DOI: 10.3886/icpsr37848.v3
title: Mother and Infant Home Visiting Program Evaluation (MIHOPE), United States, 2012-2019
title: Version 3

description: In 2010, the United States Congress authorized the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program, which started a major expansion of evidence-based home visiting programs for families living in at-risk communities. MIECHV is administered by the Health Resources and Services Administration (HRSA) in collaboration with the Administration for Children and Families (ACF) within the U.S. Department of Health and Human Services (HHS). The authorizing legislation required an evaluation of the program, which became the Mother and Infant Home Visiting Program Evaluation (MIHOPE). The evaluation is being conducted for HHS by MDRC with James Bell Associates, Johns Hopkins University, Mathematica, the University of Georgia, and Columbia University. MIHOPE was designed to learn whether families benefit from MIECHV-funded early childhood home visiting programs, and if so, how. The study included the four evidence-based models that 10 or more states chose in their initial MIECHV plans in fiscal year 2010-2011: Early Head Start - Home-based option, Healthy Families America, Nurse-Family Partnership, and Parents as Teachers. MIHOPE was the first study to include all of these four evidence-based models. To provide rigorous evidence on the MIECHV-funded programs' effects, the study randomly assigned more than 4,200 families to receive either MIECHV-funded home visiting or information on community services. As is the standard method in studies that use random assignment, the primary analytical strategy in MIHOPE was to compare the outcomes of the entire program group with those of the entire control group. As per the authorizing legislation, the study measured early effects on family and child outcomes in the areas listed below, with the exception of school readiness and academic achievement (which were not included at this point because children were too young to measure those outcomes): Prenatal, maternal, and newborn health Child health and development, including child maltreatment Parenting skills School readiness and child academic achievement Crime and domestic violence Family economic self-sufficiency Referrals and service coordination <strong>Videos and Video Metadata:</strong> Two sets of videos are included in the MIHOPE restricted access files. They include: Mother-home visitor interactions at 387 home visits and Interactions between child and mother using the "Three Bags" and "Clean-Up" tasks with 2,832 families. The mother-home visitor interaction videos were recorded only for treatment group families at two points in time: the first was, on average, about eight weeks after the family's first home visit and the second was about eight months after the family's first home visit. Overall, 264 families are included in the mother-home visitor interaction videos in total, with 123 of these families recorded at both points in time. The mother-child interaction videos, during which the child and mother play with toys contained in three bags and place the toys back in the bags (the "Three Bags" and "Clean-Up" tasks), were recorded when the 15-month in-home assessments were conducted and are available for 2,832 families in the treatment and control groups. The videos are only linkable to a few pieces of metadata (home visiting model, video ID, treatment status, and variables indicating whether the family appears in the home visit videos, the three-bag task videos, or both). The videos in the restricted access data are not linkable to any other data included in the restricted access files. Additionally, the videos may only be viewed at the Inter-university Consortium for Political and Social Research's on-site Physical Data Enclave in Ann Arbor, Michigan.
description: The Mother and Infant Home Visiting Program Evaluation (MIHOPE) aims to provide federal and state policymakers, service providers, and other interested parties with valuable information about whether and how home visiting programs improve outcomes for children and families. MIHOPE enrolls approximately 4,300 at-risk families who are expecting a baby or have an infant up to 6 months old. The study includes 88 program sites in 12 states nationwide. MIHOPE includes four evidence-based home visiting models: Early Head Start-Home Based Program Option, Healthy Families America, Nurse-Family Partnership, and Parents as Teachers. MIHOPE has a number of aims. It will: Assess the effects of the programs on child and parent outcomes, including prenatal, maternal, and newborn health; child health and development; parenting skills; school readiness and academic achievement; crime and domestic violence; family economic self-sufficiency; and referrals and service coordination Examine how the program models operate in their local and state contexts, linking implementation strategies to program impacts to inform the field about the types of program features or strategies that might lead to greater impacts on families Assess the potential of the programs to affect the health care system and to reduce costs
