delivery in the home with families with children from birth through age 5.	Meets HHS criteria? No	Findings Favorable: 0 No effect: 3 Unfavorable or ambiguous: 0	For more information Model effectiveness Implementation Outcome details
Video-Feedback Intervention to Promote Positive Parenting-Sensitive Discipline^® (VIPP-SD)	Meets HHS criteria? No	Findings Not measured	For more information Model effectiveness Implementation