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 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 federal and state 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 federal and state investment at into evidence-based home visiting programs, identifying the extent to which home visiting programs provide value for families and children, even if the families 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 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. CFRP is assessing the parents and children at multiple time points, and combining these assessments with administrative data to measure the benefits families gain from varying levels of program participation.


Resources: Home Visiting Publications and Posts

More Early Childhood Investments projects: Public Prekindergarten