description: <strong>Family Analysis Data:</strong> The family analysis dataset contains the family baseline and outcome measures used in the Mother and Infant Home Visiting Program Evaluation (MIHOPE) implementation research and 15-month impact reports as well as selected variables derived from administrative data sources. More specifically, these data sources include: Interviews with mothers and observation ratings of the family home and external environment at the time of study entry (conducted between October 2012 and September 2015); Interviews with the children's primary caregivers and in-home assessments when children were approximately 15 months old (conducted between May 2014 and June 2017); 2014 American Community Survey five-year estimates (ACS) on characteristics of the community (specifically, the census tract) a family lived in when entering the study; and Administrative data from the 12 states included in the evaluation (specifically, birth records data, Medicaid and Children's Health Insurance Program [CHIP] enrollment records and health care use data for mothers and children, and child protective services data). <strong>Family Baseline-Study Intake Data:</strong> The family baseline data set is primarily comprised of the family's demographic and household characteristics information from the family baseline interviews, which were conducted with mothers at the time of study entry. In this data set, these data are supplemented with study intake, vital records, and Medicaid data about characteristics of the mother at baseline. Family baseline surveys were completed between October 2012 and September 2015. <strong>Family 15-Month Caregiver Interview Data:</strong> This file includes information from the caregiver interview conducted via telephone when the child was approximately 15 months old. The survey asked about outcomes in the following domains: (1) maternal health, (2) family economic self-sufficiency, (3) intimate partner violence, (4) parenting, (5) child maltreatment, (6) child health, and (7) child development. Family 15-month caregiver surveys were completed between May 2014 and June 2017. <strong>Family 15-Month In-Home Assessment Data:</strong> The 15-month assessments were conducted with the focal child and their primary caregiver in the family's home when the child was approximately 15 months old. Family 15-month in-home assessments were completed between June 2014 and June 2017. These assessments gathered information using several different methods: The "Three-Bags" and "Clean-Up" Activities; The "English Preschool Language Scales, Fifth Edition (PLS-5), Auditory Comprehension" scale; The "Infant-Toddler Home Observation Measurement of the Environment (IT-HOME)" interview and observational ratings; Height and weight measurements for the child; and Weight measurement for the mother. <strong>Service Delivery Data:</strong> The family service logs completed by the home visitors are the source of service delivery information for families participating in MIHOPE. They provide information on dosage, including the frequency, type, and duration of contacts with the family; home visitor continuity; visit content, including topics discussed and referrals provided; and levels of family responsiveness. Only families in the treatment group have service delivery data. Family service logs were completed between November 2012 and June 2016. <strong>Home Visitor Survey Data</strong> and <strong>Supervisor Survey Data:</strong> Home visitors and supervisors (of home visitors) working in local programs that were participating in MIHOPE took the home visitor and supervisor survey, respectively, which provide data on staff demographics as well as past and current work experiences among other information. Home visitors and supervisors were administered surveys at two time points: at baseline (when the local program entered MIHOPE) and 12 months after the program entered the study. Data from both rounds of surveys are included in the home visitor and supervisor survey data. Home visitor and supervisor surveys were completed between September 2012 and July 2015. <strong>Home Visitor and Supervisor Training</strong> and <strong>Home Visitor Supervision Data:</strong> Training logs completed by home visitors and supervisors are the source of information on trainings attended during the study by home visitors and supervisors at local programs participating in MIHOPE. Similarly, supervision logs - completed by supervisors about home visitors on their caseloads - are the source of information on the level of supervision provided to individual home visitors during the study. The supervision logs provide information on both formal and informal supervision that occurred during the reporting week. Training logs were completed between November 2012 and May 2016. Supervision logs were completed between November 2012 and February 2016. <strong>Home Visitor and Supervisor Job Description Coding Data:</strong> Local programs participating in MIHOPE were asked to submit copies of job descriptions used in hiring home visitors and supervisors. In some instances, local programs indicated they used the job description form provided by their evidence-based model. The four evidence-based models included in MIHOPE also provided copies of these job descriptions when available. All job descriptions were coded by the research team. <strong>Local Program Data:</strong> Most of the local program-level data come from the program manager surveys that were conducted with the program manager at each of the 88 local programs included in MIHOPE. The program manager