Evidence-Based Home Visiting Models Model Fact Sheets Fact Sheet: Early Head Start PROGRAM SPECIFICS EHS PROGRAM HIGHLIGHTS: • CHILD SCREENING: All children receive developmental & sensory screening inc. cognitive, behavioral, vision, hearing & a dental exam. Children are referred for necessary care Population & age served Curriculum Data System/Tech requirements • MEDICAL HOME: All children must receive medical & dental visits and all families are linked to a medical home Low-income pregnant women and families with children birth to age 3; at least 10% of enrollment must be available to children with disabilities (eligible for Part C) No specific required curriculum. Program must select an inhome, group-based curriculum. No specific infrastructure or data system requirements • MATERNAL CARE: Pregnant women are screened for PPD and are referred for prenatal and postpartum care • ON-GOING ASSESSMENTS: Continual developmental and health/risk assessments for children and pregnant women • SOCIO-ECONOMIC SUPPORT: Assistance with issues such as food, housing, utilities, & referrals HOME VISIT LOGISTICS: • PARENTING SKILLS: Family literacy & parent training skills • Home Visitors: Paraprofessional Home Visitors • Caseload per Home Visitor: 12 Families Early Head Start Average Costs: • Onset, Duration, Frequency of Visits: 1 home visit per family per week for a minimum of 90 minutes, prenatally through age 3 • No information is available • Group socialization activities: minimum 2 per month Maternal Health Child Health Evidence-based outcomes Improved maternal and newborn health MIEC Benchmarks Child Development & School Readiness Positive Parenting YES YES Improvement in School Readiness & Achievement Child Maltreatment Family Economic Self Sufficiency Linkages & Referrals Juvenile Delinquency, Family Violence, Crime Improvements in the coordination and referrals for other community resources and supports Reduction in Crime or Domestic Violence YES Prevention of child injuries, abuse, neglect, maltreatment, and reduction of emergency dept. visits Improvements in family economic selfsufficiency Fact Sheet: Family Check Up Theoretical model: PROGRAM SPECIFICS •The Family Check-Up (FCU) model is the cornerstone of a more general intervention framework referred to as an Ecological Approach to Family Intervention and Treatment (EcoFIT). FCU is designed to address a range of needs of families from prevention to treatment for children ranging in age from 2 to 17 years old. In contrast to traditional clinical models, FCU utilizes a health maintenance model involving regular periodic contact between client and provider to prevent problems proactively. Population & age served Curriculum Data System/Technology Requirements Families with children from 2-17 years old, with risk factors including socioeconomic, academic failure, depression and risk for early substance abuse Everyday Parenting High-speed internet to upload digital images of intervention sessions for supervision HOME VISIT LOGISTICS: • Home Visitors: a parent consultant who has been trained in the program model and has an advanced degree in psychology or a related field • Caseload per Home Visitor: not specified Family Check Up Average Costs: no information available Maternal Health Evidence-based outcomes MIEC Benchmarks Child Health • Onset, Duration, Frequency of Visits: 3 initial home visits, followed by Everyday Parenting curriculum and annual “checkups” Child Development & School Readiness Positive Parenting YES YES YES Improved maternal and newborn health Improvement in School Readiness & Achievement Child Maltreatment Family Economic Self Sufficiency Linkages & Referrals Juvenile Delinquency, Family Violence, Crime Prevention of child injuries, abuse, neglect, maltreatment, and reduction of emergency dept. visits Improvements in family economic selfsufficiency Improvements in the coordination and referrals for other community resources and supports Reduction in Crime or Domestic Violence Fact Sheet: Healthy Families America HFA PROGRAM HIGHLIGHTS: PROGRAM SPECIFICS •PROMOTE FAMILY WELLNESS :Help families access primary care and track immunizations Population & age served Curriculum Data System/Technology Requirements Varies, typically first time parents/ children at risk for abuse/neglect HFA does not require a specific curriculum. Online database •CHILD SCREENING: All children receive developmental screening •ON-GOING ASSESSMENTS: Continual developmental and health/risk assessments for children •FAMILY GOAL SETTING: Family centered approach focused on dyad and family’s