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Assessing the Deployment of Home Visiting: Learning from a State-Wide Survey of Home Visiting Programs

Abstract

Objectives Large-scale planning for health and human services programming is required to inform effective public policy as well as deliver services to meet community needs. The present study demonstrates the value of collecting data directly from deliverers of home visiting programs across a state. This study was conducted in response to the Patient Protection and Affordable Care Act, which requires states to conduct a needs assessment of home visiting programs for pregnant women and young children to receive federal funding. In this paper, we provide a descriptive analysis of a needs assessment of home visiting programs in Ohio. Methods All programs in the state that met the federal definition of home visiting were included in this study. Program staff completed a web-based survey with open- and close-ended questions covering program management, content, goals, and characteristics of the families served. Results Consistent with the research literature, program representatives reported great diversity with regard to program management, reach, eligibility, goals, content, and services delivered, yet consistently conveyed great need for home visiting services across the state. Conclusions Results demonstrate quantitative and qualitative assessments of need have direct implications for public policy. Given the lack of consistency highlighted in Ohio, other states are encouraged to conduct a similar needs assessment to facilitate cross-program and cross-state comparisons. Data could be used to outline a capacity-building and technical assistance agenda to ensure states can effectively meet the need for home visiting in their state.

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References

  1. 1.

    American Academy of Pediatrics Council on Community Pediatrics. (2009). The role of preschool home-visiting programs in improving children’s developmental and health outcomes. Pediatrics, 123, 598–603.

    Article  Google Scholar 

  2. 2.

    Donelan-McCall, N., Eckenrode, J., & Olds, D. L. (2009). Home visiting for the prevention of child maltreatment: Lessons learned during the past 20 years. Pediatric Clinics of North America, 56(2), 389–403.

    Article  PubMed  Google Scholar 

  3. 3.

    Howard, K. S., & Brooks-Gunn, J. (2009). The role of home-visiting programs in preventing child abuse and neglect. The Future of Children, 19(2), 119–146.

    Article  PubMed  Google Scholar 

  4. 4.

    Daro, D. (1993). Child maltreatment research: Implications for program design. In D. Cicchetti & S. L. Toth (Eds.), Child abuse, child development, and social policy (pp. 331–367). Norwood, NJ: Ablex.

    Google Scholar 

  5. 5.

    Guterman, N. (1997). Early prevention of physical child abuse and neglect: Existing evidence and future directions. Child Maltreatment, 2(1), 12–34.

    Article  Google Scholar 

  6. 6.

    Karoly, L. A., Greenwood, P. W., Everingham, S. S., Hoube, J., Kilburn, M. R., & Rydell, C. P. (1998). Investing in our children: What we know and don’ t know about the costs and benefits of early childhood interventions. Santa Monica, CA: RAND.

    Google Scholar 

  7. 7.

    Ramey, C. T., & Ramey, S. L. (1998). Prevention of intellectual disabilities: Early interventions to improve cognitive development. Preventive Medicine, 27(2), 224–232.

    Article  CAS  PubMed  Google Scholar 

  8. 8.

    Seitz, V., Rosenbaum, L. K., & Apfel, N. H. (1985). Effects of family support intervention: A ten-year follow up. Child Development, 56(2), 376–391.

    Article  CAS  PubMed  Google Scholar 

  9. 9.

    Health Care Reform Act. (2010). The Patient Protection and Affordable Care Act (Health Care Reform Act H.R. 3590), Sec. 2951 Maternal, Infant, and Early Childhood Home Visiting Programs. Page 220 (d)(3)(A)(i).

  10. 10.

    Paulsell, D., Avellar, S., Sama Martin, E., & Del Grosso, P. (2010). Home visiting evidence of effectiveness review: Executive summary. In Office of planning, research and evaluation, administration for children and families. Washington, DC: U.S. Department of Health and Human Services.

  11. 11.

    Child Trends. (2010). Home visiting application process: A guide for planning state needs assessments. Early Childhood Highlights, 1(4), 1–25.

    Google Scholar 

  12. 12.

    Donelan-McCall, N., Eckenrode, J., & Olds, D. L. (2009). Home visiting for the prevention of child maltreatment: Lessons learned during the past 20 years. Pediatric Clinics of North America, 56, 389–403.

