Because young children are more likely than older children to be maltreated, the goal of some of the early childhood home visiting models in the HomVEE review is to prevent or reduce the incidence of child abuse and neglect. To achieve this goal, home visitors typically work with parents to improve knowledge, skills, and behaviors that are associated with maltreatment. For example, they may educate parents on how to interact with their children in a more responsive manner, teach them alternative ways to discipline their children, or provide strategies for meeting their children’s developmental needs. They may also attempt to decrease the numbers of stressors that may make families vulnerable to inappropriate parenting. For example, home visitors may work to enhance children’s functioning by improving child health and development or connect families with community resources (such as mental health and substance abuse services).
Reductions in child maltreatment
Effectiveness
Measurement considerations
Outcomes in this domain include measures and assessments related to child maltreatment. Outcome measures include evidence of substantiated child maltreatment from administrative records and counts taken from medical records of encounters with health care providers for injuries or ingestions. Encounters with health care providers may include physician visits, emergency room visits, or hospitalizations. Parents in home visiting programs may be encouraged to use health care services more often, such as for well child care visits. In addition, families’ patterns of health care use may change after enrollment in a home visiting program. For example, if a program connects families with primary care physicians, they may reduce their use of the emergency room for health care. Therefore, in the HomVEE review, only health care encounters that may occur as a result of child maltreatment, such as treatment for injuries or ingestions, are included in the reductions in child maltreatment domain.
There is some concern that counts of child maltreatment reports may not be accurate indications of the incidence of maltreatment. For example, participation in early childhood home visiting programs increases surveillance of families and may result in increased reports of child maltreatment. Therefore, this review includes only substantiated reports of child maltreatment as an outcome measure; outcome measures based on unsubstantiated reports are excluded. HomVEE also includes child welfare outcomes such as placement outside the home.
HomVEE has classified the Conflicts Tactics Scale-Parent Child (CTS-PC), a measure that assesses neglectful, psychologically aggressive, and abusive parenting behavior, as a measure of child maltreatment.
HomVEE includes only substantiated reports of child maltreatment and child welfare measures such as custody loss and placement outside the home; outcome measures based on unsubstantiated reports are ineligible for review. There is some concern that counts of child maltreatment reports may not be accurate indications of the incidence of maltreatment. For example, participation in home visiting programs increases surveillance of families and may result in increased reports of child maltreatment.
Only health care encounters that may occur specifically as a result of child maltreatment, such as treatment for injuries or ingestions, are included in the reductions in child maltreatment domain. Encounters with health care providers may include physician visits, emergency room visits, or hospitalizations. Parents in home visiting programs may be encouraged to use health care services more often, such as for well child care visits. In addition, families’ patterns of health care use may change after enrollment in a home visiting program. For example, if a program connects families with primary care physicians, families may reduce their use of the emergency room for health care. Therefore, HomVEE places other health care encounter measures in the child health domain.
Categorizing runaway information. If a child running away is measured in child welfare records, that measure would be listed here. In contrast, if a parent or child reports that the child ran away from home, that measure would be reported in the child development and school readiness domain.
