Efficacy of a Home Visiting Program on Child Outcomes: A Randomized Controlled Trial

Background: High-quality home visiting programs are designed to improve child health and support expecting and new parents. These programs can assist families in developing skills and garnering the resources necessary to raise healthy children. A non-profit organization operating in the Southwestern United States provides a universal home visiting program to families having their first child (first-time for either the mother or father), including child by birth, adoption, or child placement. The program includes participant advocacy, home-based visits, and an enhanced referral program. The present study examines the effects of the program on child development outcomes at 12-month follow-up.

Methods: Data were collected as part of a larger randomized controlled trial in which first-time families were randomly assigned to the home visiting program (n = 179) or a business-as-usual control group (n =164). This study follows the family and the child until the child graduates from high school or turns 19. The Ages & Stages Questionnaire (ASQ) was used to assess five domains of child development. Although this outcome was measured at 2, 6, 12, 18, 24, and 36-month, the present study focuses on the five domain outcomes at 12 months.

Results: Results of independent-sample t-tests showed that, compared to controls, children in the home visiting program reported significantly better communication (t(280)=2.328, p=0.02, d=.277 [small effect]), gross motor skills (t(280)=2.601, p=0.01, d=.306 [small effect]), fine motor skills (t(280)= 3.010, p=.008, d=.357 [small effect]), problem-solving (t(280)=5.218), p<.001, d=.631 [moderate effect]), and personal-social functioning (t(280)=3.355, p=.002, d=.404 [small effect]) at 12-month follow-up.

Conclusion: The 12-month follow-up showed promising evidence of the effectiveness of the home visiting program under investigation. It is important to continue to follow these children to determine longer-term outcomes. As this study is ongoing, we will be able to examine the degree to which these early childhood outcomes are predictive of school readiness, broader dimensions of health functioning, and decreased criminal justice involvement.