6-MW26-8 HOM-VEE-website-MECSH-comparisons MW-2025-12-01.pdf

Comparisons from the Home Visiting Evidence of Effectiveness (HOM-VEE) website ( https://homvee.acf.gov/models?field_miechv_eligible=1&meets-hhs=1 )

Overview

Model Name Maternal Early Childhood Sustained Home-

Visiting Program (MECSH) Healthy Beginnings Preparing for Life—Home Visiting Healthy Families America (HFA)® Nurse-Family Partnership (NFP)®

Last Updated 2023 2024 2023 2024 2024

Description

Developed in Australia, the Maternal Early Childhood Sustained Home-Visiting (MECSH) program is designed to enhance maternal and child outcomes by providing prenatal and postnatal services. The model can be adapted for systems outside of Australia and to meet local needs.

MECSH serves parents or caregivers at risk of adverse parental and/or child health and development outcomes. Registered nurses with experience with and/or postgraduate training in child and family health conduct a minimum of 22 (for postnatal enrollment) to 25 (for prenatal enrollment) 60- to 90-minute home visits.

Nurse home visitors deliver services until the child’s second birthday. During the visits, nurses focus on parent education, child development, parent-child relationships, maternal health and well-being, family relationships, goal setting, and other issues such as housing and finances. Also available are parenting groups, activities to link families to the community, and referrals to other specialized care (such as dietitians and drug and alcohol counselors).

Healthy Beginnings serves first-time mothers of infants from socially and economically disadvantaged areas in Sydney, Australia. The model aims to prevent childhood obesity by improving children’s and families’ eating patterns, reducing sedentary activities such as television viewing, and increasing physical activity. In Healthy Beginnings, nurse home visitors address the following topics during each visit: infant nutrition and physical activity, family nutrition and physical activity, and family social support.

The nurse home visitors offer referrals if the family has questions or concerns unrelated to the discussion topics.

Telephone support is available between visits. Families receive eight home visits from the prenatal period through when the child is 24 months old. Each visit ranges in length from 45 to 90 minutes.

Preparing for Life (PFL) is a prevention and early intervention program serving families living in disadvantaged communities in Ireland. The model serves families and children from pregnancy to school entry, and it aims to support the creation of a nurturing home environment, improve parenting outcomes such as parental self-efficacy and well-being, and promote children’s school-readiness. PFL is a multi-component program delivered over four to five years that offers home visiting, prenatal education classes, breastfeeding support, baby massage, and Triple P Positive Parenting Program classes (for families with children between 2 and 3 years old). The HomVEE review focuses on the home visiting component of the model (PFL–Home Visiting), which is available for families with pregnant women and children up to school entry. During monthly visits, home visitors share information about child development and engage families through role-playing, modeling, demonstration, coaching, discussion, and encouragement. Home visitors recommend that families participate in the program’s baby massage and Triple P Positive Parenting Program courses.

Healthy Families America (HFA) includes

(1) screenings and assessments to determine whether families are at risk for child maltreatment or other adverse childhood experiences; (2) home visiting services; and (3) routine screening and assessment of parent–child interactions, child development, and maternal depression. In addition, many HFA sites offer parent support groups and services to promote fathers’ involvement. HFA is designed to cultivate and strengthen nurturing parent-child relationships, promote healthy childhood growth and development, and enhance family well-being by reducing risk and building protective factors. Local HFA sites select the focus population they plan to serve and offer weekly, hour-long home visits beginning prenatally or within the first three months after a child’s birth. Visit frequency decreases over time based on family progress, and services are offered until children are between the ages of 3 and 5.

Nurse-Family Partnership (NFP) is designed for pregnant women with low-incomes and their children and focuses on first-time parents. Participating clients receive one-on-one home visits from a registered professional nurse. The visits begin early in the client’s pregnancy (with program enrollment no later than the 28th week of pregnancy) and conclude when the client’s child turns 2 years old. NFP is designed to improve (1) prenatal and maternal health and birth outcomes, (2) child health and development, and (3) families’ economic self-sufficiency and maternal life course development.

