April 2003Vol. 4, No. 3Home Visiting Programs Help Reduce Child Maltreatment
The effectiveness of home visiting can be difficult to measure, because programs vary greatly in both design and desired outcomes. A number of recent studies, however, show home visiting can be an effective way to prevent child maltreatment in high-risk populations.
In February 2002, the Centers for Disease Control and Prevention Task Force on Community Preventive Services concluded "there is strong evidence to recommend home visitation to reduce child maltreatment." The group based this recommendation on a review of 25 studies that found an overall 39 percent reduction of child maltreatment in high-risk families.
A fact sheet released by Prevent Child Abuse America provides evidence from more than 20 evaluations that the Healthy Families America model, in particular, is effective in reducing child maltreatment and achieving other positive outcomes for children. The Healthy Families America approach to home visiting involves a wide-ranging umbrella of services, statewide infrastructures, and a framework of 12 research-based "critical elements." Findings include:
- In fiscal year 2000-2001, the child maltreatment rate among participants in a Pinellas County, Florida, program was 1.6 percent, compared to 4.9 percent for the county as a whole.
- In an evaluation of a Hawaii program, the rate of substantiated cases of child maltreatment for families receiving program services was found to be less than half that of a control group (3.3 percent vs. 6.8 percent).
- Healthy Families Maryland had only two indicated reports of child maltreatment (both for neglect) among 254 families served in 4 years of program operation (a rate of .8 percent).
The document, Healthy Families America Reduces Child Maltreatment, is one of a series of fact sheets about the program. The series can be found on the Prevent Child Abuse America website at http://www.healthyfamiliesamerica.org/downloads/hfa_fact_a.pdf.
Other sources of information about home visiting models:
- An article in the December 2002 issue of Archives of Pediatrics and Adolescent Medicine, "Effect of Volunteer Home Visitation for Adolescent Mothers on Parenting and Mental Health Outcomes," presents the findings of a study that used volunteers to teach a parenting curriculum to adolescent parents. Participating parents showed significantly increased parenting behavior scores compared to a control group. Read an abstract on the American Medical Association website at http://archpedi.ama-assn.org/cgi/content/short/156/ 12/1216.
- The National Governors Association Center for Best Practices bulletin, The Benefits and Financing of Home Visiting Programs, focuses on how States fund home visiting programs using Medicaid, Title V Maternal and Child Health Services Block Grant funds, and Temporary Assistance for Needy Families. This document is available online in text format at www.nga.org/common/issueBriefDetailPrint/1,1434,3927,00.html (note: this link is no longer available) or as a PDF file at www.nga.org/cda/files/BENEFITSFINANCINGHOME.pdf.
- The Promising Practices Network (www.promisingpractices.net) gives the Nurse Family Partnership (formerly the Prenatal and Infancy Nurse Home Visitation Program) a rating of "proven." Find their overview of the program at www.promisingpractices.net/program.asp?programid= 16&benchmarkid=8.
Read more in "Home Visitation Measured as a Way to Prevent Child Abuse" in the November 2000 issue of Children's Bureau Express.