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 — Reductions in child maltreatment domain
Model | Meets HHS criteria | Findings | For more information |
---|---|---|---|
Arizona Health Start Program |
Meets HHS criteria? No
|
Findings Not applicable
|
For more information
|
Attachment and Biobehavioral Catch-Up (ABC) -Infant |
Meets HHS criteria? Yes
|
Findings Not measured
|
For more information
|
Attachment and Biobehavioral Catch-Up (ABC) -Toddler |
Meets HHS criteria? No
|
Findings Not measured
|
For more information
|
Child First |
Meets HHS criteria? Yes
|
Findings Not measured
|
For more information
|
Child Parent Enrichment Project (CPEP) |
Meets HHS criteria? No
|
Findings Favorable: 0 No effect: 1 Unfavorable or ambiguous: 0 |
For more information
|
Childhood Asthma Prevention Study (CAPS) |
Meets HHS criteria? No
|
Findings Not measured
|
For more information
|
Computer-Assisted Motivational Intervention (CAMI) |
Meets HHS criteria? No
|
Findings Not measured
|
For more information
|
Computer-Assisted Motivational Intervention plus enhanced home visiting (CAMI+) |
Meets HHS criteria? No
|
Findings Not measured
|
For more information
|
Early Head Start—Home-based option |
Meets HHS criteria? Yes
|
Findings Favorable: 0 No effect: 1 Unfavorable or ambiguous: 0 |
For more information
|
Early Head Start Infant Mental Health Home-Based Services Adaptation (IMH-HB EHS) |
Meets HHS criteria? No
|
Findings Not measured
|
For more information
|
Early Intervention Program for Adolescent Mothers |
Meets HHS criteria? Yes
|
Findings Not measured
|
For more information
|
Early Start (New Zealand) |
Meets HHS criteria? Yes
|
Findings Favorable: 2 No effect: 0 Unfavorable or ambiguous: 0 |
For more information
|
Early Steps to School Success™—Home Visiting |
Meets HHS criteria? No
|
Findings Not applicable
|
For more information
|
Even Start-Home Visiting (Birth to Age 5) |
Meets HHS criteria? No
|
Findings Not applicable
|
For more information
|
Family Check-Up® For Children |
Meets HHS criteria? Yes
|
Findings Not measured
|
For more information
|
Family Connections (Birth to Age 5) |
Meets HHS criteria? No
|
Findings Not applicable
|
For more information
|
Family Connects |
Meets HHS criteria? Yes
|
Findings Favorable: 0 No effect: 3 Unfavorable or ambiguous: 0 |
For more information
|
Family Spirit® |
Meets HHS criteria? Yes
|
Findings Not measured
|
For more information
|
First Born® Program |
Findings Not measured
|
For more information
|
|
Following Baby Back Home (FBBH) |
Meets HHS criteria? No
|
Findings Not applicable
|
For more information
|
Health Access Nurturing Development Services (HANDS) Program |
Meets HHS criteria? Yes
|
Findings Favorable: 1 No effect: 0 Unfavorable or ambiguous: 0 |
For more information
|
HealthConnect One's® Community-Based Doula Program |
Meets HHS criteria? No
|
Findings Not applicable
|
For more information
|
Healthy Beginnings |
Meets HHS criteria? Yes
|
Findings Not measured
|
For more information
|
Healthy Families America (HFA)® |
Meets HHS criteria? Yes
|
Findings Favorable: 20 No effect: 188 Unfavorable or ambiguous: 1 |
For more information
|
Healthy Steps (National Evaluation 1996 Protocol) |
Meets HHS criteria? Yes
|
Findings Favorable: 0 No effect: 1 Unfavorable or ambiguous: 0 |
For more information
|
Home Instruction for Parents of Preschool Youngsters (HIPPY)® |
Meets HHS criteria? Yes
|
Findings Not measured
|
For more information
|
Home-Start |
Meets HHS criteria? No
|
Findings Not applicable
|
For more information
|
HOMEBUILDERS (Birth to Age 5)® |
Meets HHS criteria? No
|
Findings Not applicable
|
For more information
|
Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) |
Meets HHS criteria? Yes
|
Findings Not measured
|
For more information
|
Maternal Early Childhood Sustained Home-Visiting Program (MECSH) |
Meets HHS criteria? Yes
|
Findings Not measured
|
For more information
|
Maternal Infant Health Outreach Worker (MIHOW)® |
Meets HHS criteria? Yes
|
Findings Not measured
|
For more information
|
Maternal Infant Health Program (MIHP) |
Meets HHS criteria? Yes
|
Findings Favorable: 0 No effect: 13 Unfavorable or ambiguous: 5 |
For more information
|
Minding the Baby® Home Visiting (MTB-HV) |
Meets HHS criteria? Yes
|
Findings Not measured
|
For more information
|
MOM Program |
Meets HHS criteria? No
|
Findings Not measured
|
For more information
|
