Improving connections to early childhood systems of care via a universal home visiting program in Massachusetts

Chie Kotake; Rebecca C Fauth; Katie Stetler; Jessica L Goldberg; Christine F Silva; Susan E Manning

doi:10.1016/j.childyouth.2023.106995

Improving connections to early childhood systems of care via a universal home visiting program in Massachusetts

Child Youth Serv Rev. 2023 Jul:150:10.1016/j.childyouth.2023.106995. doi: 10.1016/j.childyouth.2023.106995.

Authors

Chie Kotake¹, Rebecca C Fauth¹, Katie Stetler², Jessica L Goldberg¹, Christine F Silva², Susan E Manning^{2

3}

Affiliations

¹ Tufts Interdisciplinary Evaluation Research (TIER), Eliot-Pearson Department of Child Study and Human Development, Tufts University, Medford, MA, USA.
² Massachusetts Department of Public Health, Bureau of Family Health and Nutrition, Boston, MA, USA.
³ Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, GA, USA.

PMID: 38655564
PMCID: PMC11034735 (available on 2024-07-01)
DOI: 10.1016/j.childyouth.2023.106995

Abstract

Welcome Family is a universal, short-term nurse home visiting program designed to promote optimal maternal and infant physical and mental well-being and provide an entry point into the early childhood system of care to all families with newborns up to 8 weeks old living in defined communities in Massachusetts. The present study examines whether: 1) Welcome Family meets its goal of successfully connecting families to two early childhood programs-evidence-based home visiting (EBHV) and early intervention (EI)-relative to families with similar background experiences who do not participate in Welcome Family, and 2) whether these impacts are conditional on families' race and ethnicity and their primary language-two characteristics that are related to structural racism and health inequities. The study used coarsened exact matching (CEM) based on birth certificate data to match Welcome Family participants who enrolled during 2013-2017 to mothers and their infants living in the home visiting catchment areas who did not receive home visiting during the study period. Primary study outcomes included enrollment in any EBHV program supported by the Massachusetts Maternal, Infant, and Early Childhood Home Visiting (MA MIECHV) program up to age 1 year, measured using MA MIECHV home visiting program data, and EI service receipt for children aged up to age 3 years, measured using EI program data. Impacts were assessed by fitting weighted regression models adjusted for preterm birth, maternal depression, and substance use. Mothers' race, ethnicity, and language were included in the model as moderators of Welcome Family impacts on enrollment in EBHV and EI. Welcome Family participants (n = 3,866) had more than double the odds of EBHV enrollments up to age 1 and had 1.39 greater odds of receiving EI individualized family service plans (IFSPs) up to age 3 relative to the comparison group (n = 46,561). Mothers' primary language moderated Welcome Family impacts on EBHV enrollments. Universal, short-term programs such as Welcome Family may be an effective method of ensuring families who could benefit from more intensive early childhood services are identified, engaged, and enrolled.

Keywords: Early childhood system of care; Early intervention; Home visiting.

Grants and funding

CC999999/ImCDC/Intramural CDC HHS/United States