Home-based programs allow children and families to receive one-on-one support through home visits from
healthcare providers, social service providers, or other community supporters. While home visits target
parents, or families holistically, they often help educate and empower parents or caretakers with strategies to
improve their family's health. Home-based programs allow service providers the flexibility to meet families
where they are, tailoring support to meet their unique needs. Parents and caregivers, particularly those with
infants or young children, may prefer to receive services in the comfort of their own homes.
Home visits often address social determinants of health that indirectly affect a child's health and well-being.
For example, some models incorporate assistance related to employment and transportation. Home-based programs
may be especially beneficial for families experiencing substance use or other behavioral health issues, because
receiving support from the privacy of one's home can help reduce the negative impact of stigma.
Home-based programs can be particularly beneficial in rural communities, where long distances to healthcare or
community centers and limited transportation options are barriers to accessing services. Evidence indicates that
visiting programs reduce child maltreatment, reduce child injury, improve parenting, and improve
economic security. The Community Preventive Service Task Force (CPSTF) recommends home-based programs for improving
asthma symptoms among children and reducing the number of school days missed due to asthma, as well as
home visits to improve
Examples of Home-Based Models
The Turtle Mountain Tribal Home Visiting
Program is implementing
the Parents as Teachers curriculum in Rolette County, North Dakota.
A community needs assessment found young families were facing challenges related to poverty, education, and
substance use disorders. While there were some services already available in the community, not many of these
services were for families with infants or young children. The home visiting program offers parenting education
and resources to support child development and family stability. Program data have reported an increase in the
recommended number of well-child visits attended, a decrease in the percentage of children reported to Child
Protective Services, and an increase in development screenings.
Healthy Families America is an evidence-based home
program with sites in 38 states. Families enrolled in the program receive services for a minimum of three years
and are paired with home visitors that are chosen based on their ability to establish strong and trusting
relationships with the family. The program is designed to build healthy parent-child relationships by helping
with family goal planning, accessing healthcare, providing referrals to community resources, and offering parent
Early Head Start Home-Based
available in all 50 states, aims to enhance the development of infants and very young children as well as to
strengthen family functioning. The program offers one home visit each week per family for a minimum of 46 visits
per year. The home visits last about 90 minutes each. The program also offers opportunities for monthly small
group socializations with other participating families.
Considerations for Implementation
Family engagement. Often, home-based programs target families dealing with challenging life
circumstances, such as poverty or domestic violence. Families in these situations may be overwhelmed with other
problems and therefore unable to fully commit to an intervention. Additionally, home visits can feel invasive
which may prevent families from fully engaging. One way to keep families engaged in a program is by establishing
a good, trusting relationship between program staff and the family.
Staffing. Home visiting programs need well-trained, experienced staff who are able to build
strong relationships with families. However, these personnel may be hard to recruit and retain in rural
settings. Low pay, stressful work conditions, and potentially long travel distances may contribute to staffing
challenges for home-based programs.
Cultural factors and language. Home visiting programs often address fundamental beliefs about
parenting — beliefs that are heavily influenced by culture. Home visiting programs should consider
factors and language with pairing home visitors with families. Home visiting personnel should be familiar with
the various cultures in their communities and able to communicate with families in a clear and effective way.
For more examples and information on home visiting programs, see Home Visiting Programs
to Overcome Transportation Barriers in the Rural Transportation Toolkit.
Program Clearinghouse Examples
Resources to Learn More
Infant, and Early Childhood Home Visiting Program
Introduces the Health Resources and Services Administration's (HRSA) home visiting grant program in partnership
with the Administration for Children and Families (ACF) for developing and implementing evidence-based,
voluntary infant and early childhood programs to support and improve child development and health.
Organization(s): Health Resources and Services Administration (HRSA)
Early Childhood Home Visiting
Programs and Health
Provides an overview of early childhood home visiting programs for new and expectant parents. Offers information
supporting maternal and child health, child safety, food security, and positive parenting skills. Includes
discussion of research relevant to home visiting and health.
Author(s): Heather Sandstrom
Organization(s): Health Affairs