Importance of Evaluation
Continuous quality improvement efforts are essential in the home visiting field to produce projected outcomes, improve the welfare of children and families, implement a comprehensive system, and sustain those gains. This can only be accomplished through ongoing evaluation and funding. During the evaluation process, four key questions must be asked.
- Is the program reaching the targeted population that was identified as most in need of the services?
- Is the program implementation efficient?
- Is the program achieving its planned outcomes?
- Is the program’s return worth the investment?
Extensive data collection and research yields the answers to these questions.
Data and Research
Home visitors are the primary collectors of data entered into the Maternal, Infant and Early Childhood Home Visiting (MIECHV) database system. The quantitative data collected indicates which federal benchmarks are being achieved by home-based services and what areas can be improved. Additional data quality monitoring is overseen by an evaluation team, which is provided on the state level by South Carolina Rural Health Research Center and the Core for Applied Research and Evaluation at the University of South Carolina.
The evaluation team facilitates quality control and training during learning collaboratives. It also assesses how community partners interact with the MIECHV programs through a Social Network Analysis (SNA). SNA is an assessment tool that captures attributes of MIECHV home visiting systems at local and state levels that may influence patient-centered care.
Evaluation on the national level is currently being conducted through the Mother and Infant Home Visiting Program Evaluation (MIHOPE). MIHOPE is a legislative-mandated evaluation project that measures the effects of four home visiting program models funded by MIECHV: Early Head Start, Healthy Families America, Nurse-Family Partnerships, and Parents as Teachers.
Also on the national level, sites from each state are participating in the Home Visiting Collaborative Improvement and Innovation Network (HV CoIIN). HV CoIIN’s mission is to achieve breakthrough improvements in select process and outcome measures while reducing or maintaining programs costs and developing the means to spread the initial improvements more widely within participating organizations.
On the state level, sites are engaged in quality improvement (QI) projects, which include the state’s second learning collaborative. Current QI project topics focus on improving family engagement and developmental promotion through early intervention and developmental screening. QI projects on the national and state level will analyze program outcomes, study the variation in how programs are implemented, and assess the possible effects the programs have on health care systems, including reducing or maintaining the cost.
Funding and Sustainability
It is critical that home visiting programs be examined thoroughly to determine their long-term impacts. However, possible long-term impacts will not be experienced if programming is not sustained.
Grantees throughout the U.S. received $386 million in 2015 from the Health Resources and Services Administration (HRSA) to implement program models that are evidence based and to evaluate “promising” approaches. South Carolina received funding that allowed 17 sites across the state to incorporate home vising programs in diverse community settings.
Through the evaluation process, successes have been identified that communicate the vital need for home visiting programs to current and potential funders, legislators, and the general public. In addition, these successes show a return on the investment and convene partners to influence the policy agenda to make early childhood care and development a priority.