program evaluation report 2008-2009 funding yearuwsemi.3cdn.net/ec348f09b11b8caaa7_xnm6b40yi.pdf ·...

U n i t e d W a y o f S o u t h e a s t e r n M i c h i g a n W o m e n ’ s I n i t i a t i v e

I n i t i a t i v R e p o r t

Program Evaluation Report

2008-2009 Funding Year

United Way of Southeast Michigan

Women‟s Initiative

Prepared by

Ty Partridge, Ph.D.

September 18, 2009



Executive Summary

139 families received services from the five women‟s initiative partner agencies during the 2008-

2009 grant year.

We have conducted a validation study on the literacy survey used in the Women‟s Initiative. The

findings demonstrated that the survey developed for the Women‟s Initiative evaluation has very

strong psychometric properties and fills an important gap in the measurement of early childhood

literacy skills and supportive literacy environments. The manuscript stemming from the validation

study is currently under review for the academic journal Applied Developmental Psychology.

Support from the UWSEM Women‟s Initiative is acknowledged and will bring National and

International attention to the work of the Women‟s Initiative following publication. Additionally,

the instrument could be copyrighted and become a source of revenue for the Women‟s Initiative.

Over the four years of Women‟s Initiative funding the home visitor turnover has been less than

10% with the average home visitor having a tenure span of 4 or more years. This is remarkably

higher than the National averages for home visitation programs. The National turnover rate is

approximately 50% with the average length of tenure

In a 1999 Future of Children report on home visitation programs it was concluded that… “In most

of the studies described, programs struggled to enroll, engage, and retain families.” Yet, among

the Women‟s Initiative partner agencies there has been:

o Little difficulty enrolling families. All five agencies hit target enrollments and have full

caseloads. Neighborhood Service Organization‟s HIPPY program for example has a

current wait list of 75 families. Moreover, the number of families that enroll in the

program and then drop-out is under 6% overall.

o Little difficulty engaging families with over 87% of all scheduled home visits occurring.

This is compared to National averages of 42%.

o Little difficulty retaining families. Neighborhood Service Organization‟s HIPPY program

is a shining example of the family commitments – they had a 100% retention of families

participating in their 3yr old curriculum continuing to their 4yr old curriculum.

The scope of impact is also expanding into the broader community. In a sociometric analysis we

found that the average Women‟s Initiative program participant shared what they were learning

regarding early childhood literacy with at least 2 other families. At just one step removed from the

direct service provision the programs are influencing approximately 278 additional families.

There are several key opportunities for the Women‟s Initiative to have an impact on the National

dialogue regarding early childhood literacy and home visitation.

o This is the only funded program that incorporates four of the five empirically validated

home visiting programs under one funding systems and one evaluation umbrella. Such

integration was recently recommended by the…

o The aims of the women‟s initiative parallel the direction of several key Health and Human

Service agencies including the Administration for Children and Families and the Office of

Planning, Research, and Evaluation. These agencies are targeting funding initiatives

toward early childhood literacy and school readiness programs and highlighting home

visitation as a key service delivery model.



One-year after participating in the program, children whose families participated in the Women’s

Initiative programs:

Had school readiness scores consistent with children from low-risk families

Were significantly more prepared to enter Kindergarten than a comparison group of children

whose families had risks for poor academic achievement similar to their own family’s

Improved support for reading in the home, increased parent knowledge and expectations about

early childhood reading, and improved basic reading readiness skills combined to have a

fundamental and lasting impact on the child and his or her family.



Background and Statement of Need

The importance of early literacy

Without question, the most vital of all intellectual skills for success in school, and in life, is the

ability to read. Reading is the cornerstone of modern society, which makes even more alarming the

current trend in America of a regression to a divided society of literate and illiterate sub-cultures. The

existence of an inclusive and enlightened society is predicated upon universal literacy. So, how do we

reverse a trend in which 70% of American 7-year-old children do not have a basic understanding of

printed materials (National Council on Reading, 2002)?

Our schools have effective curricula for reading instruction, but for these teaching approaches to

be effective, children must come to school prepared to engage. For those children who start school

lacking fundamental pre-reading skills, the educational community does have demonstrably effective

strategies for remediation such as reading recovery: yet these programs are extremely expensive, time and

resource intensive, and the child begins school already having to work twice as hard just to keep even

with his or her friends.

