Research has consistently documented impressive outcomes for families enrolled in home visitor programs which are intensive, comprehensive, well integrated into other community services, and flexible in responding to a family's unique needs. Strategically, it makes sense to reach families as early as possible, when a child is born, in order to build parenting skills and prevent childhood health problems, notably child abuse and neglect. The initiative, launched in 1992, was conceived from a successful model already in place. The Hawaiian Model Healthy Start, the Hawaiian model which began as a demonstration program of the Hawaii Family Stress Center in 1985, was so successful in strengthening families that Hawaii's Legislature and the State Department of Health appropriated funding to expand Health Start services statewide. Families receive weekly home visits from trained paraprofessionals, tapering off to quarterly visits as a family's stability improves.
Services can continue until the child reaches age five and enters school.
Paraprofessionals also coordinate access to community-based services such as housing, substance abuse treatment and supplemental food programs. All families are linked to a health care provider to ensure that their children receive on-going care, are screened for developmental delays, and are immunized on schedule. Child health, child welfare, and education advocates across the country are now working to implement universal home visitor service systems in their states. They know that improving the quality of early childhood experiences increases a child's chance for optimal development. While incorporating the critical elements that research has found to contribute to program effectiveness, HFC services are being tailored to the unique needs and strengths of the communities in which they are implemented.