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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCHbest. NPM 7: Injury Hospitilization

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Strategy. Home Visiting Interventions to Prevent Child Maltreatment

Approach. Conduct home visiting programs that promote positive parenting skills.

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Overview. Studies show that home visiting programs have a positive effect on improving parenting competence and reducing child maltreatment. 1-7

Evidence. Moderate/Emerging. Home visiting programs appear to be effective in promoting positive parenting and preventing child maltreatment. Programs based on this strategy are likely to work. 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. Caregivers: families at risk for child maltreatment (e.g., young mothers from disadvantaged backgrounds; early Head Start families).

Outcome.  Increase in positive parenting skills (e.g. parental responsiveness, developmental knowledge; problem solving skills; attachment). 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 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. You may also want to look at evidence that supports educational programs in other NPM topic areas that can be translated to this specific topic area.

Sample ESMs. Using the approach “Conduct home visiting programs that promote positive parenting skills,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework:

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

  • Number of families receiving home visits to promote positive parenting skills.
  • Number of families served in home visiting programs who have reports of child maltreatment.

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

  • Percent of families receiving home visits to promote positive parenting skills.
  • Percent of families served in home visiting programs who have reports of child maltreatment.

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

  • Number of mothers receiving home visits who showed an increase in knowledge of positive parenting behaviors.
  • Number of mothers receiving home visits who showed an increase in knowledge of child development.

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

  • Percent of mothers receiving home visits who showed an increase in knowledge of positive parenting behaviors.
  • Percent of mothers receiving home visits who showed an increase in knowledge of child development.

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 Fergusson DM, Boden JM, Horwood LJ. Nine-year follow-up of a home-visitation program: A randomized trial. Pediatrics 2013; 131: 297–303.

2  Galanter R, Self-Brown S, Valente RR, Dorsey S, Whitaker DJ, Bertuglia-Haley M, et al. Effectiveness of Parent– Child Interaction Therapy delivered to at-risk families in the home setting. Child & Family Behavior Therapy 2012; 34: 177–196.

3 Green BL, Ayoub C, Dym Barlett J, Von Ende A, Furrer C, Chazan-Cohen R, et al. The effect of Early Head Start on child welfare system involvement: A first look at longitudinal child maltreatment outcomes. Children and Youth Services Review 2014; 42: 127–135.

4 Green BL, Tarte JM, Harrison PM, Nygren M, Sanders MB. Results from a randomized trial of the Healthy Families Oregon accredited statewide program: Early program impacts on parenting. Children and Youth Services Review 2014; 44: 288–298.

5 Harden BJ, Sandstrom H, Chazan-Cohen R. Early Head Start and African American families: Impacts and mechanisms of child outcomes. Early Childhood Research Quarterly 2012; 27: 572–581.

6 Harden BJ, Chazan-Cohen R, Raikes H, Vogel C. Early head start home visitation: The role of implementation in bolstering program benefits. Journal of Community Psychology 2012; 40: 438–455.

7 Lowell DI, Carter AS, Godoy L, Paulicin B, Briggs-Gowan MJ. A randomized controlled trial of Child FIRST: A comprehensive home-based intervention translating research into early childhood practice. Child Development 2011; 82: 193–208.

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.