HARC: A Research and Development Platform
Sponsor: Health Resources and Services Administration (HRSA)
The Home Visiting Applied Research Collaborative (HARC) is a research and development platform that aims to intensify the use of breakthrough impact research methods to address national HV priorities around HV precision and impact among at-risk families and communities and to accelerate translation of research results into practice.
You can find out more about HARC on the HARC website.
Sponsor: NHLBI and multiple federal partners
HARC is partnering with the Johns Hopkins Center for Clinical Trials and Evidence Synthesis (CCTES) and the Johns Hopkins Center for Health Equity on the Resource and Coordinating Center for Early Intervention to Promote the Cardiovascular Health of Mothers and Children (ENRICH). ENRICH is testing the effectiveness of an implementation-ready intervention, delivered in the context of early childhood home visiting, to promote and address disparities in maternal and early childhood cardiovascular health. This is an exciting opportunity to tailor interventions to diverse populations, test what works best, for whom, under what conditions, and promote health equity.
Maryland Prenatal-to-Age-Three (PN3) Project
Sponsor: Pritzker Children’s Initiative, J.B. and M.K. Pritzker Family Foundation
Maryland's prenatal-to-age-three (PN3) initiative focuses on expanding high-quality services and programs available to children birth up to age three. This project is in partnership with Maryland Family Network (MFN) and the Maryland State Department of Education (MSDE) to build on ongoing initiatives (i.e., the Preschool Development Birth through Five Grant) to develop and implement a plan to expand state and local services to address the health, development, and social-emotional needs of expectant families and families with children birth up to age three. This is a statewide collaborative effort, and Maryland is one of the two states to have been award both the Pritzker Grant and the National Governor's Association Prenatal to Age 3 Policy Academy Grant to further support the advancement of prenatal to age 3 efforts.
Maryland State Maternal, Infant, and Early Childhood Home Visiting Evaluation
Sponsor: HRSA / University of Maryland Baltimore
Children of parents with intellectual disabilities and other learning differences are at disproportionate risk for adverse birth outcomes and negative outcomes across the life course. Evidence-based maternal, infant, and early childhood home visiting (EBHV) is a promising strategy to improve outcomes for this population. The purpose of this evaluation is to understand and improve services and promote positive outcomes for families enrolled in EBHV in which the primary caregiver has a learning difference. The topic was suggested by Maryland EBHV staff who shared their concerns that caregivers with learning differences seemed less able to understand, retain, and use information provided, and less engaged than caregivers without these challenges. The aims of the project are to: 1) develop a conceptual model to guide practice, research, and evaluation, 2) assess current HV practice, 3) identify or adapt a screening tool that is feasible, acceptable, and useful in the EBHV context, and 4) use the conceptual model to inform an inventory of strategies and resources for EBHV.
New Jersey Early Childhood Comprehensive Systems Impact (ECCS Impact) Initiative
Through ECCS Impact, New Jersey (NJ) is working to bolster the state’s system of care for expectant families and families with young children by enhancing developmental health promotion. Since 2016, state leaders from the NJ Department of Children and Families have partnered with five Place-Based Communities (PBCs) (Camden, Cumberland, Essex, Middlesex and Passaic) and Early Childhood Specialists from all 21 of the state’s counties to promote the online ASQ Family Access Portal and to provide outreach and education to parents about developmental promotion. We have supported NJ’s ECCS Impact Initiative with evaluation and Continuous Quality Improvement (CQI) supports. Our team has collaborated with PBCs to complete an environmental scan of developmental screening across the five communities. We have also worked with the NJ State Team to train PBCs in CQI fundamentals and strategies and to provide ongoing CQI support to PBCs as they conduct tests.
New Jersey Evidence-Based Home Visiting Evaluation
Sponsor: HRSA/State of New Jersey
Through MIECHV, New Jersey (NJ) is setting the pace for the country in the scale-up of home visiting (HV) as part of the state’s system of care for expectant families and families with young children. Using federal and state funding, the NJ Department of Health and NJ Department of Children and Families have collaborated for more than a decade to build the state’s infrastructure for supporting and expanding their home visiting initiative. Since 2009, we have supported NJ in advancing the effectiveness of home visiting services through rigorous, evaluative research and continuous quality improvement (CQI).
Evaluation aims have included:
- describing how local programs deliver HV services and comparing actual service delivery to state performance standards;
- assessing and explaining variation in how local HV programs operate and provide services to families;
- assessing the efficiency and effectiveness of NJ’s Central Intake (CI) in referring expectant and parenting mothers to home visiting; and
- identifying CI and HV practices aimed at improving family engagement and retention in HV.
New Jersey Preschool Development Grant Birth through Age Five (PDG B-5)
Sponsor: US Department of Health & Human Services, Administration for Children & Families (ACF), Office of Child Care
New Jersey’s PDG B-5 project is a two-generational approach that promotes a comprehensive, coordinated early childhood (EC) system of care in addressing the physical, social-emotional, behavioral and cognitive aspects of child wellbeing and school readiness from prenatal (PN) through age five. New Jersey engages with parents to promote a competent workforce, provide equitable access to affordable services for all children and families, ensure adequate and sustainable financing, provide varied high-quality service delivery options, and create a system for ongoing accountability including evaluation and continuous quality improvement.
New Jersey Universal Home Visiting Evaluation
Sponsor: New Jersey Department of Children and Families
The evaluation will assess the implementation and outcomes of a statewide implementation of universal home visiting in a state with a county-based single point of entry system for connecting expectant families and families with young children to an array of services.
