• April 2010
  • Vol. 11, No. 3

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Supporting Evidence-Based Home Visiting (EBHV) Grantees: Lessons Learned From Planning Year 1

For home visiting interventions to have the greatest effects possible, the systems in which home visiting programs operate must be integrated, supportive, and conducive to service delivery. Knowledge is needed about how to build the infrastructure and service systems necessary to implement and sustain EBVH programs with fidelity to their models and whether and how to scale up these programs and adapt them for new target populations.

In 2008, the Children’s Bureau (CB) funded 17 grants, through 5-year cooperative agreements, to address this knowledge gap and prevent child maltreatment. Grantees are to leverage their grant funding with other funding sources to support the implementation of, scaling up, and sustaining home visiting programs with high fidelity to their evidence-based models. In addition, grantees will contribute to the knowledge base about large-scale implementation with fidelity by conducting local implementation and outcome evaluations, along with analysis of program costs. The first year (fiscal year [FY] 2008-2009) was a planning year; grantees are to implement their plans during the remaining 4 years (FY 2009-2010 through FY 2012-2013 subject to the availability of Federal funding). The grantees, spread across 15 States, are supporting five different home visiting models:

  • Healthy Families America
  • Nurse Family Partnership
  • Parents as Teachers
  • Positive Parenting Program
  • SafeCare

The cross-site evaluation is being conducted by Mathematica Policy Research and Chapin Hall.  The following are the lessons learned from the first year of this initiative:

  • The importance of contextual change on EBHV initiative implementation and local evaluation. All grantees have seen significant funding cuts at the Federal, State, and local levels, which will impact their ability to serve as many families as planned or in some cases may jeopardize the future of the grant. Grantees are adjusting their implementation and local evaluation plans to coincide with their current funding realities.
  • The complexity of integrating home visiting models into local service networks. Implementing home visitation models into existing local service networks requires grantees to engage with multiple partners and build capacity in key resources and functions, including planning, operations, workforce development, funding, collaboration, communication, political support, and quality assurance or program evaluation. To build infrastructure, the grantees may need to engage in even a wider array of activities than initially anticipated.  
  • The importance of establishing rigorous evaluation standards and implications for technical assistance (TA) needs and related resources. By setting high expectations, the cross-site evaluation served as a catalyst for a change process that elevated the threshold for what constituted rigorous research and identified specific areas in which greater investments in research would result in higher quality, more policy-relevant data. Although still evolving in light of the current funding situation, the process has underscored the importance of both raising expectations and articulating the types of TA and financial support required to ensure achievement of these higher standards.
  • The importance of identifying and directly addressing data ownership issues and lines of communication when implementing home visiting models. States that are implementing multiple EBHV programs, such as Illinois, New Jersey and, more recently, Utah, are already engaged in ways to integrate the various model-specific management information systems into a tool that can be used by State administrators and policymakers to better assess the combined coverage and level of effort achieved across all of the models being implemented. Creating ways in which data can be shared among State administrators, the various national models, and local researchers in a manner that addresses the diverse needs of all users will be essential.
  • The importance of creating opportunities for grantees to teach, as well as learn, from each other. The Peer Learning Network (PLN) serves as a venue for knowledge exchange among grantees. The Mathematica-Chapin Hall and FRIENDS National Resource Center team members are facilitators of the PLN and are engaging grantees and helping to identify commonalities across grantees and potential opportunities for learning.
  • Opportunities for identifying commonalities and shared learning opportunities across evidence-based models. The EBHV grant initiative offers a unique opportunity to engage multiple models around a common goal—the success of the EBHV grantees.  The Mathematica-Chapin Hall team conducted calls with the national model developers and created a forum for the national model developers to discuss the different strategies they have used to ensure high quality replication of their efforts.
  • Opportunities for identifying commonalities and shared learning opportunities across diverse Federal initiatives. There is the potential to collaborate with cross-site evaluators of other Federal initiatives, namely ECCS and Project LAUNCH, which also focus efforts on systems development and change. The effort to collaborate across Federal initiatives may produce lessons that go beyond any one initiative and can speak more broadly to the issues of infrastructure development and systems change to support high quality service provision for families and children.    
  • The importance of maintaining open and transparent communication among all partners engaged in complex initiatives. This initiative embraces a number of goals that have implications at the program, State, and Federal levels, and it addresses an array of planning and implementation concerns that impact both practice and research. Over the past year, a key implementation challenge for all of those involved has been resisting this tendency to focus on their own priorities and to embrace the need to remain fully informed of the interests, concerns, and limitations of the other partners. By requiring regular communication among all of the partners, the CB/ACF developed an environment that maximized exposure to diverse viewpoints and competing priorities.

Information about each of the 17 programs, the cross-site evaluation design, and resources on home visiting is now available through the Supporting EBHV website. The website was developed and is maintained by the FRIENDS National Resource Center for Community-Based Child Abuse Prevention:

www.supportingebhv.org

The project has also produced an online newsletter, the EBHV Connector, which can be accessed through the website and includes articles on each grantee's work:

www.supportingebhv.org/newsletter

Reference:

DelGrosso, P., & Daro, D. (2009). Cross-site evaluation of the supporting Evidence-Based Home Visiting grantees: Summary of the planning year. Children’s Bureau, Administration for Children and Families, US Department of Health and Human Services. Contract No. GS10F-0050L/HHSP233200800065W. Available from Mathematica Policy Research, Princeton, NJ.

Contributed by Melissa Brodowski, the Children's Bureau, Office on Child Abuse and Neglect

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