- Program Brief: Maternal, Infant, and Early Childhood Home Visiting Program (PDF - 320 KB)
- Home Visiting Program State Fact Sheets
- Early Childhood Comprehensive Systems
- Tribal Home Visiting Program (PDF - 480 KB)
- Discretionary Grant Information System (DGIS)
- Demonstrating Improvement in the Maternal, Infant, and Early Childhood Home Visiting Program: A Report to Congress (PDF - 1 MB)
- Developing Data Exchange Standards for MIECHV Home Visiting Programs (PDF - 189 KB)
- Home Visiting Applied Research Collaborative (HARC) Overview (PDF - 215 KB)
- Home Visiting Collaborative Improvement and Innovation Network (HV CoIIN) 2.0 Overview (PDF - 330 KB)
- MIECHV Program Learning Agenda Overview (PDF - 354 KB)
From its inception, the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program has adopted a learning agenda approach that focuses research and evaluation efforts on improving program effectiveness and building the knowledge base. MIECHV promotes rigorous evaluation at the national, state, and local levels and supports research infrastructure in the field.
HRSA also requires MIECHV awardees to collect certain data and report on their program’s performance. For more information, visit the MIECHV Data & Continuous Quality Improvement page.
HRSA, in partnership with the Administration of Children and Families (ACF), supports awardees in conducting rigorous evaluations of their programs. State-led evaluations help to a) build the evidence of effectiveness on promising approach home visiting models, b) examine the replication of evidence-based home visiting models across new settings and contexts, c) answer questions of local salience, and d) use empirical information to improve service delivery.
Awardees who chose to implement a model that qualifies as a promising approach are required to conduct a well-designed and rigorous evaluation of the program’s impact. MIECHV evaluations of promising approach models are expected to help build the evidence base around the service delivery model towards HHS’ evidence of effectiveness. See the U.S. Department of Health & Human Services’ Home Visiting Evidence of Effectiveness website.
In FY 2021, HRSA launched a new approach to voluntary, state-led evaluation of evidence-based home visiting programs. Under this new approach, referred to as coordinated state evaluation, MIECHV awardees conducting state-led evaluation must select to conduct evaluation on a priority topic, identified by HRSA, in coordination with other MIECHV awardees. In consultation with key partners, HRSA identified four priority topic areas in which awardees could propose to conduct coordinated state evaluations:
- Family engagement & health equity,
- Implementation quality/fidelity,
- Maternal health, and
- Workforce development.
Participating awardees work together in peer networks with technical assistance specialists to plan and conduct evaluations aligned around a shared agenda and common elements.
HRSA places an emphasis on dissemination, encouraging awardees to share information and learn from each other by highlighting evaluation experiences and findings through webinars, technical assistance documents, program newsletters, and meetings and conferences.
ACF, in collaboration with HRSA, is overseeing a large-scale, random assignment evaluation of the effectiveness of the MIECHV Program: The Maternal, Infant, and Early Childhood Home Visiting Evaluation (MIHOPE).
On July 1, 2022, HRSA awarded $1.5 million to Johns Hopkins University to support a cooperative agreement for the Home Visiting Research and Development (R&D) Platform.
This funding aims to develop and maintain one transdisciplinary research network for scientific collaboration and infrastructure building for innovative home visiting research. The research network will work toward advancing the field of precision home visiting to better understand how home visiting programs impact families.
During the five-year funding period, the awardee will focus on growing the network, advancing innovative research methods, promoting data sharing and partnerships, and mentoring the next generation of early childhood researchers. Find out more information at the Home Visiting Applied Research Collaborative’s website.
The Measuring Implementation Quality in MIECHV-Funded Evidence-Based Home Visiting Programs Evaluation aims to identify how implementation quality measurement can better support MIECHV awardees in program decision making. Implementing evidence-based home visiting programs in alignment with model fidelity and implementation standards is important for achieving expected outcomes. However, there is no agreed-upon conceptualization of home visiting implementation quality and limited evidence about which specific features of implementation promote better family outcomes. To address these gaps, HRSA, in collaboration with the Administration for Children and Families (ACF), contracted with Child Trends and James Bell Associates to develop a conceptual framework for implementation quality in home visiting.
