Evidence-Based Home Visiting Models

1. Evidence-Based Home Visiting Models Model Fact Sheets

3. EHS PROGRAM HIGHLIGHTS: • CHILD SCREENING: All children receive developmental & sensory screening inc. cognitive, behavioral, vision, hearing & a dental exam. Children are referred for necessary care • MEDICAL HOME: All children must receive medical & dental visits and all families are linked to a medical home • MATERNAL CARE:Pregnant women are screened for PPD and are referred for prenatal and postpartum care • ON-GOING ASSESSMENTS: Continual developmental and health/risk assessments for children and pregnant women • SOCIO-ECONOMIC SUPPORT:Assistance with issues such as food, housing, utilities, & referrals • PARENTING SKILLS: Family literacy & parent training skills Fact Sheet: Early Head Start • HOME VISIT LOGISTICS: • Home Visitors:Paraprofessional Home Visitors • Caseload per Home Visitor:12 Families • Onset, Duration, Frequency of Visits: 1 home visit per family per week for a minimum of 90 minutes, prenatally through age 3 • Group socialization activities: minimum 2 per month • Early Head Start Average Costs: • No information is available

4. Fact Sheet: Family Check Up Theoretical model: • The Family Check-Up (FCU) model is the cornerstone of a more general intervention framework referred to as an Ecological Approach to Family Intervention and Treatment (EcoFIT). FCU is designed to address a range of needs of families from prevention to treatment for children ranging in age from 2 to 17 years old. In contrast to traditional clinical models, FCU utilizes a health maintenance model involving regular periodic contact between client and provider to prevent problems proactively. • HOME VISIT LOGISTICS: • Home Visitors: a parent consultant who has been trained in the program model and has an advanced degree in psychology or a related field • Caseload per Home Visitor:not specified • Onset, Duration, Frequency of Visits: 3 initial home visits, followed by Everyday Parenting curriculum and annual “check-ups” Family Check Up Average Costs: no information available

5. HFA PROGRAM HIGHLIGHTS: • PROMOTE FAMILY WELLNESS :Help families access primary care and track immunizations • CHILD SCREENING: All children receive developmental screening • ON-GOING ASSESSMENTS: Continual developmental and health/risk assessments for children • FAMILY GOAL SETTING: Family centered approach focused on dyad and family’s goals; create a family plan. Inclusive of fathers • SOCIO-ECONOMIC SUPPORT:Assistance, referrals, and connections to community resources around issues such as food, housing, utilities, job training • PARENTING SKILLS: Promotes positive parenting Fact Sheet: Healthy Families America • HOME VISIT LOGISTICS: • Home Visitors:Paraprofessional Home Visitors • Caseload per Home Visitor:15 Families • Onset, Duration, Frequency of Visits:Biweekly visits for prenatal participants, changing to weekly for 6 months postpartum, and tapering to biweekly. Visits typically 1 hour. Services continue until child is 3-5 years old. • Healthy Families America Average COSTS: • According to a survey conducted in 2004 of HFA programs in 15 states, the average cost of HFA per family per year is $3,348, with a range of $1,950 to $5,768.

6. HEALTHY STEPS PROGRAM HIGHLIGHTS: • PARENT-PROVIDER RELATIONSHP BUILDING: Services provided by a pediatric or family practice. Relationship building to address and developmental and emotional needs of young children. • WELL CHILD & FAMILY CHECK-UP: Well child visits with clinician and home visitor & regular family check-ups • CHILD HEALTH SCREENINGS: All children receive health & developmental screenings • PARENT EDUCATION: Help parents learn about early child health and development • FAMILY SUPPORT: Linkages and referrals to community resources Fact Sheet: Healthy Steps • HOME VISIT LOGISTICS: • Home Visitors: Professional Home Visitors (bachelor’s degree with advanced training) • Caseload per Home Visitor:150-300 • Onset, Duration, Frequency of Visits:different levels of intensity ranging from 2 visits between birth and 12 months (low intensity) to 5 visits between birth and 30 months (high intensity) • HEALTHY STEPS COSTS: • START-UP COSTS:  $10,000-$15,000 (3 staff- average) • AVERAGE ANNUAL AGENCY COST: $29,000 - $82,600 per year per 100/200 families ($290-$413 per family)

7. Fact Sheet: Home Instruction Program for Preschool Youngsters (HIPPY) Theoretical Model: HIPPY is a home-based, family-focused program model that helps parents support the development of their preschool children. HIPPY believes that parents are crucial to the early education of children. The HIPPY program supports parents who may not feel confident in fostering school readiness for their children and is designed to remove barriers to participation in education. It is delivered by home visitors who are members of the participating communities and parents in the program. • HOME VISIT LOGISTICS: • Home Visitors: recruited from local community and have a child of HIPPY-age, or have access to a practice child they can engage in the HIPPY curriculum • Caseload per Home Visitor:25 children per full-time HV • Onset, Duration, Frequency of Visits: this is a 2 or 3 year program for 3-, 4-, and 5-year-olds, providing bi-weekly visits HIPPY Average Costs: $1,250 per child per year

8. Fact Sheet: Nurse-Family Partnership Theoretical Model NFP is shaped by human attachment, human ecology, and self-efficacy theories. The nurse home visitors use principles of motivational interviewing to promote low-income, first-time mothers’ health during pregnancy, care of their child, and own personal growth and development. Nurse home visitors guide parents to reinforce the model’s goals. • HOME VISIT LOGISTICS: • Home Visitors: registered professional nurses with baccalaureate degree in nursing • Caseload per Home Visitor:no more than 25 clients • Onset, Duration, Frequency of Visits: biweekly in prenatal period, then weekly for first 6 weeks, biweekly until 20 months, then monthly until 24 months; typically 75 mins. • Nurse-Family Partnership Average Costs: • $4,500 per family per year (with a range of $2,914 to $6,463). The driving factor of cost is local nurse salaries.

9. PAT PROGRAM HIGHLIGHTS: • PARENT EDUCATION/ SCHOOL READINESS: Help parents learn about early child development and prepare their children for educational success • CHILD SCREENING: All children receive health, vision, hearing & developmental screening • SOCIO-ECONOMIC SUPPORT: Linkages and referrals to community resources • PARENTING SKILLS: Promotes positive parenting skills Fact Sheet: Parents as Teachers Parents As Teachers AVERAGE COSTS: $1,400-$1,500 per family per year • HOME VISIT LOGISTICS: • Home Visitors:Paraprofessional Home Visitors • Caseload per Home Visitor:Site specific; recommend no more than 48 visits per month • Onset, Duration, Frequency of Visits:At least one visit a month, visits can be weekly or biweekly; visits last 50-60 minutes; each program determines length of service (minimum 2 years)

10. More Model Information • For additional information on all Evidence-Based Home Visiting Models visit the US Dept of Health and Human Services (HHS) Home Visiting Evidence of Effectiveness website: http://homvee.acf.hhs.gov/Default.aspx • Early Head Start:http://www.acf.hhs.gov/programs/ohs/ • Family Check Up: http://www.uoregon.edu/~cfc/educa-training.htm • Healthy Families America:www.healthyfamiliesamerica.org • Healthy Steps: http://www.healthysteps.org • Home Instruction for Parents of Preschool Youngsters (HIPPY): www.hippyusa.org • Nurse-Family Partnership: http://www.nursefamilypartnership.org • Parents as Teachers:www.parentsasteachers.org