To be sure, pre-reading or what reading experts call emergent literacy skills are highly complex

and can seem overwhelming to a parent of a struggling reader. And yet, when these skills are learned at

the appropriate developmental time period, they seem as natural to the child as walking. Oddly enough,

the first task in learning to read is learning to hear. The child must be able to not only recognize words

when he or she hears them (what experts call receptive language), but must be able to decipher all of the

individual sounds which make up the word. We are used to thinking of words as being made up of letters

– the basic building blocks of a word. Similarly, each spoken word is comprised of “sound letters”

known as phonemes. To both hear and say a word correctly a child must be able to distinguish all of the

sound letters in a word. For example, if two year old Sally cannot distinguish between the „p‟ sound and

the „b‟ sound, the words „cap‟ and „cab‟ are identical; however, if someone tells you to take a „cap‟ to get

to the airport, it is going to be an arduous trip. The next step in learning to read is by linking the auditory

world to the visual world. Young children, if they are able to distinguish and recognize all of the “sound

letters” in a language, must then begin to understand that each “sound letter” is linked to a specific visual

letter or combination of letters. Rhyming words are extremely effective at helping the child to make these

links. As they are repeatedly presented with words which all either begin with the same sound (think the

quick queen of quincy and her quacking quackeroo) or end with the same sound (Knox in box on fox in

socks) a child begins to see that these words which have the same “sound letters” also have the same

“visual letters”. Acquiring these auditory and visual skills is foundational to learning to read words, but

to comprehend what is read, the child also needs to understand how a narrative works, in other words,



how strings of words together tell a story or provide information beyond simple word recognition; the

sequence of ideas and events conveyed by words is important. There is no better way for children to

develop this skill than through story telling. Repeatedly hearing a parent tell or read a story and the child

having the opportunity to make up or tell his or her own story are vital to understanding the nature of

narrative.

Emergent literacy is an umbrella concept, which encompasses a host of verbal and cognitive skills that

are necessary precursors to effective reading and writing. Some of these skills include:

1. The child being able to discuss his or her experiences through out the day in a narrative format.

2. The child pretends to both write and read; writing with distinct shapes and in a linear order,

reading by telling narrative stories that are implied to be associated with a text.

3. The child is familiar with the conventions of a book: that there is a front where the story begins,

and a back where the story ends; that reading is done from left-to-right

4. That the child shows basic phonological awareness (i.e,. that individual sounds are linked together

to make words) and that there is a basic understanding of speech sounds corresponding to

individual letters of the alphabet.

5. That the child engages in repeated story-telling and links events in the story to background

knowledge.

Above and beyond these skills the context of reading in the home is critical. Consistently research

has indicated that adult monitored reading in which the pre-reading child engages in word play and is

encouraged to “pretend to read” with adult reinforcement of reading conventions leads to higher quality

reading than simple exposure to books or non-interactive reading where the parent reads aloud with no

participation from the child. Additionally, several studies have found that socioeconomic status is, in and

of itself, unrelated to emergent literacy skills and that rather it is factors such as; parental attitudes toward

education, the educational aspirations for the child of the parent, conversations in the home which are

narrative and include books, that there is accessible reading material in the home, and cultural exposure to

institutions such as the public library.

This is indeed a complicated set of skills and seems to require an elaborate training program,

specialized instruction, and an expensive budget; but nothing could be further from the truth. An engaged

adult, a healthy child, a few really good books from a local library, and 15 minutes a day are all that is

required. One might ask the question, how is it that remediation programs such as reading recovery

require such elaborate programming and yet to prepare a child to be ready to read upon entering school

costs nothing but time and interest?



16

Human Human Brain Brain at Birthat Birth

6 Years 6 Years

OldOld

14 14

Years Years

OldOld It turns out that the reason becomes quite clear when one

takes a look at the developing brain of a young child. By the

beginning of the third-trimester the creation of new neurons in the

human brain slows considerably. In fact, while we do continue to

develop new neurons over the course of our lives, at the start of

the third trimester an individual has more neurons than they will

have at any other time in life. Yet at birth, the human infant‟s

brain is approximately 20% of his or her adult brain weight. By the time the child is 2-years-old,

however, his or her brain will weigh approximately 75% of its full adult weigh.

