Abstract
The objective of this study is to report the findings of a 7-month pilot for an integrated system evaluating a state-wide
home visiting program. A cross-sectional study design was used to determine baseline process and outcome measures for Tennessee’s
home visiting program which provides services to families, from pregnancy through 5-years-old. Baseline process measures included:
time to initiate service after referral; frequency, duration and intensity of visits; completion of continuous assessment;
and time from identification of a need to referral. The baseline outcome measures included: needs of eligible services (e.g. developmental screenings, WIC); prenatal care utilization; biological risks (prematurity; low birth weight); tobacco use
and second-hand smoke exposure; and family planning utilization. During the pilot, 3,794 families were enrolled, representing
68% (± 1.5%) of incoming referrals. Enrollment dropped from 82% (90 days) to 69% (120 days); 52% of the families received
a visit every month. Ninety percent of families had at least one full assessment after enrollment; 60% occurred within the
first 60 days. Over 92% of outgoing referrals were made within 7 days. Immunization status (70%) is below the state level
(80.8%). A quarter of the infants enrolled in the program are low birth weight and premature (state level 9.2%). Current tobacco
use by the prenatal population is 16% compared to the state, 19.7%. The HUGS program serves high risk/high need clients and
is consistent with other national home visiting models that have shown higher levels of attrition and lower levels of visits
than intended by the model.
home visiting program. A cross-sectional study design was used to determine baseline process and outcome measures for Tennessee’s
home visiting program which provides services to families, from pregnancy through 5-years-old. Baseline process measures included:
time to initiate service after referral; frequency, duration and intensity of visits; completion of continuous assessment;
and time from identification of a need to referral. The baseline outcome measures included: needs of eligible services (e.g. developmental screenings, WIC); prenatal care utilization; biological risks (prematurity; low birth weight); tobacco use
and second-hand smoke exposure; and family planning utilization. During the pilot, 3,794 families were enrolled, representing
68% (± 1.5%) of incoming referrals. Enrollment dropped from 82% (90 days) to 69% (120 days); 52% of the families received
a visit every month. Ninety percent of families had at least one full assessment after enrollment; 60% occurred within the
first 60 days. Over 92% of outgoing referrals were made within 7 days. Immunization status (70%) is below the state level
(80.8%). A quarter of the infants enrolled in the program are low birth weight and premature (state level 9.2%). Current tobacco
use by the prenatal population is 16% compared to the state, 19.7%. The HUGS program serves high risk/high need clients and
is consistent with other national home visiting models that have shown higher levels of attrition and lower levels of visits
than intended by the model.
- Content Type Journal Article
- Pages 1-12
- DOI 10.1007/s10995-011-0905-7
- Authors
- Bridget K. McCabe, Bureau of Health Services, Tennessee Department of Health, Cordell Hull Building, 4th Floor, 425 5th Avenue North, Nashville, TN 37243, USA
- Dru Potash, Bureau of Health Services, Tennessee Department of Health, Cordell Hull Building, 4th Floor, 425 5th Avenue North, Nashville, TN 37243, USA
- Ellen Omohundro, Bureau of Health Services, Tennessee Department of Health, Cordell Hull Building, 4th Floor, 425 5th Avenue North, Nashville, TN 37243, USA
- Cathy R. Taylor, Bureau of Health Services, Tennessee Department of Health, Cordell Hull Building, 4th Floor, 425 5th Avenue North, Nashville, TN 37243, USA
- Journal Maternal and Child Health Journal
- Online ISSN 1573-6628
- Print ISSN 1092-7875