goals; create a family plan. Inclusive of fathers •SOCIO-ECONOMIC SUPPORT: Assistance, referrals, and connections to community resources around issues such as food, housing, utilities, job training HOME VISIT LOGISTICS: • Home Visitors: Paraprofessional Home Visitors •PARENTING SKILLS: Promotes positive parenting • Caseload per Home Visitor: 15 Families Healthy Families America Average COSTS: • According to a survey conducted in 2004 of HFA programs in 15 states, the average cost of HFA per family per year is $3,348, with a range of $1,950 to $5,768. Maternal Health Evidence-based outcomes Child Health Child Development & School Readiness Positive Parenting Child Maltreatment Family Economic Self Sufficiency Linkages & Referrals Juvenile Delinquency, Family Violence, Crime YES YES YES YES YES YES YES Prevention of child injuries, abuse, neglect, maltreatment, and reduction of emergency dept. visits Improvements in family economic selfsufficiency Improvements in the coordination and referrals for other community resources and supports Reduction in Crime or Domestic Violence Improved maternal and newborn health MIEC Benchmarks • Onset, Duration, Frequency of Visits: Biweekly visits for prenatal participants, changing to weekly for 6 months postpartum, and tapering to biweekly. Visits typically 1 hour. Services continue until child is 3-5 years old. Improvement in School Readiness & Achievement Fact Sheet: Healthy Steps HEALTHY STEPS PROGRAM HIGHLIGHTS: PROGRAM SPECIFICS • PARENT-PROVIDER RELATIONSHP BUILDING: Services provided by a pediatric or family practice. Relationship building to address and developmental and emotional needs of young children. Population & age served • WELL CHILD & FAMILY CHECK-UP: Well child visits with clinician and home visitor & regular family check-ups Children birth to age 3 Curriculum Data System/Technology Requirements Strategies for Change Unknown • CHILD HEALTH SCREENINGS: All children receive health & developmental screenings • PARENT EDUCATION: Help parents learn about early child health and development • FAMILY SUPPORT: Linkages and referrals to community resources HOME VISIT LOGISTICS: HEALTHY STEPS COSTS: • Home Visitors: Professional Home Visitors (bachelor’s degree with advanced training) • START-UP COSTS: $10,000-$15,000 (3 staffaverage) • Caseload per Home Visitor: 150-300 • Onset, Duration, Frequency of Visits: different levels of intensity ranging from 2 visits between birth and 12 months (low intensity) to 5 visits between birth and 30 months (high intensity) • AVERAGE ANNUAL AGENCY COST: $29,000 $82,600 per year per 100/200 families ($290-$413 per family) Maternal Health Evidence-based outcomes Child Health Child Development & School Readiness Positive Parenting YES YES YES Improved maternal and newborn health MIEC Benchmarks Improvement in School Readiness & Achievement Child Maltreatment Family Economic Self Sufficiency Linkages & Referrals Juvenile Delinquency, Family Violence, Crime Prevention of child injuries, abuse, neglect, maltreatment, and reduction of emergency dept. visits Improvements in family economic selfsufficiency Improvements in the coordination and referrals for other community resources and supports Reduction in Crime or Domestic Violence Fact Sheet: Home Instruction Program for Preschool Youngsters (HIPPY) PROGRAM SPECIFICS Theoretical Model: HIPPY is a home-based, family-focused program model that helps parents support the development of their preschool children. HIPPY believes that parents are crucial to the early education of children. The HIPPY program supports parents who may not feel confident in fostering school readiness for their children and is designed to remove barriers to participation in education. It is delivered by home visitors who are members of the participating communities and parents in the program. Population & age served Curriculum Data System/Technology Requirements Parents who have doubts about or lack confidence in their ability to instruct their children and prepare them for school. Series for 3-yearolds, 4year-olds, & 5-yearolds Online data management program HOME VISIT LOGISTICS: • Home Visitors: recruited from local community and have a child of HIPPY-age, or have access to a practice child they can engage in the HIPPY curriculum • Caseload per Home Visitor: 25 children per full-time HV • Onset, Duration, Frequency of Visits: this is a 2 or 3 year program for 3-, 4-, and 5-year-olds, providing bi-weekly visits HIPPY Average Costs: $1,250 per child per year Maternal Health Child Health Evidence-based outcomes Improved maternal