This component analysis used meta-analytic techniques to synthesize the results of 77 published evaluations of parent training programs (i.e., programs that included the active acquisition of parenting skills) to enhance behavior and adjustment in children aged 0-7. Characteristics of program content and delivery method were used to predict effect sizes on measures of parenting behaviors and children's externalizing behavior. After controlling for differences attributable to research design, program components consistently associated with larger effects included increasing positive parent-child interactions and emotional communication skills, teaching parents to use time out and the importance of parenting consistency, and requiring parents to practice new skills with their children during parent training sessions. Program components consistently associated with smaller effects included teaching parents problem solving; teaching parents to promote children's cognitive, academic, or social skills; and providing other, additional services. The results have implications for selection and strengthening of existing parent training programs.

Introduction Although several systematic reviews have concluded that home visiting has strong evidence of effectiveness, individual evaluations have produced inconsistent results across and within programs. We used a component-based, domain-specific approach to determine which program characteristics most strongly predict outcomes across a range of programs and models. Methods Medline and PsycINFO searches identified evaluations of universal and selected home visiting programs implemented in the United States. Coders trained to criterion coded characteristics of research design, program content, and service delivery. We conducted random-effects, inverse-variance-weighted linear regressions using program characteristics to predict effect sizes (ESs) on six outcome domains (birth outcomes, parenting behavior, maternal life course, child cognitive outcomes, child physical health, and child maltreatment). Results Aggregated to a single ES per study (k=51), the mean ES was 0.20 (95% CI = 0.14, 0.27), with a range of – 0.68 to 3.95. Mean ESs were significant and positive for three of the six outcome domains (maternal life course outcomes, child cognitive outcomes, and parent behaviors and skills), with marked heterogeneity of ESs in all six outcome domains. Research design characteristics generally did not predict ESs across the six outcome domains. No consistent pattern of effective components emerged across all outcome domains. Conclusions Home visiting programs evidenced small but significant overall effects, with wide variability in the size of domain-specific effects and in the components that significantly predicted domain-specific effects. Communities may need complementary or alternative strategies to home visiting programs to ensure widespread impact on these six important public health outcomes.

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Home visiting can play a key role in the early childhood system of services. For home visiting to achieve its potential, decision-makers must make informed choices regarding adoption, adaptation, coordination, scale-up, and sustainment. We need a coordinated, focused, and theory-based home visiting research infrastructure to inform such decisions. The transdisciplinary Home Visiting Research Network (HVRN) was established in July 2012 with funding from the Health Resources and Services Administration. Its goal is to promote the translation of research findings into policy and practice. Its objectives are to (1) develop a national home visiting research agenda, (2) advance the use of innovative research methods; and (3) provide a research environment that is supportive of the professional development of emerging researchers interested in home visiting. A Management Team designs and directs activities to achieve these objectives through Work Teams. A Steering Committee of national leaders representing stakeholder groups oversees progress. HVRN’s Coordinating Center supports the Work Teams and HVRN’s Home visiting Applied Research Collaborative, a practice-based research network of home visiting programs. This article describes HVRN’s rationale, approach, and anticipated products. We use home visiting–primary care coordination as an illustration, noting potential roles for pediatric practices and pediatric researchers and research educators in HVRN activities. HVRN creates the infrastructure for a rigorous program of research to inform policy and practice on home visiting as part of the system of services to improve family functioning, parenting, and child outcomes.

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