Journal Issue: Home Visiting Volume 3 Number 3 Winter 1993
Home visiting appears to be one of the most frequently used early intervention strategies or family support programs in the United States to improve the health and development of children. Although some home visiting programs are conceptualized merely as an efficient or economical means of service delivery, these programs are most often construed as a treatment strategy that contains unique and powerful characteristics relative to improving children's health and development. As one recent review of home visiting programs concluded, however, the diversity among programs providing home visiting and the "incomplete but suggestive empirical support for its usefulness, creates an imperative for a more systematic approach to demonstration and evaluation efforts in this area."l
This article outlines one of the next steps in developing such an approach. It offers a conceptual framework for understanding and describing more precisely the modes of operation of home visiting programs and the specific domains of early childhood health and development they intend to address. Thus, the article begins with a discussion of health and development in the first three years of life. Then, the implications of this knowledge for the design of home visiting programs are considered. Finally, an analytical grid is presented as a tool for both describing and evaluating home visiting programs. Although this article focuses on children, programs that improve their health and development are likely also to bring about beneficial changes in their parents and the family as a whole.