Federal home visiting program can be improved to better meet needs of families

June 1, 2018, University of Missouri-Columbia
Julie Kapp, Ph.D., associate professor of health management and informatics at the University of Missouri School of Medicine. Credit: Justin Kelley/MU Health

The multibillion-dollar MIECHV program was formed as part of the 2010 Patient Protection and Affordable Care Act. It provides funding to organizations that offer home visiting services to improve maternal-child health. These organizations are required to demonstrate improvements over time, and the MIECHV program monitors this progress through specific benchmarks.

"Our country has one of the highest compared with peer countries, so it's vital that this program mobilize the right resources in the most effective ways possible," said Julie Kapp, Ph.D., associate professor of health management and informatics at the MU School of Medicine and an author of the study. "While the MIECHV program as a whole and the federal initiatives around maternal-child health are trying to take the right steps to help families, our research suggests there may be ways to improve upon their implementation."

The MIECHV program has established six benchmarks for organizations to demonstrate improvement, which can ultimately impact funding decisions. The research team evaluated the evidence for one benchmark, "Maternal and Newborn Health," which is broken down into six measurable sub-categories, or constructs.

  1. Preterm birth
  2. Breastfeeding
  3. Depression screening
  4. Well-child visits
  5. Postpartum care
  6. Tobacco cessation referrals

Using a federally established database called the Home Visiting Evidence of Effectiveness, or HomVEE, the team reviewed literature to determine whether or not these constructs are supported by evidence-based research.

"We were surprised to find that only three of the six constructs—preterm birth, breastfeeding and well-child visits—are supported by established research," said Sofia Campos with the global consulting and digital services provider ICF, a co-author of the review. "Of the 59 articles we reviewed, only 14 measured outcomes aligned with any of the six constructs. None of the articles directly measured depression screening, postpartum care or tobacco cessation referrals. That means that we have no evidence from this key library that home visiting actually improves these maternal and child health outcomes."

While only three of these six federally mandated constructs is supported by a federal library of evidence-based home visiting research, the team identified 16 other non-mandated constructs that have evidence of home visiting improving maternal-child health. These constructs include maternal depression symptoms and psychological outcomes, use of community resources, emergency visits and more.

"Based on our review, we recommend that the process for establishing these constructs include evaluation of the evidence-based research," Kapp said. "By setting goals that have been proven to improve the of mother and child, MIECHV can make more positive, sustained changes for hundreds of thousands of families nationally. Additionally, more confident funding decisions can be made when informed by performance measures that are evidence-based."

Explore further: New parent home visiting program reduces infants' need for medical care

Related Stories

New parent home visiting program reduces infants' need for medical care

December 15, 2016
Infants in families who participated in an intensive new parent home visiting program involving both nurses and lay educators used significantly less medical services during the first year of life, according to a new RAND ...

Home visits lessen emergency care for infants

November 1, 2013
Home visits from a nurse are a proven, but expensive, way to help newborns get a good start in life.

New approach may be key to improving US population health

October 11, 2016
The United States spends more on health care than any other country in the world, yet the life expectancy of its citizens is significantly shorter when compared to other high-income countries. Now, researchers at the University ...

Saving dollars while helping babies: Nurse home visits for infants save $3 for every $1 spent

December 19, 2013
As healthcare costs continue to balloon, a new Duke study points to a surprising avenue for potential savings: nurse home visits. For every $1 spent on nurse home visiting for newborns, $3 were saved in healthcare costs. ...

Well-child visits are effective time to help moms, study shows

March 15, 2018
In an effort to improve birth outcomes, well-child visits provide an opportune time to deliver basic screenings and health care interventions for new mothers between pregnancies, according to a new study led by UPMC.

Home visiting program for first-time moms may be struggling to reduce serious injuries to children

December 12, 2012
New research from PolicyLab at The Children's Hospital of Philadelphia shows that one of the nation's largest programs providing home visitation support for at-risk mothers and children may not be as successful in reducing ...

Recommended for you

Scientists identify new genetic causes linked to abnormal pregnancies and miscarriages

November 20, 2018
A team of scientists at the Research Institute of the McGill University Health Centre (RI-MUHC) and McGill University have identified three genes responsible for recurrent molar pregnancies, a rare complication that occurs ...

RNAi therapy mitigates preeclampsia symptoms

November 19, 2018
A collaboration of scientists from the University of Massachusetts Medical School, Beth Israel Deaconess Medical Center and Western Sydney University, have shown that an innovative new type of therapy using small interfering ...

New blood test detects early stage ovarian cancer

November 19, 2018
Research on a bacterial toxin first discovered in Adelaide has led to the development a new blood test for the early diagnosis of ovarian cancer—a disease which kills over 1000 Australian women and 150,000 globally each ...

Human Cell Atlas study reveals maternal immune system modifications in early pregnancy

November 14, 2018
The first Human Cell Atlas study of early pregnancy in humans has shown how the function of the maternal immune system is affected by cells from the developing placenta. Researchers from the Wellcome Sanger Institute, Newcastle ...

Soy formula feeding during infancy associated with severe menstrual pain in adulthood

November 9, 2018
New research suggests that infant girls fed soy formula are more likely to develop severe menstrual pain as young adults. The finding adds to the growing body of literature that suggests exposure to soy formula during early ...

A major role for a small organ in the immune response during pregnancy

November 9, 2018
The immune system of a pregnant woman is altered during pregnancy, but not in the way previously believed, according to results from a study at Linköping University, Sweden. This study, published in the Journal of Allergy ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.