survey data set is supplemented with selected site log data, 2014 ACS five-year estimates data, and data on local program policies' alignment with those reported by the national model developer. Program managers provided responses to surveys between September 2012 and June 2015. <strong>Videos and Video Metadata:</strong> The mother-home visitor interaction videos were recorded for treatment group families only at two points in time: the first was, on average, about eight weeks after the family's first home visit and the second was about eight months after the family's first home visit. Overall, 264 families are included in the mother-home visitor interaction videos in total, with 123 of these families recorded at both points in time. Two sets of videos were included in the MIHOPE. They included: Mother-home visitor interactions at 387 home visits Interactions between child and mother using the "Three Bags" and "Clean-Up" tasks with 2,832 families <strong>Mother-Home Visitor Interaction Video Coding Data:</strong> Among the 387 mother-home visitor interaction videos that were recorded and included in the MIHOPE, 200 videos were selected to be coded as a "sub-study." The 200 videos were selected to be representative of states, local programs, home visitors, and families in MIHOPE. The coding of these videos describes the content and nature of mother-home visitor communication in visits and allows for assessment of the completeness and accuracy of the family service log data that are used to describe the content of visits. The video coding data is linkable to other quantitative data, but not linkable to the videos themselves. Observations were conducted between March 2013 and July 2015. <strong>Family-Level Cost Data:</strong> The family-level cost data set draws from multiple data sources. For MIHOPE program group families, the family service logs provide information related to the number of home visits (completed and attempted but incomplete) received, staff travel time to and from home visits, staff time spent preparing and communicating with the participating family, and costs of materials provided to family. Expenditure reports provided to MDRC by participating local programs provide information about costs that cannot be tied to individual families (for example, costs that provide an aggregate benefit to all families, such as the cost of office space). Medicaid data provide information about healthcare utilization costs by both program and control group families in MIHOPE. <strong>Local Program-Level Cost Data:</strong> The local program-level cost data set draws from expenditure reports provided to MDRC by local home visiting programs participating in MIHOPE. Local programs typically provided information on expenditures using an end-of-year financial report for the most recently completed fiscal year. MIHOPE research staff reviewed the information submitted by local programs and conducted follow-up phone calls to clarify questions and to ensure accuracy to the extent possible. These efforts helped ensure that local programs used the same operational definitions for expenditure categories, that they valued resources consistently, and that they used consistent time periods for expenditures and activities. Expenditure reports were requested from local programs for 2014 and 2015, and those that provided two years of high-quality data had their expenditures averaged across the two years. Otherwise, the year with the higher-quality data contributed to the analysis alone. <strong>Check-In Analysis Data:</strong> The Check-in analysis dataset contains the measures used in the MIHOPE Check-in report that cannot be found in data files included in the baseline and 15-month MIHOPE Restricted Access Files (RAF). More specifically, these data sources include: Surveys conducted with the children's primary caregivers when children were approximately 2.5 years old (conducted between September 2015 and June 2018) Surveys conducted with the children's primary caregivers when children were approximately 3.5 years old (conducted between June 2017 and June 2019) These data were used in combination with family baseline measures and outcome measures from the 15-month follow-up to provide a snapshot of families' life circumstances at each time point <strong>Family 2.5-Year Caregiver Survey Data:</strong> This data includes information from the caregiver survey conducted via telephone or web when the child was approximately 2.5 years old. The survey includes information on the following: (1) child health, (2) parenting, (3) discipline, (4) parent health and well-being, (5) health insurance, (6) family economic self-sufficiency, (7) parent mental health, (8) social services, and (9) confirming contact information. Family 2.5-year caregiver surveys were completed between September 2015 and June 2018. <strong>Family 3.5-Year Caregiver Survey Data:</strong> This data includes information from the caregiver survey conducted via telephone or web when the child was approximately 3.5 years old. The survey includes information on the following: (1) child health, (2) parenting, (3) discipline, (4) parent health and well-being, (5) health insurance, (6) family economic self-sufficiency, (7) parent mental health, (8) social services, and (9) confirming contact information. Family 3.5-year caregiver surveys were completed between June 2017 and June 2019.
