Maternal and Child Home Visiting

The North Carolina Landscape Study of Early Home Visiting Programs, provides the first in-depth analysis of the field of maternal and child health home visiting (HV) in its current form in North Carolina. Despite the increased awareness of the health, family, and educational benefits as well as cost savings that result from broad scale-up of HV programs, the public health impact of HV has been limited due to fragmented prenatal and early childhood systems, disparate funding streams, and the need to better match families with programs.

However, leaders in the field of home visiting are certain that a tipping point is within reach. A universally-available, comprehensive continuum of early parent and childhood services is possible. A better understanding of the field and the services provided to families is critical to future policy planning and to identify strategies to maximize efficiency and effectiveness.

The assessment was funded by the Winer Family Foundation, The Duke Endowment, the John Rex Endowment, and the ChildTrust Foundation. It was led by Drs. Paul Lanier and Sarah Verbiest at the Jordan Institute for Families at the UNC School of Social Work with key support from Katherine Bryant at the Center for Maternal and Infant Health and Gerard Chung, a doctoral student at the School of Social Work. A mixed methods design leveraging multiple data sources was used to provide a comprehensive statewide landscape analysis. Data sources included; 1) existing data from program reports or published literature from EHV models, 2) a project developed statewide survey, and 3) key informant interviews. The team also received support and feedback from three different advisory groups.

Our team at the Jordan Institute for Families in the School of Social Work at the University of North Carolina at Chapel Hill hopes that the information shared in the landscape analysis will be of value to the many partners across the state who deeply care about serving families.

Review the North Carolina Early Home Visiting Landscape Analysis Report here.

Click here to review maps and additional county-level information from the landscape of home visiting in North Carolina.

Click here for the executive summary.

Comments? Email Paul Lanier.

Additional Resources:

The National Home Visiting Resource Center offers many valuable resources – to our project and your work as well. Click here to access their 2017 Home Visiting State by State report.

A new report on Strengthening Home Visiting in Los Angeles, California may be of interest.

The purpose of the 2020 North Carolina (NC) Maternal Infant and Early Childhood Home Visiting (MIECHV) needs assessment was to identify populations at the greatest risk for poor maternal and child health outcomes and support decision-making about home visiting models that best meet state and local needs.¹ This report outlines the 2020 North Carolina (NC) Maternal Infant and Early Childhood Home Visiting (MIECHV) Needs Assessment by examining existing home visiting programs and specific counties identified as at-risk through community assessments. This work was done to highlight gaps in services for at-risk populations and emphasize strengths in NC’s home visiting programs.  

Our team at the University of North Carolina at Chapel Hill (UNC) utilized the resources provided by the US Department of Health and Human Services Health Resources and Services Administration (HRSA)1 to guide our process. We also engaged public and private partners in the needs assessment process. Our primary strategy for soliciting feedback came from engaging an advisory group which we convened regularly to provide updates and seek input. In addition, the UNC team had regular meetings with the NC MIECHV team and relied heavily on their expertise for interpreting findings and engaging with local partners. Further, the NC Home Visiting Consortium, convened by the NC Division of Public Health, provided input and resources for this work. The UNC team provided regular updates at each quarterly Consortium meeting. 

This report has five sections that are briefly outlined here. Part I: County Risk Assessment presents analysis of county-level quantitative data on a set of risk indicators culminating in a recommended set of six “high priority” counties. Part II: Readiness for Implementing Home Visiting follows from the first section by presenting findings from a qualitative analysis of focus groups conducted in the six high priority counties. These focus groups explored local readiness to implement home visiting. Part III: Existing Home Visiting Programs provides an in-depth inventory and descriptive analysis of existing home visiting programs in NC, focusing mainly on the quality and capacity of existing programs. The results of this section were primarily derived from a statewide survey fielded in late 2019. Part IV: Substance Use Disorder Prevention and Treatment focuses on the critical connection between home visiting and substance use services in NC. Like many other states in the region, NC is attempting to recover from a major substance use epidemic driven largely by untreated opioid addiction. Home visiting services are potentially a connection to treatment particularly for pregnant women and new parents. This section describes the landscape of substance use services in NC and how to improve this service connection. Part V: Coordination with other Needs Assessments situates the MIECHV needs assessment within the larger framework of public health and social services delivered in NC. We describe how the findings from this needs assessment has been coordinated with other state partners and how future efforts can continue coordination.  

This report provides additional details about the county risk assessment, the inventory of home visiting programs in the state, and survey results regarding the quality and capacity of current home visiting programs. The results of this needs assessment will support the NC Division of Public Health to identify target populations and select home visiting strategies that best meet state and local needs.  

The full Maternal Infant and Early Childhood Home Visiting Program North Carolina 2020 Statewide Needs Assessment report is available here. 

Our team developed three research briefs on specific topics reviewed during the North Carolina 2020 Statewide MIECHV Needs Assessment process. These are available at the links below.  

Research Brief One: County Risk Assessment 

Research Brief Two: Home Visiting Programs In North Carolina 

Research Brief Three: Home Visiting and Substance Use Disorder Treatment 

This MIECHV Needs Assessment was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $3,534,457 with 0 percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government.