    Article  PubMed  Google Scholar 

  13. 13.

    Olds, D. L. (2002). Prenatal and infancy home visiting by nurses: From randomized trials to community replication. Prevention Science, 3(3), 153–172.

    Article  PubMed  Google Scholar 

  14. 14.

    Olds, D. L. (2006). The nurse-family partnership: An evidence-based preventive intervention. Infant Mental Health Journal, 27(1), 5–25.

    Article  Google Scholar 

  15. 15.

    Sweet, M. A., & Appelbaum, M. I. (2004). Is home visiting an effective strategy? A meta- analytic review of home visiting programs for families with young children. Child Development, 75(5), 1435–1456.

    Article  PubMed  Google Scholar 

  16. 16.

    Olds, D. L., & Kitzman, H. (1993). Review of research on home visiting for pregnant women and parents of young children. The Future of Children, 3(3), 53–92.

    Article  Google Scholar 

  17. 17.

    De la Rosa, I. A., Perry, J., & Johnson, V. (2009). Benefits of increased home-visitation services: Exploring a case management tool. Family & Community Health, 32(1), 58–75.

    Article  Google Scholar 

  18. 18.

    Thomas, N., Komiti, A., & Judd, F. (2014). Pilot early intervention antenatal group program for pregnant women with anxiety and depression. Archives of Women’s Mental Health, 17, 503–509.

    Article  PubMed  Google Scholar 

  19. 19.

    Avellar, S., Paulsell, D., Sama-Miller, E., Del Grosso, P., Akers, L., & Kleinman, R. (2014). Home visiting evidence of effectiveness review: Executive summary. In Office of planning, research and evaluation, administration for children and families. Washington, DC: U.S. Department of Health and Human Services.

  20. 20.

    Olds, D. L., Kitzman, H., Cole, R., Robinson, J., Sidora, K., Luckey, D. W., et al. (2004). Effects of nurse home-visiting on maternal life force and child development: Age 6 follow-up results of a randomized trial. Pediatrics, 114(6), 1550–1559.

    Article  PubMed  Google Scholar 

  21. 21.

    Eckenrode, J., Zielinski, D., Smith, E., Marcynyszyn, L. A., Henderson, C. R, Jr, Kitzman, H., et al. (2001). Child maltreatment and the early onset of problem behaviors: Can a program of nurse home visiting break the link? Development and Psychopathology, 13, 873–890.

    CAS  PubMed  Google Scholar 

  22. 22.

    Witkin, B. R., & Altschuld, J. W. (1995). Planning and conducting needs assessments: A practical guide. Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  23. 23.

    Lillie-Blanton, M., & Hoffman, S. C. (1995). Conducting an assessment of health needs and resources in a racial/ethnic minority community. Health Services Research, 30(1), 225–236.

    PubMed Central  CAS  PubMed  Google Scholar 

  24. 24.

    Kazda, M. J., Beel, E. R., Villegas, D., Martinez, J. G., Patel, N., & Migala, W. (2009). Methodological complexities and the use of GIS in conducting a community needs assessment of a large U.S. municipality. Journal of Community Health, 34(3), 210–215.

    Article  PubMed  Google Scholar 

  25. 25.

    Johnson, K. (2009). State-based home visiting: Strengthening programs through state leadership. In National Center for Children in Poverty. New York: Columbia University.

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Acknowledgments

Funding for this research was provided by the Ohio Department of Health through a contract with the Center for Child Health and Policy at University Hospitals Rainbow Babies and Children’s Hospital. The authors wish to acknowledge the leadership and contributions of their colleague Leona Cuttler, M.D. who passed away in 2013. Dr. Cuttler, a professor of pediatrics at the Case Western Reserve University School of Medicine, led the broader project of which this study was a part.

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Correspondence to Elizabeth R. Anthony.

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Fischer, R.L., Anthony, E.R., Lalich, N. et al. Assessing the Deployment of Home Visiting: Learning from a State-Wide Survey of Home Visiting Programs. Matern Child Health J 20, 674–683 (2016). https://doi.org/10.1007/s10995-015-1867-y

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Keywords

  • Needs assessment
  • Home visiting
  • Maternal and child health
  • Affordable Care Act