Federal Investments in Evidence‐Based Early Childhood Home Visiting: A Multiple Streams Analysis

Abstract

AbstractChild poverty, child maltreatment, and child health and development are major public policy issues. By the end of the Great Recession in 2009, as many as one in four children under the age of five were living in poverty and six million children were subject to child maltreatment reports in America. For decades, evidence‐based home visiting (EBHV) programs have provided effective early interventions for preventing child maltreatment and promoting child and family outcomes to pregnant women and families with children age birth to five years old. Despite this, no widespread federal policies or funding supported home visiting before 2010. Through the Patient Protection and Affordable Care Act (ACA), the federal government invested $1.5 billion in home visiting with the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) initiative. While many articles examine the effectiveness of home visiting and call attention to the unprecedented features of MIECHV, this article applies the multiple streams framework to illuminate the unique social and political contexts culminating in the inclusion of MIECHV in ACA. The findings in this article are significant for policy analysts, advocates, and program developers and for establishing policies requiring evidence‐based practices.