In 2010, Congress authorized the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program, which started a major expansion of evidence-based home visiting programs for families living in at-risk communities. MIECHV is administered by the Health Resources and Services Administration in collaboration with the Administration for Children and Families within the U.S. Department of Health and Human Services (HHS). The authorizing legislation required an evaluation of the program, which became the Mother and Infant Home Visiting Program Evaluation (MIHOPE), conducted for HHS by MDRC with James Bell Associates, Johns Hopkins University, Mathematica Policy Research, the University of Georgia, and Columbia University.
MIHOPE was designed to learn whether families benefit from MIECHV-funded early childhood home visiting programs, and if so, how. The study includes the four evidence-based models that 10 or more states chose in their initial MIECHV plans in fiscal year 2010-2011: Early Head Start — Home-based option, Healthy Families America, Nurse-Family Partnership, and Parents as Teachers. MIHOPE is the first study to include these four evidence-based models. To provide rigorous evidence on the MIECHV-funded programs’ effects, the study randomly assigned about 4,200 families to receive either MIECHV-funded home visiting or information on community services.
This report presents the early effects on family and child outcomes from the local programs included in the study. Key findings include:
There are positive effects, and they are generally similar to but somewhat smaller than the average effects found in past studies. Of 12 outcomes the study focused on, 4 had estimated effects that are statistically significant. No outcome area stands out as one where home visiting programs had large effects.
Differences in effects among the evidence-based models are generally consistent with the models’ focuses. For example, Parents as Teachers produced the largest increase in parental supportiveness and Nurse-Family Partnership produced the largest reduction in emergency department visits for children, although the differences are sensitive to the statistical methods used.
Effects on family outcomes do not vary much by family characteristics, suggesting that home visiting is not having larger effects for different types of families. The effects may vary in ways that were not examined in this report.
This report examines MIECHV-funded home visiting programs from 2012 through 2017, and local programs have continued to evolve. In addition, this report presents effects when children are only 15 months old, which may be too early to see effects on child development. There is evidence from past studies that the benefits of home visiting persist, so it may be too early to make a final judgment about the programs studied in MIHOPE. For that reason, the study is planning to collect follow-up data over the longer term with participating families.