Considerations on the Implementation, Innovation, and Improvement of Evidence-Based Home Visiting Programs

Abstract

Home visiting as an approach to deliver services to at-risk young children and families, particularly mothers, has grown in visibility and acceptance. Home visiting has been endorsed by many organizations, including those in the business community, and research reviews have found supportive evidence. However, some concerns with the magnitude of home visiting outcomes and with discrepancies in replication research on identified programs in different communities have been found. A recent US federal initiative (Maternal, Infant, and Early Childhood Home Visiting [MIECHV]) funds the implementation of evidence-based programs while requiring impacts in outcome areas not necessarily identified in the research studies that supported the programs’ evidence-based designation. There exists a tension between research-identified directions for home visiting and policy-mandated directions. This chapter focuses on this tension between research, policy, and practice and the innovations needed to reduce this tension when implementing programs. The identification of evidence-based practices is discussed along with some cautions. Programs that work with at-risk families can use these research based strategies to incorporate innovative program components as they expand, allowing them to remain true to program fidelity. The goal of this chapter is to provide innovative solutions that can help programs meet required outcomes, for most families, most of the time.