This report also includes a review of an alternate implementation of NFP in which paraprofessionals, rather than nurses, conducted the home visits. The paraprofessionals received the same length of training as the nurses and carried the same caseloads but had a higher ratio of supervisors to home visitors.

https://homvee.acf.gov/models/maternal-early-childhood-sustained-home-visiting-program-mecsh https://homvee.acf.gov/models/maternal-early-childhood-sustained-home-visiting-program-mecsh https://homvee.acf.gov/models/healthy-beginnings https://homvee.acf.gov/models/preparing-life-home-visiting https://homvee.acf.gov/models/healthy-families-america-hfar https://homvee.acf.gov/models/nurse-family-partnership-nfpr

Prenatal Prenatal Prenatal Prenatal

0-6 months 0-6 months 0-6 months 0-6 months 0-6 months

7-11 months 7-11 months 7-11 months 7-11 months 7-11 months

12-23 months 12-23 months 12-23 months 12-23 months 12-23 months

24-35 months 24-35 months

36-47 months 36-47 months

48+ months 48+ months

Families who are serving or formerly served in the Armed Forces

Families with a history of child abuse or neglect, or interactions with child welfare services

Families with a history of child abuse or neglect, or interactions with child welfare services

Families with a history of child abuse or neglect, or interactions with child welfare services

Families with a history of child abuse or neglect, or interactions with child welfare services

Families with a history of substance use disorders or in need of substance use disorder treatment

Families with a history of substance use disorders or in need of substance use disorder treatment

Families with children who have low student achievement

Families with children who have low student achievement

Families with children with developmental delays or disabilities

Families with children with developmental delays or disabilities

Families with low-income Families with low-income Families with low-income Families with low-income

Families with pregnant women under age

Families with pregnant women under age

Families with pregnant women under age

Families with pregnant women under age

Families with users of tobacco products in the home

Families with users of tobacco products in the home

Services Intended at Ages

Populations Intended Information not available

Related Model(s) No related models No related models No related models No related models No related models

Effectiveness

Model Name Maternal Early Childhood Sustained Home- Visiting Program (MECSH)

Healthy Beginnings Preparing for Life—Home Visiting Healthy Families America (HFA)® Nurse-Family Partnership (NFP)®

Evidence-based model Evidence-based model Evidence-based model Evidence-based model Evidence-based model

MIECHV eligible MIECHV eligible MIECHV eligible MIECHV eligible MIECHV eligible

4 3 10 32 32

Manuscripts Manuscripts Manuscripts Manuscripts Manuscripts

Impact studies rated high or moderate quality Impact studies rated high or moderate quality Impact studies rated high or moderate quality Impact studies rated high or moderate quality Impact studies rated high or moderate quality

Child development and school readiness Child development and school readiness Child development and school readiness Child development and school readiness Child development and school readiness

Child health Child health Child health Child health Child health

Family economic self-sufficiency Family economic self-sufficiency

Linkages and referrals

Maternal health Maternal health Maternal health Maternal health Maternal health

Positive parenting practices Positive parenting practices Positive parenting practices Positive parenting practices Positive parenting practices

