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Heather Weiss, director at the Harvard Family Research Project, describes a consortium of national organizations working to improve home visitation systems to help young children and their families.

The Home Visit Forum is a group of six national home visitation programs working together to strengthen the research and evaluation capacity of home visitation and contribute to continuous improvement efforts in the home visit arena. The Forum consists of representatives from Early Head Start, Healthy Families America, Home Instruction for Parents of Preschool Youngsters, the Nurse-Family Partnership, Parents As Teachers, and the Parent-Child Home Program. To maximize the potential for organizational learning and application at local, state, and national levels, each program brings to the table its chief executive officer, directors of research and of training, a local program director and, in several cases, a university-based research and evaluation partner.

The Forum's management, facilitation, and strategic planning are provided by Dr. Deborah Daro, from the Chapin Hall Center for Children at the University of Chicago; Dr. Barbara Wasik, from the Center for Home Visiting at the University of North Carolina at Chapel Hill; and myself, Dr. Heather B. Weiss, from Harvard Family Research Project, Harvard Graduate School of Education.

In the sometimes-competitive world of home visitation, the Forum is committed to achieving three goals:

  • Strengthening the empirical and clinical capacity to improve home visitation services and outcomes
  • Developing strategic and multimodel research efforts that link to and improve practice, model development, and training
  • Sharing lessons with the broader home visitation and early childhood fields through papers, publications, new tools, and a website

While each of the six participating program models has unique attributes, all share a number of goals and challenges. In each case, home visitation is the main mechanism by which services are delivered. Each program is engaged in efforts to scale up and develop a strong national organization that supports state and local affiliates. The six groups work together to create areas for cross-model cooperation and learning that benefit the Forum and the home visitation field as a whole, as well as each participating organization.

The Forum has developed a three-stage theory of change¹ that guides its work. During the first stage, members shared information and learned about one another's models, evaluation strategies, and organizations. They also discussed areas where joint inquiry and practice-based research would be helpful to their own and other home visitation and early childhood programs.

After considering a broad range of issues, Forum members voted to focus the second stage of their work on the major issue of participant recruitment, engagement, and retention. Once a shared set of research questions had been developed and a commitment to sharing results had been made, each model received a mini grant to conduct research with affiliate sites. Doing cross-model planning for the mini grants and conducting research with local affiliates resulted in clarification and revision of the definitions of enrollment and retention rates and how to measure them.

Additionally, several new partnerships between the models and university-based researchers interested in applied research were formed. Emphasis on affiliate data quality and the use of data to inform training and supervision practices increased, and new means were developed to monitor and support affiliate development. Forum members shared data collection instruments and measurement tools along with research results.

Discussion of the mini grant results surfaced a number of lessons and issues for consideration at the national-office level and beyond. These include the way contextual factors—particularly the multiple and unstable sources of funding—influence home visitor training and retention, and how this in turn affects recruitment and parent engagement. The lessons also include recognizing the need for better understanding of the role and training of supervisors or program coordinators, the tensions around delivering the model and meeting other family needs, and finding the right balance between replication and local individualization of the model.

The cross-model learning process prepared the Forum for its third and current stage—collaborative work to develop materials that will be useful beyond the Forum and the examination of the roles home visitation can play in broader systems of early childhood services. This current work is guided by three cross-model working groups focusing on public policy and advocacy, training and supervision, and research and evaluation. The first group is preparing materials to inform policymakers about the benefits of home visitation; the second is developing tools to improve home visitor supervision. The third group, working on research and evaluation, is examining and comparing the theories of change used by each of the six models to further clarify and test them.

The Forum, in keeping with the goal of sharing its work, will post these materials on its website. The Forum's facilitators will also be preparing a paper² assessing the group's development and effectiveness as a means of moving from competition to coopetition (i.e., selective cooperation) in order to support continuous learning and improvement to strengthen the home visitation field.

More information on the Home Visit Forum is available on the website.

¹ A program's theory of change explicitly articulates how the activities provided lead to the desired results by linking service receipt to intermediate changes (such as changes in attitudes or in-program behaviors) to short- and longer-term outcomes in participants.
² This paper is due out in late 2004 and will be posted on the Forum's website.

Heather B. Weiss, Ed.D., Founder & Director, HFRP

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