Supporting and Strengthening the Home Visiting Workforce
Sponsor: Office of Planning, Research, and Evaluation Administration for Children and Families
The early childhood home visiting workforce has a critical role to play in meeting the evolving needs of families across the country. The effectiveness of home visitors depends in part on their professional well-being and on collaborative relationships with supervisors that foster learning and growth. This project works to advance understanding of how to support and strengthen the home visiting workforce, including programs funded through the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) and Tribal MIECHV programs. The initial groundwork will involve developing and refining research-based conceptual models of professional well-being and reflective supervision. Additional efforts may include adapting or developing and testing measures, evaluating the efficacy of strategies, and conducting further research on related topics.
RECENTLY COMPLETED PROJECTS
California Home Visiting Coordination Initiative (HVC)
Sponsor: First 5 California (F5CA)
The HVC Initiative aims to increase local capacity to improve home visiting coordination among agencies that provide home visiting and those that provide family support services, in order to understand and strengthen the role of home visiting within the early childhood system and help counties meet the needs of families amid the COVID-19 pandemic. This project is conducted in partnership with James Bell Associates.
Cross-Model Collaboration and Data Sharing project (MODS)
Sponsor: Health Resources and Services Administration (HRSA)
MODS is a 2-year project that aims to build home visiting models’ capacity for collaborative research, answer home visiting models’ key questions by sharing existing data, and advance social services informatics. In the first year of the project, team members established and facilitated a community of practice of home visiting models, prioritized research questions, and developed study designs for a subset of those questions. Major goals for the second year include developing a conceptualization of engagement in home visiting, indicators for engagement, and factors of engagement. The information gathered through this project can be used to better understand what aspects of home visiting work for which families and to improve the power and precision of available data.
Cross-Model Precision Prenatal Home Visiting Project
Sponsor: Pritzker Children’s Initiative
This project aims to build the field’s capacity for precision prenatal home visiting to broaden and strengthen effectiveness. It has four main objectives. The first is to describe the techniques endorsed by EBHV models to promote good birth outcomes. The second is to review the literature to assess the evidence base for use of techniques to promote good birth outcomes. The third is to explore family preferences regarding techniques. The final objective is to describe implementation systems to support home visitor’s use of techniques.
Evaluation of the Knit to Quit Program in Baltimore City
Sponsor: Lerner Center for Health Promotion
Despite robust evidence linking perinatal tobacco exposure with poor maternal and child outcomes, a majority of pregnant women receiving opioid maintenance medication treatment smoke cigarettes. B’more for Healthy Babies (BHB) and the Baltimore City Health Department (BCHD) designed Knit to Quit, a group intervention to support smoking cessation among clients and staff at local substance use disorder treatment and recovery programs serving women of reproductive age. The model integrates psychoeducation and motivational messaging within a semi-structured group knitting class to improve participants' knowledge, self-efficacy, and motivation to quit, increase social support for quitting, reduce stress, and, ultimately, reduce tobacco use. The goal of this project is to evaluate implementation and preliminary efficacy of the Knit to Quit intervention.
Evidence-Based Early Home Visiting for Parents with Intellectual Disabilities
Sponsor: JHSPH Faculty Innovation Award
Children of parents with intellectual disabilities (ID) are at disproportionate risk for adverse birth outcomes and negative outcomes across the life course. Evidence-based maternal and early childhood home visiting (EBHV) is a promising strategy to improve outcomes for this population. The aims of this national study are to 1) evaluate current EBHV practices for addressing the needs of parents with ID, and 2) assess multi-level factors associated with variability in practices.
HARC-Stakeholder Partnership in Refining and Disseminating an Observation-Based Toolkit to Build Home Visitors’ Communication Skills
Sponsor: Heising-Simons Foundation
This is the final phase of a project to develop a toolkit of eleven communication strategies to promote responsive partnership between home visitors and families. We will work closely with diverse stakeholders at multiple levels to: 1) enhance the toolkit; 2) develop and launch a web-based version of the toolkit; and 3) disseminate the toolkit in concert with other ongoing professional development initiatives and in ways that promote uptake and sustained use.
Maternal and Infant Home Visiting Evaluation (MIHOPE)
Sponsor: Administration of Children and Families (ACF)
The Mother and Infant Home Visiting Program Evaluation (MIHOPE) is a legislatively mandated, large-scale evaluation of the effectiveness of home visiting programs funded by MIECHV. It systematically estimated the effects of MIECHV home visiting programs on a wide range of outcomes and studied the variation in how programs are implemented. The PFRH Early Childhood Services Research Team has been a part of MIHOPE since the very beginning. Dr. Anne Duggan, ScD, directed all aspects of the implementation research work, from initial study conceptualization and design through interpretation and translation of final results. Several other team members from the Early Childhood Services Research Team designed instrumentation, conducted interviews, collected and analyzed data, and wrote multiple reports. More information and study results can be found on the MDRC website.
Maryland and New Jersey Innovations Project: Goal Plan Strategy (GPS) Implementation and Evaluation
The goal of this project is to test alternative approaches to staff coaching in scaling up an integrated implementation system with training, coaching, Management Information System (MIS) and Continuous Quality Improvement (CQI) to promote family engagement through enhanced family goal plan processes.
Research to Strengthen Home Visiting Impact on Parental Engagement in Children's Education
Sponsor: Heising-Simons Foundation
Adaptation of a set of observational research measures of visitor – family communication for use in program evaluation and routine staff professional development and testing of alternative dissemination strategies.