The Power and Potential of Home Visiting

Home visitors offer vital support for families as they welcome a new child into the home. From helping parents and caregivers learn about safe sleep, healthy eating, and play habits to supporting the mental health and well-being of the adults in the home, home visiting has been shown to have a positive impact on maternal and child health outcomes even years after home visiting visits have ended.

As part of EDC’s work to improve maternal and child health, EDC is strengthening and supporting our nation’s dedicated corps of home visitors, as well as the state and territory teams that implement home visiting across their jurisdictions. This includes providing extensive assistance to Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program initiatives. Two of EDC’s home visiting experts, Zhandra Levesque and Allison Parish, recently sat down to discuss the pivotal role that home visiting plays in families’ lives and some of the challenges facing the field.

Q: A newly published study shows that home visiting has long-term positive impacts on families and children. What insights can you share on the new research?

Parish: It’s a great finding. The MIHOPE study launched over 10 years ago. It is one of the largest, most comprehensive home visiting studies undertaken. It looked at different evidence-based home visiting models across the country. Researchers have continued to follow families impacted by those home visiting programs for multiple years. This most recent study examined whether the positive outcomes of home visiting were still maintained when children are in kindergarten, because by that point the families are done with home visiting services. And they found that, yes, there were still positive effects, which is great for the field.

Q: You both see the positive impacts of home visiting every day. Why is it important that research also captures those benefits?

Levesque: In our field, public health and early childhood, it’s incredibly important that we’re leading with evidence. We don’t have infinite resources. We have to make sure that we’re using our resources responsibly and efficiently. We need to put programming out there that works. We also have to think about what works for whom and in what context. Research like this helps the field think about who we’re reaching and who we’re not. It helps us understand the impact of home visiting across many, many populations throughout the country.

Q: What are some of the biggest challenges facing the field of home visiting right now?

Levesque: I think expanding the home visiting workforce is a big one. We are not even coming close to reaching the need that is out there.

Parish: I agree. And to do this, we need to strengthen the pipeline into the workforce. Home visiting is not something that students often learn about as a career option in high school. Working closely with our funder, Health Resources and Services Administration (HRSA), EDC’s Institute for Home Visiting Workforce Development team is really working on lifting that up and thinking about how we get not only more people to go into the home visiting field, but to stay in the home visiting field. Because it can be an incredibly rewarding job, but it is not an easy job.

Levesque: The good news is that federal investments in home visiting continue to grow. Congress increased funding for the MIECHV Program when it was reauthorized in 2022. And across the country, we are seeing states, philanthropic organizations, and private investors recognize the value of home visiting. Sustaining and growing this workforce will require collaboration across sectors—government, philanthropy, and private partners—to ensure we are building a strong, stable system that supports families for the long term.

Q: You mentioned workforce as a significant issue facing home visiting. What are the perils if enough people do not go into the field?

Parish: Families don’t get services. It’s as simple as that. Programs cannot enroll families if they don’t have enough home visitors. And there are also caps on the number of families that each home visitor can take on. So, if a local agency doesn’t have a home visitor who can take on a family because they have open positions or because their caseload is maxed out, then that family just doesn’t get enrolled in the program.

Q: So how do you recruit and retain new home visitors? Because as you said, it’s a rewarding field, but very few people know about it.

Parish: We’re seeing a trend in which former home visiting participants are becoming home visitors themselves. These people become some of the most effective home visitors and passionate ambassadors for home visiting. They know the value of home visiting because they have experienced the benefits. It’s a nice thing for them to then be able to turn around and offer those services to others. Outside of people with lived experience of home visiting, we need to get better at the way that we recruit. That means speaking more about the benefits of this role and how rewarding it can be. And then, ultimately, partnering with high schools and colleges for this profession to even get on the radar of young people who are looking for a career path.

Levesque: I think that’s definitely right. I think the other part is being partners with home visitors and helping them stay in the field. They do a lot. They don’t have enough time to do it. And the reason they wake up and go to work each day is to support families. What we saw in the MIHOPE research is that they’re valued, they’re trusted, and they do incredible work.

Q: How is EDC helping advance the field of home visiting?

Levesque: The home visiting initiatives that EDC leads for HRSA are here to do the legwork that supports these dedicated home visitors and gives them the information they need to succeed and stay in the field. In addition, we are working to help grow the field by finding, training, and supporting people who want to be home visitors.

Parish: State-level staff are really facing their own challenges, including turnover and positions that go unfilled. So, we’ve been doing things such as orientation and onboarding for anyone that comes into a leadership position on a state or territory team. Mainly to help them get quickly acclimated to the world of home visiting. We also offer a leadership academy, so they learn to grow as leaders. And then we do communities of practice on various topics. We’ve discussed topics such as pay and benefits, and how those are important to retain staff. But we’ve also discussed how home visitors find joy in their work. Because that, too, is an important part of remaining in the field. People need to be supported at all levels of home visiting. And I think that’s what we are doing well.

We invite you to learn more about our Maternal Health & Home Visiting initiatives.