Is home visiting an effective strategy?


Home visiting programs have been providing services to families with young children in the United States since the 1880's. Today, it is estimated that thousands of such programs are in existence, funded by millions of public and private dollars. Until now, however, no comprehensive quantitative evaluation of home visiting programs has been undertaken. In this report, we quantitatively combined information and evaluation of 60 home visiting programs to determine if they enhance the lives of those visited.

Home visiting programs send visitors into families' homes, to work with parents to help their children in some way. Three beliefs are key:
1) families are best helped in their own homes,
2) helping parents to help their children is more effective than directly helping children, and
3) children are best off if help is provided early, before formal schooling begins.

Beyond these similarities, however, programs vary greatly. For instance, some employ professionals, such as nurses, to visit families. Others employ women from the same community served to visit families and act as a role model. Some programs target solely health and safety related issues, others target children's cognitive or social development, and yet others target a variety of child and parent outcomes. The term "home visiting" implies the strategy for delivering the service, not the service itself.

Given that programs work with parents to teach them how to improve children's lives, both parent and child outcomes were included in this meta-analytic review. How well a program worked was measured by comparing families in a home visiting program to families who weren't in the program. Parents in home visiting programs had better parenting attitudes and parenting behaviors than other parents, and they returned to school or sought further education at a higher rate. Children in home visiting programs had higher levels of cognitive and social functioning than other children, and were less likely to be physically abused by their parents. The magnitude of these differences, while statistically significant, was often small.

In summation, home visiting does help families with young children; whether the amount of help is worth the cost of creating and implementing programs has yet to be determined. What makes a home visiting program successful is unclear, although it is clear that home visiting programs tend to be multi-faceted and complex. This meta-analytic review provides a starting place for practitioners, program developers, evaluators, and funding agencies to begin thinking about the utility of home visiting as a strategy to help families. Future cost-benefit analyses and analyses comparing home visiting programs to other types of child and family support programs may serve to clarify the usefulness and effectiveness of home visiting as a strategy.

Source: Eurekalert & others

Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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