BY PAUL H. DWORKIN
My introduction to home visiting dates back to 1988, while on sabbatical leave in Oxford, England with my family.
My wife and I dutifully visited the local general practitioner to register for care. We were somewhat bemused by the lack of attention afforded our then 4-year-old daughter, only to be reassured two days later when a nurse health visitor showed up at our door to perform a home-based child health assessment.
The home visiting process so intrigued my wife, a certified health education specialist, and I that we conducted a study of British mothers’ perceptions of preventive health care. (Dworkin PH, Dworkin SM, Bernstein B, Sefi S, Macfarlane A. Maternal perceptions of preventive health care: a cross-cultural comparison. Health Visitor 1990;63:339-341)
In 2002, while I was advocating for inclusion of support for statewide dissemination of Help Me Grow within the Connecticut budget, the Director of the State Office of Policy and Management asked me whether Help Me Grow was related to home visiting.
I replied affirmatively, if hesitantly, reasoning that home visitors need access to Help Me Grow to ensure the linkage of their clients to community-based programs and services, and that home visiting services are important components of the Help Me Grow resource inventory. This exchange undoubtedly informed the placement of Help Me Grow within the Connecticut Children’s Trust Fund, our state agency responsible for child abuse prevention and for overseeing home visiting services of The Nurturing Families Network.
The evolving association between home visiting and Help Me Grow is further evidenced by requirements of The Maternal, Infant, and Early Childhood Home Visiting program (MIECHV) of HRSA, in collaboration with the Administration for Children and Families, as authorized by the Patient Protection and Affordable Care Act of 2010.
The program requires collaboration with Title V agencies, child welfare agencies, State Advisory Councils, and others, and several states have opted to strengthen these partnerships through building Help Me Grow systems.
New research findings from New Zealand offer yet more proof of the synergy between home visiting and the work that Help Me Grow does to facilitate the linkage to community-based programs and services. A nine-year follow-up of a home-visitation program, called Early Start, demonstrates moderate benefits in terms of reducing child abuse, increasing parental competence, and improving childhood behavioral adjustment.
The investigators, encouraged by the positive findings, suggest the possibility of even greater benefits by “…the closer integration of home-visiting services … into organizations providing health, educational, and behavioral support.” (Fergusson, DM, Boden JM, Horwood LJ. Nine-year follow-up of a home-visitation program: A randomized trial. Pediatrics 2013;131:297-303)
Help Me Grow partnership with home visiting programs enables the type of cross–sector collaboration among child health, early care and education, and family support that is so critical to ensure the promotion of children’s healthy development. At present, 12 of our Help Me Grow affiliate states (CA, CO, CT, DE, FL, IA, KY, LA, MA, NJ, NY, OR, UT, WA, WV) also receive MIECHV funds.
Help Me Grow/home visiting partnerships are far more than simply administrative conveniences. We consistently emphasize that effective programs such as Help Me Grow are best viewed in the context of comprehensive state systems supporting young children’s healthy development. Findings from the New Zealand study reinforce this message by suggesting the compelling benefits of fully harnessing the synergy between Help Me Grow and home visiting.