MIHOPE: Minding the Gap

Although evidence-based home visiting models have individually been found to produce some positive effects, there are many remaining gaps in knowledge about home visiting programs. The Mother and Infant Home Visiting Program Evaluation (MIHOPE) will help fill the gaps in evidence, as described below.

MIHOPE will provide consistent information across all relevant outcome areas, for all four evidence-based models in the study. Past studies have measured different outcomes. In part this is because different home visiting models target different domains (such as positive parenting practices, child maltreatment, and maternal health). MIHOPE will be able to make comparisons across programs because it is collecting uniform data using the same measures across all four home visiting models — Early Head Start (EHS), Healthy Families America (HFA), Nurse-Family Partnership (NFP), and Parents as Teachers (PAT) — as well as across all the local programs that are in the study.

MIHOPE will help identify what works for different types of families. Past studies have been too small to conclude whether home visiting models worked for particular types of families. MIHOPE aims to answer such questions as: Does home visiting have larger or smaller effects when parents entering the program are teenagers or adults? What about when they have particular risk factors, such as mental health or substance abuse issues? What features of the program design, its implementation, or the availability of community services seem to be associated with these results?

MIHOPE will provide a systematic examination of how program features are associated with service delivery and impacts. Evaluations of home visiting programs have rarely collected detailed information on how staff are supported in their jobs and on the services actually delivered. MIHOPE will look at program impacts across local programs with different features. For example, the study will ask about: staff training; the frequency and length of home visits that are expected as well as those that are actually conducted; the content that is covered in home visits and methods for delivering content; and the ways in which staff are supervised and supported with program infrastructure, like management information systems.  

Program effectiveness after scaling up. Federal funding provided an opportunity for evidence-based home visiting programs to reach more families and for states to fund new home visiting services. MIHOPE will examine how the programs are working after the expansion of services supported by federal Maternal, Infant and Early Childhood Home Visiting (MIECHV) funding.

These gaps in prior research indicate the tremendous potential for MIHOPE to strengthen the field of home visiting — helping states, communities, program developers, and program operators build programs that produce strong, consistent impacts across the full range of intended outcomes and population subgroups who will benefit most from services.

Source: Charles Michalopoulos, Anne Duggan, Virginia Knox, Jill H. Filene, Helen Lee, Emily K. Snell, Sarah Crowne, Erika Lundquist, Phaedra S. Corso, Justin B. Ingels. (2013). Revised Design for the Mother and Infant Home Visiting Program Evaluation. OPRE Report 2013-18. Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.