Understanding and Expanding the Reach of Home Visiting (HV-REACH)

2021 - 2026

Maternal, infant, and early childhood home visiting, an evidence-based service delivery model, can support child and maternal health, child development and school readiness, and family economic self-sufficiency, and help reduce child abuse and neglect. According to the National Home Visiting Research Center, home visiting programs, including those funded through the Health Resources and Services Administration (HRSA) and the Administration for Children and Families’ (ACF) Maternal, Infant, and Early Childhood Home Visiting (MIECHV) and Tribal MIECHV programs, reached nearly 335,000 families in 2019. Although many families participate in home visiting services, many more could benefit. States, territories, Tribes, and local programs face a variety of challenges in identifying, recruiting, retaining, and engaging families in home visiting.

In conducting the Understanding and Expanding the Reach of Home Visiting (HV-REACH) project, ACF aims to deepen understanding of how home visiting can better reach families, including: (1) families who are not recruited in the first place; (2) families who are recruited for home visiting but do not enroll; (3) families who enroll, but never engage to receive services; and (4) families who are recruited and engage initially, but end their participation early. The project will build knowledge about factors at the family-, home visitor-, program-, community -, and systems-levels that influence outreach, recruitment, retention, and active participation of families. HV-REACH is intended to directly benefit home visiting programs by identifying, developing, studying, and disseminating evidence-informed resources and strategies they can implement to ensure more equitable access to and participation of families in home visiting and, ultimately, more positive outcomes for children and families. The project is being conducted by Mathematica in partnership with the Brazelton Touchpoints Center and Social Grove. 

The project has completed five initial activities: (1) reviewed existing literature on factors that support the participation of families in home visiting, (2) developed a conceptual framework that identifies family-, home visitor-, program-, community-, and systems-level factors that influence engagement in home visiting, (3) identified innovative outreach, recruitment, retention, and active participation practices in use by states, territories, and Tribes, (4) identified information needs and recommended ways to fill gaps in current knowledge, and (5) designed four studies to address gaps in the knowledge base. The project is currently: (1) developing tools and resources to help home visiting programs improve outreach, recruitment, retention, and active participation of families, and (2) designing and conducting a study to understand the features of six purposively selected centralized, coordinated, or collaborative intake (c-intake) systems that refer to early childhood home visiting. The project will actively engage interested individuals and groups (such as parents, local, state, and tribal home visiting program administrators and leaders, and technical assistance providers) in shaping project activities and products.

This contract was awarded to Mathematica in 2021. The OPRE Point of Contacts are Kelly Jedd McKenzie and Jesse Coe.

Related Resources

The Family Engagement toolkit is a guide to help early childhood home visiting programs improve family engagement in their services.

Early childhood home visiting is a service delivery strategy that supports a range of positive outcomes, including improved child and maternal health, children’s development and school readiness, family economic self-sufficiency, and the reduction of child abuse and neglect. Evidence-based home visiting programs reached about 278,000 families in 2021, according to the National Home Visiting Resource Center, but many more families are eligible and could benefit from these programs. This literature synthesis aims to deepen understanding of the facilitators of and barriers to family engagement in home visiting, the strategies programs use to support engagement, and topics that would benefit from further research.