Mothers’ Advocates in the Community (MOSAIC) |
Meets HHS criteria? No
|
Findings Not applicable
|
For more information
|
New Forest Parenting Programme (NFPP) |
Meets HHS criteria? No
|
Findings Not applicable
|
For more information
|
North Carolina Baby Love Maternal Outreach Workers Program |
Meets HHS criteria? No
|
Findings Not applicable
|
For more information
|
Nurse-Family Partnership (NFP)® |
Meets HHS criteria? Yes
|
Findings Favorable: 7 No effect: 19 Unfavorable or ambiguous: 0 |
For more information
|
Nurses for Newborns® |
Meets HHS criteria? No
|
Findings Not applicable
|
For more information
|
Nurturing Parenting Programs (Birth to Age 5) |
Meets HHS criteria? No
|
Findings Not applicable
|
For more information
|
Oklahoma’s Community-Based Family Resource and Support (CBFRS) Program |
Meets HHS criteria? Yes
|
Findings Not measured
|
For more information
|
Parent-Child Assistance Program (PCAP) |
Meets HHS criteria? No
|
Findings Not applicable
|
For more information
|
ParentChild+® Core Model |
Meets HHS criteria? No
|
Findings Not measured
|
For more information
|
Parents as Teachers (PAT)® |
Meets HHS criteria? Yes
|
Findings Favorable: 0 No effect: 4 Unfavorable or ambiguous: 0 |
For more information
|
Baby FACE, an adaptation of Parents as Teachers |
Meets HHS criteria? No
|
Findings Not measured
|
For more information
|
Parents as First Teachers (New Zealand) |
Meets HHS criteria? No
|
Findings Not measured
|
For more information
|
Philani Outreach Programme |
Meets HHS criteria? No
|
Findings Not applicable
|
For more information
|
Play and Learning Strategies (PALS) Infant |
Meets HHS criteria? Yes
|
Findings Not measured
|
For more information
|
Play and Learning Strategies (PALS) Infant + Toddler/Preschooler |
Meets HHS criteria? No
|
Findings Not measured
|
For more information
|
Play and Learning Strategies (PALS) Toddler/Preschooler |
Meets HHS criteria? No
|
Findings Not measured
|
For more information
|
Preparing for Life—Home Visiting |
Meets HHS criteria? Yes
|
Findings Not measured
|
For more information
|
Pride in Parenting (PIP) |
Meets HHS criteria? No
|
Findings Not applicable
|
For more information
|
Promoting First Relationships®—Home Visiting Intervention Model |
Meets HHS criteria? Yes
|
Findings Favorable: 1 No effect: 2 Unfavorable or ambiguous: 0 |
For more information
|
Promoting First Relationships®—Home Visiting Promotion Model |
Meets HHS criteria? No
|
Findings Not applicable
|
For more information
|
Promoting Parental Skills and Enhancing Attachment in Early Childhood (CAPEDP) Trial |
Meets HHS criteria? No
|
Findings Not measured
|
For more information
|
Resource Mothers Program |
Meets HHS criteria? No
|
Findings Not applicable
|
For more information
|
Resources, Education, and Care in the Home (REACH) |
Meets HHS criteria? No
|
Findings Not measured
|
For more information
|
REST Routine |
Meets HHS criteria? No
|
Findings Not measured
|
For more information
|
SafeCare® |
Meets HHS criteria? No
|
Findings Not applicable
|
For more information
|
SafeCare Augmented |
Meets HHS criteria? Yes
|
Findings Favorable: 1 No effect: 8 Unfavorable or ambiguous: 0 |
For more information
|
Australian adaptation of the UCLA Parent-Child Health and Wellness Project, a version of SafeCare |
Meets HHS criteria? No
|
Findings Not measured
|
For more information
|
Seattle-King County Healthy Homes Project |
Meets HHS criteria? No
|
Findings Not applicable
|
For more information
|
Triple P - Positive Parenting Program®—Variants suitable for home visiting |
Meets HHS criteria? No
|
Findings Not applicable
|
For more information
|
Triple P - Home Visiting: Standard Stepping Stones |
Meets HHS criteria? No
|
Findings Not measured
|
For more information
|
Video-Feedback Intervention to promote Positive Parenting–Sensitive Discipline® (VIPP–SD) |
Meets HHS criteria? Yes
|
Findings Not measured
|
For more information
|
Video-Feedback Intervention to promote Positive Parenting adapted to Autism (VIPP–AUTI) |
Meets HHS criteria? No
|
Findings Not measured
|
For more information
|
Video-Feedback Intervention to promote Positive Parenting (VIPP) |
Meets HHS criteria? Yes
|
Findings Not measured
|
For more information
|
British Autism Study of Infant Siblings–Video-Feedback Intervention to promote Positive Parenting (iBASIS–VIPP) |
Meets HHS criteria? No
|
Findings Not measured
|
For more information
|