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Case Study: HomVEE Literature Review Identifies Effective Home Visiting Programs
Mathematica works collaboratively with an interagency group including representatives from OPRE, ACF; the Children’s Bureau; the Centers for Disease Control (CDC); the Health Resources and Services Administration (HRSA); and the Office of the Assistant Secretary for Planning and Evaluation (ASPE).
The findings from the HomVEE study are publicly available at the HomVEE website (homvee.acf.hhs.gov), and updated annually.
Home visiting programs for pregnant women and young children are used across the United States, yet not all models have been rigorously evaluated to test whether they improve health and development outcomes for children and/or families. The ACA allocated $1.5 billion for the MIECHV program to establish home visiting programs for at-risk pregnant women and children up to age 5. The law also stipulated that 75 percent of this funding be allocated to programs with evidence of effectiveness based on rigorous evaluation research. HomVEE was launched in fall 2009 to review existing research literature on home visiting programs and to identify programs that have evidence of effectiveness. The review is updated annually.
For the initial review, Mathematica worked with a DHHS interagency group to design and carry out a thorough and transparent review of the literature on home visiting. The HomVEE project took steps to identify models that were shown to lead to improvements in health and development outcomes for children and their families. Mathematica (1) conducted a broad literature search; (2) screened studies for relevance; (3) prioritized program models for the review; (4) rated the quality of impact studies with eligible designs; (5) assessed the evidence of effectiveness for each model; (6) reviewed implementation information for each model; and (7) addressed potential conflicts of interest. These steps are repeated each year.
Among the 35 program models that have been prioritized for review as of 2013, HomVEE identified 14 models that met the DHHS criteria for an evidence-based early childhood home visiting delivery model. For each model, the review described outcomes across eight domains as well as relevant implementation guidelines.
The evidence review found that most of the models that met the DHHS criteria for an evidence-based model had favorable impacts on child development and school readiness and positive parenting practices.
The funding stipulations in the ACA support the implementation of the 14 programs that were demonstrably successful at producing favorable outcomes for children and families through home visits. Based on rigorous past research, as identified and assessed in the HomVEE project, these programs have the potential to improve the health and well-being of children and families across the country.
This case study is for informational purposes only. Mathematica Policy Research, a nonpartisan research firm, provides a full range of research and data collection services, including program evaluation and policy research, survey design and data collection, research assessment and interpretation, and program performance/data management, to improve public well-being. Its clients include federal and state governments, foundations, and private-sector and international organizations. The employee-owned company, with offices in Princeton, N.J.; Ann Arbor, Mich.; Cambridge, Mass.; Chicago, Ill.; Oakland, Calif.; and Washington, D.C., has conducted some of the most important studies of education, disability, health care, family support, employment, nutrition, and early childhood policies and programs.
The 2010 Patient Protection and Affordable Care Act (ACA) allocated $1.5 billion over five years for the new Maternal, Infant and Early Childhood Home Visiting Program (MIECHV) to establish home visiting programs for at-risk pregnant women and children up to age 5. As a requirement in the law, 75 percent of a State’s MIECHV funding must be put towards home visiting programs with evidence of effectiveness based on rigorous evaluation research.
In 2009, the U.S. Office of Planning Research, and Evaluation at the Administration for Children and Families at the Department of Health and Human Services (DHHS) contracted with Mathematica to conduct the Home Visiting Evidence of Effectiveness (HomVEE) project, a systematic review of home visiting research that identifies effective program models.