What accounts for this dramatic increase in brain development despite the fact that the infant is no

longer producing neurons in any meaningful number? This dramatic increase in brain weight is due to

connections between neurons. Neuron development, like muscle development, is activity dependent. The

experiences of infancy and early childhood literally build the child‟s brain. And like, muscle cells, more

activity means greater capacity and efficiency. But, perhaps most importantly, modern neuroscience has

demonstrated that the brain does not develop uniformly as a whole, but rather develops each area

sequentially. The first brain regions to develop are those

associated with hearing and movement, this is followed closely

by regions associated with vision. Later the hearing areas

expand into more complex language processing areas. Finally,

the brain areas become integrated with hearing, language and

vision all working together allowing the child to think more

comprehensively which ultimately leads to reading. What is

perhaps the striking is that the peak time for development of

these critical brain areas begins in the first few months of life.

The figure to the right shows the rate of neuron connections being made over time.



This, however; raises a second question; why, if it is so natural for young children to acquire the

skills necessary to read is there an epidemic of children entering school unprepared to learn?

Here are some key facts underlying the lack of early literacy and educational preparedness in Metro-

Detroit.

Children living in poverty have significantly lower levels of phonemic awareness (recognizing

letter sounds), which is perhaps the most important aspect of learning to read, than their more

affluent peers (Hecht & Greenfield, 2001; Nicholson, 1997).

Only 19% of children from families receiving public assistance have requisite preliteracy skills at

kindergarten entry (National Center for Education Statistics (NCES) 2000).

Only 38% of children whose mothers had a high school education or less entered kindergarten able to recognize letters, compared to 86% of children with highly educated mothers (National Center for Educational Statistics, 2000)

Only 50% of preschoolers receiving public assistance have alphabet books in their homes, compared to 97% of children with professional parents (McCormick & Mason 1986).

Children from low-SES families receive, on average, a total of only 25 hours of one-on-one picture book reading by school entry, compared to 1000 to 1700 hours for middle-class children (Adams 1990).

Approximately 69% of African American students and 64% of Hispanic students show reading skill deficits, whereas only approximately one third of Anglo American children face comparable difficulties (National Reading Council 1998). SES appears to be the primary force behind academic risk among minority children.

By age 3 children from upper SES families have been exposed to 30 million more words than their low SES peers (American Educator, 2003)

There is clear convergent evidence that early deficiencies in core skills common to children in

poverty significantly impede academic progress (National Read Panel, 1999).

These statistics are an unfortunate reality for many of the children in Detroit. For two-thirds of the

census districts in Detroit between 2002 and 2004, 16% of all live births are to teen mothers, with rates as

high as 23%. Even more striking, of the births to these teen mothers, 22% were repeat pregnancies.

Again for two-thirds of the census districts in Detroit, greater than 11% of women reported smoking

during pregnancy with rates as high as 18%. It should be noted that self-reported rates substantially



underestimate true-rates of use. Finally, preterm and low-birth-weight infants are the key indicators of

prenatal insult and delayed neurobehavioral development. Again, two-thirds of the census districts

reported rates greater than 13% and 15% for low-birth-weight and preterm births respectively.

Detroit, despite substantial gains in the last decade still ranks among the top five cities in the United

States for rates of nearly every component of neighborhood risk. For example, on a CDC composite

index of child well-being, Detroit ranked 100th

out of the 100 largest cities. Similarly, on a composite

index of social deprivation Detroit ranked as the third-highest out of the largest 100 cities. In fact, on any

sub-component of these indexes Detroit ranked fared no better than 10th

. These sub-components

included the percent of children living in poverty, the percent of individuals with no high school diploma,

the percent of individuals living in concentrated poverty, number of households headed by single and/or

teen mothers, number of children with inadequate prenatal and neonatal health care, and per capita rates

of violent crime.

