Last week I attended the Third National Pew Summit on Quality in Home Visiting . It opened with a great Valentines Day present for all attending. President Obama’s State of the Union speech filled our hearts and raised hopes because he specifically highlighted early childhood education and home visiting programs as key components of his policy for the next four years. Beyond a gift to those attending, the Summit Keynote speakers couldn’t resist calling this a “Valentine” to American children and families.
As stated in the White House Fact Sheet on President Obama’s Plan for Early Education for All Americans, “The beginning years of a child’s life are critical for building the early foundation needed for success later in school and in life. Leading economists agree that high-quality early learning programs can help level the playing field for children from lower-income families on vocabulary, social and emotional development, while helping students to stay on track and stay engaged in the early elementary grades. Children who attend these programs are more likely to do well in school, find good jobs, and succeed in their careers than those who don’t. And research has shown that taxpayers receive a high average return on investments in high-quality early childhood education, with savings in areas like improved educational outcomes, increased labor productivity, and a reduction in crime.”
While the President was in Georgia touting his proposal, Roberto Rodriguez, Special Assistant to the President for Education Policy, was at the Summit outlining the Administration’s vision for expanding early childhood education. This includes home visiting to build parenting skills, more quality child care for infants and toddlers, and preschool for all 4-year-olds from low- and moderate-income families, all paid for by a combination of federal and state grants. To focus the energy and passion for home visiting that flowed through the crowd, the Pew Home Visiting Summit break-out sessions spoke to the real work of ramping up program quality improvement, improving child and family outcomes, building collaborative early childhood systems of services, setting up creative financing, developing shared data systems and continuing home visiting research that translates to practice.
Here are a few highlights.
Best Fit for Families?
There are numerous evidence-based home visiting models for community programs to consider. Although we can describe home visiting service models in detail, we still know little about the essential elements of successful home visiting. What works best for which families in which communities? John Lutzker, Developer of the SafeCare® model and Director of the Center for Healthy Development, Georgia State University challenged us to ponder what's the Best Fit for Families? To begin addressing this question, the Annie E. Casey Foundation has funded a 5-year project to train and evaluate a “braided model” of the SafeCare® and Parents as Teachers® (PAT) models in Georgia and North Carolina programs. The goal of this project is to determine if a braided PAT+SafeCare program results in better outcomes for high-risk families than PAT services alone.
Home visiting programs commonly ask, “How far can we adapt the evidenced-based model for our local families and community without violating the fidelity to the service model? Dr. Lutzker’s answer was, “There is flexibility within a manualized model.” That is, what is delivered in an evidence-based model is set, but how it is delivered may be flexible. A current study headed by Gregg Aarons, University of California San Diego, and funded by the Centers for Disease Control and the National Institute of Mental Health, also spoke to this question. The project is examining how a program can be faithful to a model, yet thoughtfully adapt to the local community and family needs. The study will examine the feasibility of using the Dynamic Adaptation Process (DAP) to guide a carefully planned adaptation of the SafeCare® model, compared to the model’s intervention as usual. DAP identifies and core elements and adaptable characteristics of an evidence-based program, then supports implementation of the adapted model. These are the sorts of practical questions that are being answered by such innovative home visiting research and evaluation studies.
Home Visiting Continuous Quality Improvement
Carlos Canos, Senior Advisor to Health Research and Services Administration and Thomas Nolan, Senior Fellow, Institute Healthcare Improvement discussed how continuous quality improvement (CQI) is a core element of the MIECHV program, and demonstrated a few simple tools to support quality improvement in home visiting programs. Dr. Canos announced plans to launch a learning collaborative for MIECHV grantees, the HVCOIN, Home Visiting Collaborative Improvement & Innovation Network. This collaborative will bring together 30 cross-agency teams from 10 States to learn and apply practices aimed at improving outcomes for parents and children. The aim is to provide data over the next two years on the improved quality of US home visiting services. These will bolster home visiting evidence supporting as we wait for the 2015 results of the large-scale Mother and Infant Home Visiting Program Evaluation, fondly called MIHOPE.
Early Childhood Home Visiting Builds Human Capital
This focus on the early years comes from an understanding of its importance in building our human capital. Countries that invest in quality environments which foster thriving children will develop the most capable citizens. Those countries that nurture the best minds will be best prepared to meet the future. Nurturing the best minds means investing during those early years, when the brain is developing most rapidly. Parenting is quite likely the single strongest factor influencing child development. Thus, improving parenting should be a major focus of any informed effort aimed at developing capable citizens. CQI points to the importance of measurement in producing quality. Parenting assessments, like the Keys to Interactive Parenting Scale (KIPS), will prove essential in guiding home visiting programs’ quality improvement efforts and in documenting parenting outcomes.
Assess What Matters to Children, Their Parent’s Behavior.
KIPS Shows How Parents Grow
KIPS was validated with support from the National Institute of Child Health and Human Development. Download a summary of the research showing that KIPS is valid, reliable and practical for use in programs serving diverse families.