and newborn health MIEC Benchmarks Child Development & School Readiness Positive Parenting YES YES Improvement in School Readiness & Achievement Child Maltreatment Family Economic Self Sufficiency Linkages & Referrals Juvenile Delinquency, Family Violence, Crime Prevention of child injuries, abuse, neglect, maltreatment, and reduction of emergency dept. visits Improvements in family economic selfsufficiency Improvements in the coordination and referrals for other community resources and supports Reduction in Crime or Domestic Violence Fact Sheet: Nurse-Family Partnership Theoretical Model PROGRAM SPECIFICS NFP is shaped by human attachment, human ecology, and self-efficacy theories. The nurse home visitors use principles of motivational interviewing to promote lowincome, first-time mothers’ health during pregnancy, care of their child, and own personal growth and development. Nurse home visitors guide parents to reinforce the model’s goals. Population & age served Curriculum Data System/Technology Requirements First-time, low-income mothers and their children, from pregnancy until 2years-old NFP visitby-visit guidelines Web-based data system HOME VISIT LOGISTICS: • Home Visitors: registered professional nurses with baccalaureate degree in nursing Nurse-Family Partnership Average Costs: • $4,500 per family per year (with a range of $2,914 to $6,463). The driving factor of cost is local nurse salaries. Evidence-based outcomes • Onset, Duration, Frequency of Visits: biweekly in prenatal period, then weekly for first 6 weeks, biweekly until 20 months, then monthly until 24 months; typically 75 mins. Maternal Health Child Health Child Development & School Readiness Positive Parenting Child Maltreatment Family Economic Self Sufficiency YES YES YES YES YES YES Prevention of child injuries, abuse, neglect, maltreatment, and reduction of emergency dept. visits Improvements in family economic selfsufficiency Improved maternal and newborn health MIEC Benchmarks • Caseload per Home Visitor: no more than 25 clients Improvement in School Readiness & Achievement Linkages & Referrals Juvenile Delinquency, Family Violence, Crime YES Improvements in the coordination and referrals for other community resources and supports Reduction in Crime or Domestic Violence Fact Sheet: Parents as Teachers PAT PROGRAM HIGHLIGHTS: PROGRAM SPECIFICS • PARENT EDUCATION/ SCHOOL READINESS: Help parents learn about early child development and prepare their children for educational success Population & age served • CHILD SCREENING: All children receive health, vision, hearing & developmental screening Parents and pregnant women to Kindergarten (programs define eligibility) • SOCIO-ECONOMIC SUPPORT: Linkages and referrals to community resources Curriculum Data System/Technology Requirements PAT Born to Learn curriculum Web-based data management system • PARENTING SKILLS: Promotes positive parenting skills Parents As Teachers AVERAGE COSTS: HOME VISIT LOGISTICS: $1,400-$1,500 per family per year • Home Visitors: Paraprofessional Home Visitors • Caseload per Home Visitor: Site specific; recommend no more than 48 visits per month • Onset, Duration, Frequency of Visits: At least one visit a month, visits can be weekly or biweekly; visits last 50-60 minutes; each program determines length of service (minimum 2 years) Maternal Health Child Health Evidence-based outcomes Improved maternal and newborn health MIEC Benchmarks Child Development & School Readiness Positive Parenting YES YES Improvement in School Readiness & Achievement Child Maltreatment Family Economic Self Sufficiency Linkages & Referrals Juvenile Delinquency, Family Violence, Crime Prevention of child injuries, abuse, neglect, maltreatment, and reduction of emergency dept. visits Improvements in family economic selfsufficiency Improvements in the coordination and referrals for other community resources and supports Reduction in Crime or Domestic Violence More Model Information • For additional information on all Evidence-Based Home Visiting Models visit the US Dept of Health and Human Services (HHS) Home Visiting Evidence of Effectiveness website: http://homvee.acf.hhs.gov/Default.aspx • Early Head Start: http://www.acf.hhs.gov/programs/ohs/ • Family Check Up: http://www.uoregon.edu/~cfc/educa-training.htm • Healthy Families America: www.healthyfamiliesamerica.org • Healthy Steps: http://www.healthysteps.org • Home Instruction for Parents of Preschool Youngsters (HIPPY): www.hippyusa.org • Nurse-Family Partnership: http://www.nursefamilypartnership.org • Parents as Teachers: www.parentsasteachers.org