Beyond the Early Years: The Long-Term Effects of Home Visiting on Mothers, Families, and Children. Results from the Mother and Infant Home Visiting Program Evaluation (MIHOPE)

This report focuses on addressing the question:

What are the long-term effects of MIECHV-funded early childhood home visiting programs on maternal, family, and child outcomes when children were in kindergarten or first grade? 

The MIHOPE kindergarten follow-up was designed to measure the effects of home visiting at the outset of formal schooling, approximately five to six years after mothers enrolled in MIHOPE, as well as outcomes that predict the longer-term effects of home visiting. Additionally, the legislation that authorized MIECHV indicated that MIECHV-funded home visiting programs are expected to improve school readiness, and this was not something that could be measured during earlier MIHOPE follow-ups because the children were too young. 

To provide information about the effects of home visiting on mothers, children, and families across the broad range of areas that home visiting aims to affect, MIHOPE examined eight pre-specified research questions using a statistical test that detects patterns of effects. Five of the questions were focused on maternal and family well-being, and three were focused on child outcomes.

• MIHOPE found statistically significant and positive effects of home visiting for the five research questions that measured maternal and family well-being outcomes. Results of the tests indicate that home visiting had favorable effects on outcomes more readily impacted by direct interactions or services provided by home visitors. These include (1) maternal coping strategies and parenting behaviors that could be improved through direct interaction between parents and home visitors; (2) maternal mental and behavioral health; (3) parent-child interactions; (4) a constellation of outcomes related to conflict, violence, aggression, and maltreatment; and (5) families’ economic circumstances. 

• MIHOPE found some evidence of positive effects of home visiting for the three research questions related to child functioning outcomes. The result of the test for children’s social-emotional functioning in the home context was statistically significant and positive. A similar pattern of effects emerged on outcomes related to children’s social-emotional functioning in school settings, but the test result was not statistically significant, potentially due to the smaller sample of teachers who reported on these measures. The test result was also not statistically significant for the research question related to children’s cognitive, language, and math skills.

Early childhood home visiting programs are designed to affect a wide range of maternal, family, and child outcomes across multiple areas. Given this broad emphasis, MIHOPE collected data for its kindergarten follow-up from multiple data sources, and the study team assessed impacts on 66 outcomes across 5 outcome areas.

To provide information about the effects of home visiting on mothers, children, and families across the broad range of areas that home visiting aims to affect, MIHOPE examined eight pre-specified research questions using a statistical test that detects patterns of effects — that is, the magnitudes and directions of the effects — on a group of outcomes.  Five of the questions were focused on maternal and family well-being, and three were focused on child outcomes.

Specifically, the research questions asked whether home visiting affected:

1. outcomes that could be improved through direct interaction between parents and home visitors
2. maternal mental and behavioral health
3. parent-child interactions
4. conflict, violence, aggression, and maltreatment
5. families’ economic circumstances
6. children’s social-emotional functioning in the home context
7. children’s social-emotional functioning in school settings
8. children’s cognitive, language, and early math skills

Supplemental analyses examined whether there were differences based on the timing of data collection or by the grade of the child at follow-up. Appendices to the report include the results of exploratory analyses conducted to understand whether the effects of home visiting were larger for some families than others, based on subgroups defined by (1) families’ demographic characteristics and psychosocial risk factors such as educational attainment and adverse childhood experiences; and (2) the four evidence-based home visiting models included in MIHOPE. An additional appendix includes an exploratory examination of the mechanisms through which home visiting had effects on selected individual outcomes at the kindergarten follow-up using mediators measured at earlier waves of MIHOPE.

Portilla, Ximena A., Kristen Faucetta, Kelly Saunders, and Amy Taub. 2025. Beyond the Early Years: The Long-Term Effects of Home Visiting on Mothers, Families, and Children. Results from the Mother and Infant Home Visiting Program Evaluation. OPRE Report 2025-052. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.