Evaluating and Supporting Pennsylvania’s Home Visiting Programs
Statement of Problem
Home visiting programs provide voluntary, in-home services to under-resourced pregnant mothers and families of young children. Since 2010, the Health and Resources Administration (HRSA) in partnership with the Administration of Children and Families (ACF) has supported the expansion of evidence-based home visiting programs into communities across the country through the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program. MIECHV allows states, territories, and tribal entities to maintain and grow the evidence-based or promising programs of their choice—all of which support important aspects of child and family well-being including maternal and caregiver health, parenting and child development promotion approaches and school readiness.
The MIECHV investment supports states’ growth of evidence-based and promising home visiting services along with evaluation of home visiting performance. The focus on evaluation is critical, as the impact of these programs may be influenced by the way they are implemented across a diversity of clients, staff, health systems, and geographies within and across states nationwide.
Part of the multi-pronged data and evaluation requirements for MIECHV include a required needs assessment conducted every four years to identify the communities most in need of services and assess current capacity of home visiting programming so they can strategically allocate resources for these community-based public health services. Needs assessments are foundational public health tools for assessing a population’s risks, strengths, opportunities and trends over time.
The Commonwealth of Pennsylvania has been a national leader in supporting rigorous evaluation efforts of state-funded early childhood programs. PolicyLab partnered with Pennsylvania’s Office of Child Development and Early Learning (OCDEL) on the evaluation of the state’s MIECHV-funded home visiting programs (Nurse-Family Partnership, Parents as Teachers, Early Head Start and Healthy Families America) between 2011-2017.
Over the five years of conducting this evaluation, we learned a lot about how the expansion of home visiting services through federal funding has worked for Pennsylvanian families. For example, families are highly satisfied with the services they receive through these programs and feel participation helps socially and mentally prepare their children for school. On the other hand, we also identified areas that need additional attention, including injury prevention. For a comprehensive overview of our evaluation results, read this blog post or watch this webinar.
More recently, PolicyLab partnered with OCDEL to conduct a county-level needs assessment of the health of children, mothers, and families as well as the social and environmental conditions of communities across the state during the period of January 2019 to October 2020. Utilizing numerous methods of data collection, such as community surveys and stakeholder interviews, the 2020 Family Support Needs Assessment categorizes Pennsylvania’s 67 counties as having low, moderate, or elevated need across six domains: maternal and child health, socioeconomic status, substance use, child safety and maltreatment, community environment and child care. Additionally, the report spotlights local service providers who are making a difference in addressing the elevated needs of their communities.
The assessment showed improvement across several maternal and child health outcomes since the last report in 2014, such as:
- Improved rates of preterm and teen births (for nearly every county)
- Infant mortality (60% of counties saw improvements)
- Childhood poverty (almost half of counties saw a reduction in the percentage of children under age 5 living in poverty)
The report also sheds light on areas of need. Overall, findings demonstrate that substance use, mental health, economic needs (e.g., unemployment), and intimate partner violence are among the most pronounced issues facing families of young children across urban and rural communities in Pennsylvania. It is important to note that all data collection occurred prior to COVID-19, and the team anticipates that the pandemic exacerbated many areas of community need. View the “Research in Motion” video below for an overview of our findings and the methods we developed to support communities with identifying local maternal and child health needs.
Read the full 2020 Family Support Needs Assessment and one-page summary on the Department of Human Services’ website, as well as a press release that outlines the key findings from the needs assessment. We also developed a set of topic-specific briefs with data reviews from the 2020 Pennsylvania Family Support Needs Assessment, including:
The team continues to disseminate the needs assessment findings to communities across Pennsylvania, breaking down the results into digestible briefs and blog posts focused on specific issues. We also continue to be involved in work to evaluate and support family-serving programs in the Commonwealth and are designing and testing innovative new models of delivering community-based family support programs in collaboration with health systems.
This project page was last updated in September 2022.
Children's Hospital of Philadelphia, PolicyLab. Evaluating and Supporting Pennsylvania’s Home Visiting Programs [online]. Available at: http://www.policylab.chop.edu. [Accessed: plug in date accessed here].