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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCHbest. NPM 6: Developmental Screening

MCHbest Logo toddler and doctor playing with their noses

Strategy. Home Visiting Programs

Approach. Utilize Home Visiting/Maternal, Infant, and Early Childhood Home Visiting (MIECHV) programs to provide the Ages and Stages Developmental Screening tool to clients.

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Overview. There is growing evidence that using home visiting sessions to encourage parents to use the Ages and Stages tool may increase developmental screening rates. While there are limited number of studies that examine this intervention, it appears to be effective in this setting.1,2

Evidence. Moderate Evidence. Programs based on this strategy are likely to work, but further research is needed to confirm effects. This strategy has been tested more than once and results trend positive overall. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Parents/Caregivers.

Outcome. Receipt of developmental screening using a parent-completed screening tool. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.

Examples from the Field. Access descriptions of current ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Healthy Familis Oregon is a free family support and parent education home visiting program that focuses on strengthening the parent-child relationship. Home visitors support parents in establishing and building a nuturing, positive relationship at each visit. An assessment of the program found that 93.8% of the children of the mothers assigned to the Healthy Families program received developmental screenings, compared to 86.5% of the control group.3

The Role of Title V. Title V agencies can support developmental screening via home visiting programs through a number of appraoaches:

Sample ESMs. Using the approach “Utilize Home Visiting/MIECHV programs to provide Ages and Stages Developmental Screening tool with clients,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of children enrolled in home visiting with a timely screen for developmental delays using a validated parent-completed tool.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of children enrolled in home visiting with a timely screen for developmental delays using a validated parent-completed tool.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of children enrolled in home visiting program with a timely screening to identify developmental delays that use a validated parent-completed tool who are screened as high risk and are given resources for services.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of children enrolled in a home visiting program with a timely screening to identify developmental delays that use a validated parent-completed tool who are screened as high risk and are given resources for services.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


References:

1,3 Green B, Tarte JM, Harrison PM, Nygren M, Sanders M. Results from a randomized trial of the Healthy Families Oregon accredited statewide program: early program impacts on parenting. Child Youth Serv Rev. 2014;44:288-298.

2 Garcia S, Brown E, Strobino D, & Minokovitz C. National Performance Measure 6 Developmental Screening Evidence Review. Strengthen the Evidence for Maternal and Child Health Programs. 2018. Women's and Children's Health Policy Center, John Hopkins University, Baltimore, MD.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.