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State of the Field

Few studies have examined the nature and extent of service coordination in home visiting. We also have limited understanding of the contextual factors, implementation processes and activities that support coordination, and strengths and barriers to achieving optimal outcomes. To address this need, we conducted surveys of state MIECHV administrators and local home visiting programs. We also conducted case studies, including one-on-one interviews and document reviews, of four “high performing” home visiting programs. See below for details regarding study methods and results.

Survey of State MIECHV Administrators

The goal of this survey was to learn about the nature and extent of service coordination among federally funded Maternal, Infant, and Early Childhood Home Visiting (MIECHV) programs and other agencies, organizations, and initiatives.

In the Fall of 2016 we distributed a web-based survey to MIECHV administrators in all 50 states, 5 territories, and the District of Columbia. The survey took 30 minutes to complete. Survey items assessed five conceptual domains for coordination including: state leadership; MIECHV leadership; alignment of goals; data systems; and finance. We also assessed MIECHV administrators’ perceptions about coordination among home visiting and other agencies and sectors.

The results of this survey will be published in a peer-reviewed journal (coming soon).

Survey of HARC Local Programs

The purpose of this survey was to learn more about the nature and extent of coordination of home visiting programs with other services.

In the Spring of 2017, we recruited 105 programs from the practice-based research network of the Home Visiting Applied Research Collaborative (HARC). Programs were invited to participate if, 1) their state MIECHV administrator had completed the state survey and, 2) their state had at least 5 HARC sites. Home visiting program managers were invited to participate in a web-based survey that took 40-45 minutes to complete. Survey items assessed the contextual factors, implementation factors, and activities that were aligned with the Framework for coordination, and barriers and facilitators of coordination.

The results from these two surveys are described in a series of briefs. Results also will be published in peer-reviewed papers (coming soon).

Brief 1: Data to Inform Planning and Service Delivery

Brief 2: Availability and Accessibility of Resources

Brief 3: Family Centeredness

Case Studies of Local Programs

Case studies gather detailed information from multiple sources or perspectives about a specific experience, such as service coordination. Using a case study approach, we examined the complexity of service coordination of home visiting programs with services in a range of sectors, such as—health, human services, child welfare, and early education. The case studies addressed how home visiting programs approach coordination in their work with other child and family-serving organizations and related factors identified as facilitators and barriers.

Four HARC home visiting programs participated in case studies. We selected the sites using a multiphase strategy. First, we selected sites in states that participated in an earlier MIECHV state administrator survey. Second, we selected sites that participated in a local HARC survey. Third, we selected sites that had strong systems in place to support service coordination as indicated by their responses to questions on the local HARC survey. Within this group we selected sites that varied by a) geographic region, b) home visiting program model, c) size and d) whether or not they receive funding from the federal Maternal, Infant, and Early Childhood Home Visiting Program.

Seven to eight interviews were conducted at each of the four sites. We invited the program manager, one supervisor, and two home visitors to participate in face-to-face interviews. We asked each home visitor to identify two families for whom they had coordinated services to invite to participate in phone interviews. Finally, we collected documents from each site to enhance our understanding of their service coordination policies.