The overarching goal of the Mother and Infant Home Visiting Program Evaluation (MIHOPE) is to provide information about whether families and children benefit from Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program-funded early childhood home visiting programs as they operated from 2012 to 2017 (in the early years after the program’s inception), and if so, how. To do this, MIHOPE has examined child and family outcomes at multiple timepoints, including when the participating children were approximately 15 months old, 2.5 years old, 3.5 years old, and in kindergarten or first grade.

This report presents the results of the MIHOPE Kindergarten follow-up. Using data collected from 2018 to 2022, analyses examined the effects of early childhood home visiting programs on maternal, family, and child outcomes when children were in kindergarten or first grade.

MIHOPE is a randomized controlled trial. That is, to provide reliable estimates of home visiting programs’ effects, women who enrolled in the study were randomly assigned either to a MIEHCV-funded local home visiting program (the “program group”) or to receive information about other appropriate services in the community (the “control group”). A total of 4,229 families entered the study from October 2012 to October 2015. To be eligible for MIHOPE, women had to be at least 15 years of age and be either pregnant or have a child younger than 6 months of age when they enrolled in the study.

Purpose

The MIHOPE kindergarten follow-up was designed to measure the effects of home visiting at the outset of formal schooling, approximately five to six years after mothers enrolled in MIHOPE, as well as outcomes that predict the longer-term effects of home visiting. Additionally, the legislation that authorized MIECHV indicated that MIECHV-funded home visiting programs are expected to improve school readiness, and school readiness could not be measured during earlier MIHOPE follow-ups because the children were too young.

Key Findings and Highlights

To provide information about the effects of home visiting on mothers, children, and families across the broad range of areas that home visiting aims to affect, MIHOPE examined eight prespecified research questions using a statistical test that detects patterns of effects. Five of the questions were focused on maternal and family well-being, and three were focused on child outcomes.

• MIHOPE found statistically significant and positive effects of home visiting for the five research questions that measured maternal and family well-being outcomes. Results of the tests indicate that home visiting had favorable effects on outcomes more readily affected by direct interactions or services provided by home visitors. These outcomes include ones related to (1) maternal coping strategies and parenting behaviors that could be improved through direct interaction between parents and home visitors; (2) maternal mental and behavioral health; (3) parent-child interactions; (4) a constellation of outcomes related to conflict, violence, aggression, and maltreatment; and (5) families’ economic circumstances.

• MIHOPE found some evidence of positive effects of home visiting for the three research questions related to child functioning outcomes. The result of the test for children’s social-emotional functioning in the home context was statistically significant and positive. A similar pattern of effects emerged on outcomes related to children’s social-emotional functioning in school settings, but the test result was not statistically significant, potentially due to the smaller sample of teachers who reported on these measures. The test result was also not statistically significant for the research question related to children’s cognitive, language, and math skills.

Methods

Early childhood home visiting programs are designed to affect a wide range of maternal, family, and child outcomes across multiple areas. Given this broad emphasis, MIHOPE collected data for its kindergarten follow-up from multiple data sources, and the study team assessed impacts on 66 outcomes across five outcome areas.

To provide information about the effects of home visiting on mothers, children, and families across the broad range of areas that home visiting aims to affect, MIHOPE examined eight prespecified research questions using a statistical test that detects patterns of effects—that is, the magnitudes and directions of the effects—on a group of outcomes. Five of the questions were focused on maternal and family well-being, and three were focused on child outcomes.

Supplemental analyses examined whether there were differences based on the timing of data collection or by the grade of the child at the follow-up point. Appendixes to the report include the results of exploratory analyses conducted to assess whether the effects of home visiting were larger for some families than others, based on subgroups defined by (1) families’ demographic characteristics and psychosocial risk factors, such as educational attainment and adverse childhood experiences; and (2) the four evidence-based home visiting models included in MIHOPE. An additional appendix includes an exploratory examination of the mechanisms through which home visiting had effects on selected individual outcomes at the kindergarten follow-up using mediators measured at earlier waves of MIHOPE.