Home Visiting for Mother and Infant Well-being

(MIHOPE Trial)

Age: Any Age

Sex: Female

Trial Phase: Academic

Sponsor: MDRC

Disqualifiers: Already enrolled, Foster care, Homeless, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 4

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to evaluate the effectiveness of home visiting programs in improving the well-being of mothers and infants. The focus is on assisting families with young children through home visits, which can enhance child health, school readiness, and positive parenting. Participants are randomly assigned to receive either home visits or community service referrals. This study is ideal for those who are pregnant or have a child under 28 weeks old and qualify for the selected home visiting program. As an unphased study, this trial provides a unique opportunity to contribute to research that could enhance support for families with young children.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this home visiting program is safe for families?

Research has shown that home visiting programs are safe and well-liked by families. These programs aim to improve the health and well-being of mothers and babies by providing support and education directly in their homes. Studies have not identified major safety issues or negative effects with these programs. Instead, they have noted positive impacts on the health of mothers and children, child welfare, and early education.

The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program plays a key role in these efforts. It helps families by offering guidance and resources from professionals like nurses and educators. These professionals focus on promoting healthy habits and supporting those who may have trouble accessing other services.

Overall, evidence suggests that home visiting is a safe and helpful way to support families at higher risk. This makes these programs a promising option for many families seeking extra support and resources. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about home visiting programs because they offer a hands-on, personalized approach to improving the well-being of mothers and infants, especially in high-risk families. Unlike traditional healthcare options that might require families to visit clinics or hospitals, home visiting brings support directly to the family's doorstep. This method can enhance engagement and provide tailored guidance in familiar surroundings, which is crucial for fostering positive health, education, and parenting practices. By focusing on early intervention in the home environment, these programs aim to bridge gaps in care and reach families who might otherwise struggle to access conventional services.

What evidence suggests that home visiting is effective for mother and infant well-being?

Research shows that home visiting programs, which participants in this trial will receive, can greatly enhance the health and well-being of families. Studies have found that these programs lead to improved child development, health, and family financial stability. They also reduce child abuse and encourage positive parenting. For mothers with challenging pasts, such as those who were in foster care, home visits are linked to better health and social outcomes. Overall, evidence suggests that home visiting effectively supports families at risk and promotes early childhood health and development. ^{1 2 3 6 7}

Who Is on the Research Team?

Virginia Knox, PhD

Principal Investigator

MDRC

Charles Michalopoulos, PhD

Principal Investigator

MDRC

Anne Duggan, ScD

Principal Investigator

Johns Hopkins University

Are You a Good Fit for This Trial?

This trial is for pregnant individuals or those with a child under 28 weeks old, at least 15 years of age, and eligible for the home visiting program. It excludes women already in such programs, children in foster care using EHS model sites, homeless families at EHS sites, and non-English/Spanish speakers.

Inclusion Criteria

I am 15 years old or older.

Eligible for home visiting program selected to be in the study

Pregnant or have a child under 28 weeks old

Exclusion Criteria

homeless families in sites using EHS program model

children in foster care in sites using EHS program model

women already enrolled in home visiting (for example, with an older child)

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Data Collection

Initial data collection including a one-hour survey and home environment assessment

1-2 weeks

1 visit (in-person)

Home Visiting Program

Participants receive home visiting services or are referred to other community services

15 months

Regular visits (frequency varies)

Follow-up Data Collection

Follow-up data collection when the child is 15 months old, including surveys and assessments

1-2 weeks

1 visit (in-person)

Extended Follow-up

Additional follow-up surveys conducted when the child is 2.5 and 3.5 years old

2 years

2 visits (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Home Visiting

Trial Overview The MIHOPE study tests the effectiveness of home visiting services versus community service referrals on family outcomes. It involves over four thousand families across multiple states and uses data from various sources to evaluate these effects.

How Is the Trial Designed?

Group I: Home visiting Experimental Treatment 1 Intervention

Home visiting programs in the United States grew from three major approaches that first became prominent in the 1960s: visits by public health nurses to promote infant and child health in disadvantaged families, Head Start home visiting to promote school readiness in hard-to-reach families, and home-based family support to promote positive parenting and prevent child abuse in high-risk families. All of these approaches sought to foster early childhood health and development by intervening in the home to support and improve socialization, health, and education practices.Today, home visiting is seen as a particularly important strategy for high-risk families who may be difficult to engage in other services.

Who Is Running the Clinical Trial?

MDRC

Lead Sponsor

Trials

8

Recruited

18,900+

Mathematica Policy Research, Inc.

Collaborator

Trials

68

Recruited

31,130,000+

University of Georgia

Collaborator

Trials

109

Recruited

43,500+

Columbia University

Collaborator

Trials

1,529

Recruited

2,832,000+

Johns Hopkins University

Collaborator

Trials

2,366

Recruited

15,160,000+

James Bell Associates

Collaborator

Trials

2

Recruited

5,300+

Published Research Related to This Trial

In a study of 643 high-risk families, home visiting programs did not show significant differences in short- and long-term outcomes for mothers compared to control groups, indicating that the overall effectiveness may be limited.

However, maternal relationship security played a crucial role; mothers with high relationship anxiety but low avoidance benefited the most from home visiting, while those with high anxiety and avoidance experienced negative effects, suggesting the need for tailored approaches in home visiting services.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Maternal relationship security as a moderator of home visiting impacts on maternal psychosocial functioning. McFarlane, E., Burrell, L., Crowne, S., et al.[2021]

Citations

1. mchb.hrsa.gov mchb.hrsa.gov/programs-impact/maternal-infant-early-childhood-home-visiting-miechv-program

Maternal, Infant, and Early Childhood Home Visiting (MIECHV ... The MIECHV Program helps pregnant women and parents of young children improve health and well-being for themselves and their families.

2. acf.gov acf.gov/opre/project/mother-and-infant-home-visiting-program-evaluation-mihope-2011-2021

Mother and Infant Home Visiting Program Evaluation ... MIHOPE is a longitudinal study of the effects of Maternal, Infant, and Early Childhood Home Visiting (MIECHV)-funded home visiting on child and family outcomes.

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10468224/

Enrollment and outcomes of home visiting for mothers with ... Women previously in out-of-home care (ie, foster care) experience poorer health and psychosocial outcomes compared to peers, including higher pregnancy rates.

4. parentsasteachers.org parentsasteachers.org/wp-content/uploads/2024/10/PAT-Family-Outcomes-MIHOPE.pdf

New Insights from the Mother and Infant Home Visiting ... MIHOPE reported on 57 model-level outcomes in seven domains: child development, child health, child maltreatment, family economic self-sufficiency, intimate ...

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12013050/

Systematic review and meta-analysis of home visiting ... Numerous systematic reviews have shown home visiting interventions to be effective at improving a variety of parent and child outcomes.

6. nhvrc.org nhvrc.org/yearbook/2023-yearbook/about-home-visiting/results/

Results The 2023 Home Visiting Yearbook presents national and state data on who receives early childhood home visiting and who could still benefit.

7. mopqc.org mopqc.org/news/the-power-of-home-visiting-supporting-families-for-a-stronger-future/

The Power of Home Visiting: Supporting Families for a ... Research has consistently shown that home visiting positively impacts maternal and child health, child welfare, and early education outcomes. At ...