Home visiting helps children and parents — more families could use it

When Army Spc. Jamal Getter was deployed to Bahrain in 2014, he felt secure knowing there was someone back home helping his wife, Pauletta, and newborn daughter, the couple’s first child. That other person “on duty” was a trained nurse who regularly visited Pauletta free-of-charge as part of a voluntary home visiting program.

First, Pauletta had preterm labor problems. Then, she discovered parenting “really didn’t come naturally to me,” she says. “I had no idea if the crying meant I needed to take the baby to the doctor or not.”

{mosads}Home visiting connects expectant parents and parents of young children to a designated support person — often a trained nurse, social worker or early-childhood specialist. This nurse was part of Nurse-Family Partnership, one of 15 evidence-based home visiting models that served more than 300,000 families across the country last year.

Research shows that children’s brains develop more, and faster, during the first five years of life than at any other time. Home visiting typically serves families with children under age 6 not yet in kindergarten — from single parents juggling new responsibilities to teen parents completing high school. It can be an especially important lifeline for military families such as Jamal and Pauletta Getter, who often find themselves in unfamiliar locations far from friends and family.

According to the just-released 2018 Home Visiting Yearbook from the National Home Visiting Resource Center (NHVRC), about 18 million pregnant women and families (including more than 23 million children) across the country could benefit from home visiting. Pregnant moms enrolled in home visiting are more likely to access prenatal care and carry their babies to term. Home visitors also help parents recognize the value of activities such as reading that translate to improvements in early language and cognitive development — and later, academic achievement.

Despite home visiting’s proven potential, services reach only a fraction of eligible families. Many programs try to maximize limited resources by prioritizing families who might need extra support. The NHVRC defines high-priority families as those with an infant, single mother, income below the poverty threshold, mother under 21 or parent(s) with less than a high school education.

More than half of all eligible families meet any one of those criteria, and 1 in 5 meet two or more. On a state level, the percentage of high-priority families ranges from 43 percent in Utah to 62 percent in Mississippi and New Mexico.

The military long has recognized the need to strengthen children’s potential through robust services for families, from home visiting to quality pre-K. And at a time when the partisan divide is so great in our country, it’s reassuring to know that home visiting is something that can bring us together. This year, Congress passed and President Trump signed reauthorization for the federal Maternal, Infant, and Early Childhood Home Visiting Program. Their actions reflect bipartisan support for home visiting’s evidence base and its potential to strengthen two generations.

Today, the Getters are raising a healthy 4-year-old and eagerly awaiting the birth of their second child, a son. Pauletta helps others as a postpartum doula and early childhood educator. She credits her home visiting experience for inspiring her career and building her confidence at home. Let’s do more to help other children and families thrive.

Nancy E. Brown is a retired U.S. Navy vice admiral and member of Mission: Readiness, the organization of 750 retired admirals and generals strengthening national security by ensuring kids stay in school, stay fit, and stay out of trouble.

Anne K. Duggan is a professor of population, family and reproductive health, health policy and management, and mental health at the Johns Hopkins University Bloomberg School of Public Health. She is director of the Home Visiting Applied Research Collaborative as well as co-principal investigator of the Mother and Infant Home Visiting Program Evaluation. She is on the advisory committee for the Home Visiting Yearbook.