Affordable Care Act - Maternal, Infant, and Early Childhood Home Visiting Research Program

programs for mothers and children. The following legislative requirements apply to proposals submitted for the MIECHV Research Program: o The use of random assignment design is required to the maximum extent feasible; o Evaluation of a specific program or project shall be conducted by persons or individuals not directly involved in the operation of such program or project; o The conduct of research and evaluation activities shall include consultation with independent researchers, State officials, and developers and providers of home visiting programs on topics including research design and administrative data matching. Research proposals should address critical home visiting questions, with the following as examples: o Testing the effectiveness of approaches to the implementation of evidence-based home visiting programs within communities; o Testing the efficacy of enhancements to evidence-based home visiting programs, including but not limited to: culturally appropriate adaptations; enhancements to address intimate-partner violence, substance abuse, and maternal or paternal health and wellbeing; or enhancements related to improving the participant outcomes or benchmark domains specified in the Maternal, Infant, and Early Childhood Home Visiting legislation (i.e., (1) Improve maternal and newborn health; (2) Prevent child injuries, child abuse, neglect, or maltreatment, and reduce emergency department visits; (3) Improve school readiness and achievement; (4) Reduce crime or domestic violence; (5) Improve family economic self-sufficiency; and (6) Improve coordination and referrals for other community resources and supports); o Investigating mechanisms of change within program models or implementation systems in order to identify which program components work under which circumstances for which participants; o Creating and testing new measures of service availability, accessibility, and coordination at the community level or designing effective enhancements to support community coordination of services most relevant to home visiting, including early childhood education, early intervention, prenatal and adult health care, adult mental health care, child health care, infant mental health, substance abuse treatment, and services for victims of intimate partner violence; o Determining which program features are effective in improving participant recruitment/ retention, including father engagement; o Developing and testing approaches to screening children and families for variables highlighted as priority risk areas that can be used in conjunction with home visiting models; o Building and testing community-based partnerships that enhance a program's responsiveness to community needs; o Creating and testing coordinated approaches that support healthy development by fostering collaborations across diverse agencies that serve mothers and young children, including but not limited to early childhood education settings, health care providers, and local programs; o Conducting cost-benefit analyses of home visiting programs, particularly using data for home visiting models at scale rather than using small-scale efficacy trial impacts; o Fostering workforce development, specifically: effective techniques for reflective supervision; effective methods of training and continuing education for home visitors; recruitment and retention of effective home visitors; effective support for home visitor mental health; and other relevant topics; o Assessing the effectiveness of initiatives or mechanisms to integrate home visiting programs in a geographic jurisdiction (e.g., creation of a centralized intake process or development of a system of universal screening and referral of mothers and infants); o Describing, assessing, or testing mechanisms of effective linkage between home visiting and early intervention programs (e.g., under Part C, Child Find) to improve early detection of developmental and other delays and appropriate intervention during early childhood within a community; o Developing and testing the successful integrative efforts of home visiting services with other early childhood programs (e.g., child care and education, medical homes, etc.) and identifying their key features at the state or community level; o Assessing the penetration in the home visiting field of standardized performance measures or indicators across benchmark areas, and the use of continuous quality improvement (CQI) principles, tools, and accepted practices at the program site and state levels based on those indicators; o Determining early childhood service infrastructure characteristics at the state or local level that best support effective home visiting service programs and positive outcomes for families; and o Conducting studies of innovative and effective approaches to implementing home visiting programs for families in rural areas and in Indian tribes.