Reductions in child maltreatment Reductions in child maltreatment

Reductions in juvenile delinquency, family violence, and crime

Reductions in juvenile delinquency, family violence, and crime

Model Effectiveness

Extent of Evidence

Favorable Results From Well-

Designed Research https://homvee.acf.gov/models/maternal-early-childhood-sustained-home-visiting-program-mecsh#effectiveness https://homvee.acf.gov/models/maternal-early-childhood-sustained-home-visiting-program-mecsh#effectiveness https://homvee.acf.gov/models/healthy-beginnings#effectiveness https://homvee.acf.gov/models/preparing-life-home-visiting#effectiveness https://homvee.acf.gov/models/healthy-families-america-hfar#effectiveness https://homvee.acf.gov/models/nurse-family-partnership-nfpr#effectiveness https://homvee.acf.gov/studies?f%5b0%5d=model%3A163&f%5b1%5d=rating%3A278&f%5b2%5d=rating%3A279 https://homvee.acf.gov/studies?f%5b0%5d=model%3A157&f%5b1%5d=rating%3A278&f%5b2%5d=rating%3A279 https://homvee.acf.gov/studies?f%5b0%5d=model%3A834&f%5b1%5d=rating%3A278&f%5b2%5d=rating%3A279 https://homvee.acf.gov/studies?f%5b0%5d=model%3A158&f%5b1%5d=rating%3A278&f%5b2%5d=rating%3A279 https://homvee.acf.gov/studies?f%5b0%5d=model%3A171&f%5b1%5d=rating%3A278&f%5b2%5d=rating%3A279 https://homvee.acf.gov/studies?f%5b0%5d=model%3A163&f%5b1%5d=rating%3A278&f%5b2%5d=rating%3A279 https://homvee.acf.gov/studies?f%5b0%5d=model%3A157&f%5b1%5d=rating%3A278&f%5b2%5d=rating%3A279 https://homvee.acf.gov/studies?f%5b0%5d=model%3A834&f%5b1%5d=rating%3A278&f%5b2%5d=rating%3A279 https://homvee.acf.gov/studies?f%5b0%5d=model%3A158&f%5b1%5d=rating%3A278&f%5b2%5d=rating%3A279 https://homvee.acf.gov/studies?f%5b0%5d=model%3A171&f%5b1%5d=rating%3A278&f%5b2%5d=rating%3A279 https://homvee.acf.gov/favorable-impacts/child-development-and-school-readiness https://homvee.acf.gov/favorable-impacts/child-development-and-school-readiness https://homvee.acf.gov/favorable-impacts/child-development-and-school-readiness https://homvee.acf.gov/favorable-impacts/child-development-and-school-readiness https://homvee.acf.gov/favorable-impacts/child-development-and-school-readiness https://homvee.acf.gov/favorable-impacts/child-health https://homvee.acf.gov/favorable-impacts/child-health https://homvee.acf.gov/favorable-impacts/child-health https://homvee.acf.gov/favorable-impacts/child-health https://homvee.acf.gov/favorable-impacts/child-health https://homvee.acf.gov/favorable-impacts/family-economic-self-sufficiency https://homvee.acf.gov/favorable-impacts/family-economic-self-sufficiency https://homvee.acf.gov/favorable-impacts/linkages-and-referrals https://homvee.acf.gov/favorable-impacts/maternal-health https://homvee.acf.gov/favorable-impacts/maternal-health https://homvee.acf.gov/favorable-impacts/maternal-health https://homvee.acf.gov/favorable-impacts/maternal-health https://homvee.acf.gov/favorable-impacts/maternal-health https://homvee.acf.gov/favorable-impacts/positive-parenting-practices https://homvee.acf.gov/favorable-impacts/positive-parenting-practices https://homvee.acf.gov/favorable-impacts/positive-parenting-practices https://homvee.acf.gov/favorable-impacts/positive-parenting-practices https://homvee.acf.gov/favorable-impacts/positive-parenting-practices https://homvee.acf.gov/favorable-impacts/reductions-child-maltreatment https://homvee.acf.gov/favorable-impacts/reductions-child-maltreatment https://homvee.acf.gov/favorable-impacts/reductions-juvenile-delinquency-family-violence-and-crime https://homvee.acf.gov/favorable-impacts/reductions-juvenile-delinquency-family-violence-and-crime https://homvee.acf.gov/favorable-impacts/reductions-juvenile-delinquency-family-violence-and-crime https://homvee.acf.gov/favorable-impacts/reductions-juvenile-delinquency-family-violence-and-crime

Implementation

Model Name Maternal Early Childhood Sustained Home- Visiting Program (MECSH)

Healthy Beginnings Preparing for Life—Home Visiting Healthy Families America (HFA)® Nurse-Family Partnership (NFP)®