description: Response Rates: Family baseline survey: 100 percent Family 15-month in-home assessment: 73 percent Family 15-month follow-up survey: 79 percent Home visitor survey: 84 percent Observer Ratings of the Family Home and External Environment at baseline: 100 percent Program manager survey: 100 percent Supervisor survey: 90 percent
description: Presence of Common Scales: Adult-Adolescent Parenting Inventory-2 (AAPI-2) Attachment Style Questionnaire (ASQ); Brief Infant-Toddler Social and Emotional Assessment (BITSEA) 10-item version of the Center for Epidemiological Studies-Depression Scale (CES-D) Conflict Tactics Scale: Parent Child version (CTSPC) Emotionality, Activity, Sociability, and Impulsivity Temperament Scale - II (EASI--II) Generalized Anxiety Disorder 7-Item (GAD-7) Home Observation for Measurement of the Environment (HOME) Inventory; Home Visit Rating Observation Scales - Adapted and Extended (HOVRS-A+) Home Visiting Conversation Analysis Measure (HV-CAM) Infant-Toddler Home Observation for Measurement of the Environment (IT-HOME) Inventory Organizational Social Context (OSC); Parenting Stress Index - Short Form (PSI-SF) Pearlin Mastery Scale Preschool Language Scales, Fifth Edition (PLS-5) Revised Conflict Tactics Scale (CTS2) Roter Interaction Analysis System - Adapted for Home Visiting (RIAS-HV) Similarities Subscale of the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III) and the Spanish equivalent Escala de Inteligencia de Wechsler para Adultos-Tercera Edición (EIWA-III) Three-Bag Task and Clean-Up Task Women's Experience with Battering (WEB) Scale
description: The study team chose states to participate in the study by first reviewing the 2010 and 2011 state Maternal, Infant, and Early Childhood Home Visiting (MIECHV) plans and identifying 31 states that were the most likely to contribute the right mix and number of local programs to the study because they met the following initial set of criteria: They were planning to implement more than one of the four evidence-based models being studied by Mother and Infant Home Visiting Program Evaluation (MIHOPE). They were planning to support five or more eligible local programs. They mentioned an intention to serve military families. Next, the study team narrowed the list of eligible states by prioritizing states that would allow the final sample to: Represent each of four geographic regions of the United States (Northeast, South, Midwest and Plains, and Mountain and West). Include a similar number of local programs for each of the four evidence-based models. Include some local programs operating in nonmetropolitan areas. The study team then met with a subset of these states to assess each state's progress in implementing MIECHV, including whether other research on home visiting was taking place in the state and the status of decisions regarding MIECHV funding. The study team then expanded discussions to several additional states to ensure the models were about equally distributed and that the local programs were geographically diverse. Those discussions resulted in a choice of the following 12 states to participate in MIHOPE: California, Georgia, Illinois, Iowa, Kansas, Michigan, Nevada, New Jersey, Pennsylvania, South Carolina, Washington, and Wisconsin. Second, the study team chose local programs within the 12 states using the following criteria: They were operating one of the four evidence-based models of home visiting noted earlier. They had been in operation for at least two years. They could recruit enough families to allow for a randomly chosen control group. They had more than one MIECHV-funded home visitor. They were not operating in "frontier" locations, which were sparsely populated counties or those that were not adjacent to metropolitan areas. In states with more eligible programs than were needed for the study, the study team randomly chose programs to participate, with some weighting toward programs in rural counties where possible. Eighty-eight local programs met these criteria and agreed to participate in MIHOPE. Finally, MIHOPE included families who were interested in receiving home visiting services from one of the 88 local programs participating in the study. However, not all such families were eligible to participate in MIHOPE. Eligibility for MIHOPE was limited to women who were pregnant or had children less than 6 months old when they entered the study, were at least 15 years old, were assessed as able to provide consent and complete a survey in English or Spanish, and were not already receiving home visiting services from a local program participating in MIHOPE. MIHOPE used a random assignment design intended to create treatment and control groups that were similar when women entered the study, so that systematic differences in the outcomes of interest observed between the two groups could be attributed to the home visiting services rather than to the preexisting characteristics of the women. This process resulted in a final sample that included more than 4,200 families recruited from 88 local programs in 12 states. The 88 local programs consisted of 19 Early Head Start - Home-based option programs, 26 Healthy Families America programs, 22 Nurse-Family Partnership programs, and 21 Parents as Teachers programs.
description: Datasets: DS0: Study-Level Files DS1: Family Analysis Data DS2: Family Baseline Survey-Study Intake Data DS3: Family 15-Month Caregiver Interview Data DS4: Family 15-Month In-Home Assessment Data DS5: Service Delivery Data DS6: Home Visitor Survey Data DS7: Supervisor Survey Data DS8: Home Visitor and Supervisor Training Data DS9: Home Visitor Supervision Data DS10: Home Visitor and Supervisor Job Description Coding Data DS11: Local Program Data DS12: Videos and Video Metadata DS13: Mother-Home Visitor Interaction Video Coding Data DS14: Family-Level Cost Data DS15: Local Program-Level Cost Data DS16: Check-In Analysis Data DS17: Family 2.5-Year Caregiver Survey Data DS18: Family 3.5-Year Caregiver Survey Data
description: Local home visiting programs and participants across 12 states.
description: computer-assisted telephone interview (CATI); coded on-site observation; coded video observation; cognitive assessment test; web-based surveyFor additional information on the Mother and Infant Home Visiting Program Evaluation (MIHOPE), visit the MIHOPE study website.