Early Childhood Investments | Home Visiting

Taking Evidence-Based Home Visiting Programs to Scale in Texas 

Voluntary home visiting programs support and educate expectant parents and families of young children to improve maternal and child health, support child development, and increase family economic self-sufficiency. Though the programs have rapidly expanded across the country over the last four decades as an evidence-based policy choice for supporting families with young children, selecting an evidence-based model does not ensure effectiveness. Implementation is also a key determinant of whether or not children and families benefit from these programs. CFRP is conducting a long-term implementation evaluation of the Texas Home Visiting Program (THV), one of the largest federally-funded home visiting programs in the country. The overarching focus of the evaluation is to understand the factors that advance or limit the successful implementation of evidence-based home visiting programs and the ability of programs to produce positive outcomes for families with young children. Findings and lessons learned from this evaluation continue to inform the state’s efforts to expand THV and will contribute to the larger implementation science knowledge base.

Family Retention in Home Visiting Programs 

One of the keys to successful implementation of evidence-based home visiting programs is the capacity to recruit, enroll, and retain participants in the model’s target population. Because home visiting programs target high-need families, keeping them engaged in the program is difficult. Attrition is common across home visiting programs with an average of 50 percent of families leaving prior to completing the program. However, there is little known about how families leave home visiting programs or why they leave. Thus CFRP is studying how, when, and why families leave home visiting programs; which families are the most likely to leave; and how father involvement in the programs relates to family retention. This understanding will enhance the ability of home visiting programs to improve child and family outcomes.

Describing the Value of Home Visiting for Participating Families

Research indicates that evidence-based home visiting programs should benefit the families who participate in them through improvements in maternal and child health, parenting attitudes and behaviors, better cognitive and social-emotional outcomes for children, and a lower incidence of child abuse and maltreatment. However, existing performance measures do not measure all of the ways participation in home visiting programs is related to positive outcomes for children and families.  Given the high level of investment at the federal and state level into evidence-based home visiting programs, identifying the extent to which home visiting programs provide value for families and children even if they do not complete the program is important for demonstrating home visiting as a sound investment. The Texas Department of Family and Protective Services continues to invest in home visiting programs as an important support for families and has prioritized understanding the ways in which home visiting programs provide value for families. CFRP is working with the department’s Prevention and Early Intervention division to conduct an exploratory descriptive evaluation to identify the ways in which home visiting programs provide value to participating families and how these benefits vary across family and program factors.


More Early Childhood Investments projects: Public Prekindergarten


Related Publications and Posts

Title Type Date
Retaining Families in Home Visiting Programs by Promoting Father Participation Brief 2017 May
New Survey Instrument to Help Determine the Value of Home Visiting Post 2017 May
Home Visiting Program: Four Evidence-Based Lessons for Policymakers (Behavioral Science & Policy Journal) Publication 2017 February
Family Retention in Home Visiting Powerpoint 2015 October
The Top 5 Benefits of Home Visiting Programs (English) Post 2015 June
The Top 5 Benefits of Home Visiting Programs (Spanish) Post 2015 June
Pre-K is Good for Kids and For Texas: Short-term Savings from Pre-K Estimated at Nearly $142 Million Annually Brief 2015 April
What Should be Expected When Taking Home Visiting Programs to Scale? Brief 2015 April
From Randomized Controlled Trials to Community-Level Change: What Should Be Expected When Taking Home Visiting Programs to Scale? Working Paper 2015 April
Reality Check: Can the Effects of Home Visiting Programs Found in RCTs Be Replicated in the Real World? Working Paper 2015 April
5 things you should know about Home Visiting in Texas: A Two-Generation Approach to Supporting Families Post 2014 December
Two-Generation Approaches to Breaking the Cycle of Poverty News Post 2014 November
Special Event: Toxic Stress and Early Childhood Event 2014 November
Home Visiting Programs in Texas: Working Toward Being a Better State for Children News Post 2014 July
Increasing Father Participation in Home Visiting: Lessons from Mothers Brief 2014 May
"Expectations of Outcomes" from Variation in Service Delivery and Family Outcomes across the Texas Home Visiting Program Report Excerpt 2014 March
Early Lessons Learned from Building Local Early Childhood Comprehensive Systems in Texas (Journal of Applied Research on Children) Publication  Volume 5 Issue 1 (2014)
Perspective from Texas: Investing in Home Visiting Programs Not Prisons News Post 2013 October
Implementation Not Evidence-Base is the Key to Home Visiting Program Success News Post 2013 October
"Lessons Learned" from Observations and Early Findings from the Evaluation of the First Year of the Texas Home Visiting Program Report Excerpt 2013 September
Maternal Depression and Home Visiting Programs News Post 2013 July
Early Childhood Education is Linked to Greater Success in School News Post 2013 May
How to Involve Fathers in Home Visiting Programs News Post 2013 May