Maximum Program Duration More than one year up to three years More than one year up to three years Three years or more Three years or more More than one year up to three years

Visit Frequency Visit frequency varies Visit frequency varies Monthly or less frequently Visit frequency varies Visit frequency varies

Delivery Method Supported Supports in-person service delivery only Supports in-person service delivery only Supports in-person service delivery only Supports hybrid in-person and virtual service delivery Supports hybrid in-person and virtual service delivery

Minimum Education Requirements for

Home Visiting Staff Bachelor’s degree Bachelor’s degree Bachelor’s degree High school diploma or GED Bachelor’s degree

Implementation Support Available Yes Yes Yes Yes Yes

Spanish Arabic Spanish Spanish Spanish

Other language Chinese Other language Other language

Within the U.S. Within the U.S. Within the U.S. Within the U.S.

Internationally, outside the U.S. Internationally, outside the U.S. Internationally, outside the U.S. Internationally, outside the U.S. Internationally, outside the U.S.

Indigenous Peoples and Communities

Model Name Maternal Early Childhood Sustained Home- Visiting Program (MECSH)

Healthy Beginnings Preparing for Life—Home Visiting Healthy Families America (HFA)® Nurse-Family Partnership (NFP)®

Evidence-Based for Indigenous Peoples and Communities

No No No No No

Program is Available in Other

Language(s)

Locations Where Model Has Been

Implemented https://homvee.acf.gov/models/maternal-early-childhood-sustained-home-visiting-program-mecsh#implementation https://homvee.acf.gov/models/maternal-early-childhood-sustained-home-visiting-program-mecsh#implementation https://homvee.acf.gov/models/healthy-beginnings#implementation https://homvee.acf.gov/models/preparing-life-home-visiting#implementation https://homvee.acf.gov/models/healthy-families-america-hfar#implementation https://homvee.acf.gov/models/nurse-family-partnership-nfpr#implementation https://homvee.acf.gov/models/maternal-early-childhood-sustained-home-visiting-program-mecsh#service https://homvee.acf.gov/models/maternal-early-childhood-sustained-home-visiting-program-mecsh#service https://homvee.acf.gov/models/healthy-beginnings#service https://homvee.acf.gov/models/preparing-life-home-visiting#service https://homvee.acf.gov/models/healthy-families-america-hfar#service https://homvee.acf.gov/models/nurse-family-partnership-nfpr#service

Has been implemented with Indigenous peoples and communities

Has well-designed research that included Indigenous peoples or communities

Where to Learn More

Model Name Maternal Early Childhood Sustained Home- Visiting Program (MECSH)

Healthy Beginnings Preparing for Life—Home Visiting Healthy Families America (HFA)® Nurse-Family Partnership (NFP)®

Model Website https://www.earlychildhoodconnect.edu.au/ Healthy Beginnings https://www.preparingforlife.ie/ https://www.healthyfamiliesamerica.org/ http://www.nursefamilypartnership.org

Information not available

Has been implemented with Indigenous peoples and communitiesImplementation with Indigenous Communities

Has been implemented with Indigenous peoples and communities

Information not available https://homvee.acf.gov/models/maternal-early-childhood-sustained-home-visiting-program-mecsh#find-out-more https://homvee.acf.gov/models/maternal-early-childhood-sustained-home-visiting-program-mecsh#find-out-more https://homvee.acf.gov/models/healthy-beginnings#find-out-more https://homvee.acf.gov/models/preparing-life-home-visiting#find-out-more https://homvee.acf.gov/models/healthy-families-america-hfar#find-out-more https://homvee.acf.gov/models/nurse-family-partnership-nfpr#find-out-more https://www.earlychildhoodconnect.edu.au/ https://slhd.health.nsw.gov.au/population-health/healthy-living/health-age/healthy-beginnings https://www.preparingforlife.ie/ https://www.healthyfamiliesamerica.org/ http://www.nursefamilypartnership.org/

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