The conceptual framework presented in this report offers people working in the home visiting field a way of thinking about implementation quality across all levels of the home visiting system and across broad aspects of quality. The framework can be used as a guide for reflecting on their own efforts to promote implementation quality.
A Home Visiting Implementation Quality Conceptual Framework
- Conceptual Framework (PDF - 260 KB)
- A Conceptual Framework for Implementation Quality in Home Visiting (PDF - 2 MB)
- Quality Considerations Across Levels of the Home Visiting System: A Literature and Measure Review (PDF - 893 KB)
- A Conceptual Framework for Implementation Quality in Home Visiting Overview Video
Study Designs for Home Visiting Implementation Quality
- A Study Design Exploring Virtual Service Delivery in Home Visiting (PDF - 1 MB)
- A Study Design Exploring Family Voice and Leadership in Home Visiting (PDF - 1 MB)
- A Study Design for Developing a Measure of Commitment to Promoting Racial Equity in Home Visiting (PDF - 2 MB)
- A Study Design Exploring Time Allocated to Supervision and Home Visitor Self-Efficacy and Job Satisfaction (PDF - 1 MB)
- A Study Design to Explore Service Coordination in Home Visiting (PDF - 2 MB)
The goal of the Home Visiting Assessments of Implementation Quality project is to better understand the relationships between home visiting implementation quality, improved service delivery, and improved caregiver and child outcomes. This project builds on the aforementioned home visiting implementation quality conceptual framework, which describes key aspects or quality threads that are thought to guide how home visiting programs are designed and implemented, influencing the quality of home visiting services and positive outcomes, and home visiting implementation quality study designs. Contracted by HRSA, Child Trends and James Bell Associates have engaged MIECHV awardees and subject matter experts to prioritize which implementation quality thread to prioritize and to refine the designs. The project team will implement studies designed to better understand equity, supervision, and family voice and leadership and how they impact home visiting quality and outcomes.
The COVID-19 public health emergency amplified and exacerbated systemic health, social, and economic disparities that disproportionately impact communities with a history of racial segregation, social disadvantage (i.e., poverty, limited access to community services, and economic instability), and systemic disinvestment. Additionally, these communities, who are considered “at-risk” for undue burden due to pre-existing inequities, experienced excessive COVID-19 cases and deaths. HRSA contracted with Child Trends to conduct the Advancing Health Equity in Response to the COVID-19 Public Health Emergency project to explore the role that MIECHV-funded evidence-based home visiting programs played in advancing health equity among families and communities who were disproportionately impacted by COVID-19. Understanding how MIECHV-funded programs and home visiting services supported families in communities challenged by disparate health, social, and economic outcomes can inform future approaches that support well-being and build resiliency for children and families.
The project team developed a county index mapping tool to identify communities who have experienced systemic inequities and disproportionate rates of COVID-19 cases and deaths. Then, the team partnered with five select communities to better understand the hardships the community faced due to the public health emergency and systemic inequities, the ways home visiting programs supported health equity during unprecedented times, and each community’s strengths and efforts to reduce undue burden from the COVID-19 pandemic.
In response to the COVID-19 public health emergency, home visiting models, awardees, and LIAs adapted their approach to delivering home visiting services to meet rapidly evolving public health guidance, while maintaining alignment with home visiting model quality standards. As information emerges about these adaptations, it is important to understand which have the potential to strengthen and optimize service delivery moving forward. HRSA contracted with Policy & Research Group to conduct the Assessing and Describing Practice Transitions Among Evidence-Based Home Visiting Programs in Response to the COVID-19 Public Health Emergency (ADAPT-HV) project to identify and test elements of home visiting service delivery implementation changes. The project will generate new information about home visiting adaptations during the COVID-19 pandemic by identifying and defining changes in service delivery and designing and conducting rapid cycle and iterative tests to better understand their efficacy.