Components associated with home visiting program outcomes: a meta-analysis.

Area of Science:

• Public Health
• Developmental Psychology
• Social Work

Background:

• Systematic reviews indicate home visiting programs are effective, yet individual study results vary.
• A component-based, domain-specific approach was used to identify predictors of program outcomes.

Purpose of the Study:

• To determine which program characteristics most strongly predict outcomes in home visiting evaluations.
• To analyze effectiveness across six distinct outcome domains.

Main Methods:

• Searched Medline and PsycINFO for US-based universal and selective home visiting program evaluations.
• Coded research design, program content, and service delivery characteristics for 51 studies.
• Used random-effects, inverse-variance-weighted linear regressions to predict effect sizes.

Main Results:

• Overall mean effect size was 0.20, with significant positive effects in maternal life course, child cognitive outcomes, and parent behaviors/skills.
• Significant heterogeneity in effect sizes was observed across all six outcome domains.
• Research design characteristics did not consistently predict effect sizes; no universal effective components emerged.

Conclusions:

• Home visiting programs yield small but significant overall effects, but with considerable variability in domain-specific impacts.
• The components driving effectiveness differ across outcome domains.
• Complementary or alternative strategies may be necessary to achieve widespread public health impact.