Community Need and Resource Context

Reading achievement is particularly low for Latino and African American fourth graders, 56 percent and

60 percent, respectively, of whom read at those below-basic levels that do not even provide sufficient

support to allow the completion of schoolwork (Lee, Grigg, & Donahue, 2007). National literacy

assessments reveal that levels of literacy attainment are not much better for eighth or 12th graders or even

adults,

which is not surprising, given that beginning literacy is highly predictive of later literacy

attainment. Detroit is one of the most at-risk communities in the country with respect to literacy success.

Adult literacy rates in Detroit are among the lowest in the United States, as can be seen from findings

from the Knight Community Assessment Project.



Detroit residents have among the lowest level of library patronage in the United States.



These risks to early childhood literacy and school readiness are persistent in not only the family but at the

community level as well. The following data present some community profiles for the areas served by the

Women‟s Initiative programs.



Community Profiles

Below is a breakdown of the percentage of families served by the Women‟s Initiative partner programs by

zip-code. A sample of the community characteristics of these programs is provided as well.



Community Profile 4822326

3,194 Children 0-4yrs

61% Single Parent Families

Median Income $35,731

31% Childhood Poverty

44% of 3-4yr olds enrolled in pre-school

56% Fail to meet minimum standards in 4th grade English

50% Fail to meet minimum standards in 4th grade Math

Community Profile 48209,21727


48% Single Parent Families


36% Childhood Poverty







10/13/2009

25


47.7% Single Parent Families


28.2% Childhood Poverty





10/13/2009

25

1,638Children 0-4yrs










10/13/2009

25

1,638Children 0-4yrs







The consequences of poor early literacy

On average, a child that has low emergent literacy skills by Kindergarten has an 84% chance of

being a poor reader with poor comprehension by 3rd

grade.

“it is not that children with low levels of those skills cannot succeed in the task of learning to read.

Rather, the reason is that schools provide an age-graded rather than skills-graded curriculum in

which early delays are magnified at each additional step as the gap increases between what

children bring to the curriculum and what the curriculum demands” (Whitehurst and Lonigan,

1998 p. 865).

The education level of a child‟s maternal grandmother significantly predicts the child‟s language

skills, including reading, when that child enters kindergarten. (Luster et al., 2000).

A child with a maternal grandmother on public assistance has a 53% chance of having low literacy

skills upon entering kindergarten (Oxford & Spieker, 2006).

Children not reading well by the end of first grade have 90% chance of remaining poor readers.

(Juel, 1988)

There is an 88% chance that if a child does not "get" reading by the end of 1st grade, the child will

still be a poor reader at the end of 4th grade & there is a 95% probability that those children will

never catch up with their peers (unless there is extensive, expensive intervention) (Reach out and

Read Policy Report, 2004).

38% of 4th graders can't read to grade level. Of these, 10-15% will drop-out of high school and

only 2% will complete a 4-year college degree (Juel, 1988).



Knowledge of alphabet letters upon entry into Kindergarten is a strong predictor of 10th grade

reading ability. (Ehri, 1998)

Perry Preschool Findings

Incidence of crime. Only 7% of adults who had participated in the Perry Preschool program

had been arrested five or more times, compared with 35% of those who had not participated

in a preschool program. Of those in the preschool program group, 7% had ever been arrested

for drug-related offenses, compared to 25% of those in the no-program group.

Earnings and economic status. Adults in the program group were four times more likely

(29%) to earn $2,000 or more per month than were adults in the no-program group (7%).

Almost three times as many (36%) owned their own homes, compared to those in the no-

program group (13%). More than two times as many (program 30%, no program 13%) owned

a second car. As adults, 59% of those in the program group had received welfare assistance or

other social services at some time, compared to 80% of those in the no-program group.

Educational attainment. Seventy-one percent of those in the program group graduated from

regular or adult high schools or received General Education Development certification,

compared with 54% of those in the no-program group. Earlier in the study, the preschool

program group had significantly higher average achievement scores at age 14 and literacy

scores at age 19.

Marriage and single parenthood. Forty percent of women in the program group were

married at the time of the age-27 interview, compared to 8% of those in the no-program

group; and 57% of women in the program group were single parents, compared to 83% of

those in the no-program group.

How do the programs funded by the Women’s Initiative make a difference?

Parent-Child Home (Catholic Social Services)

Every Parent-Child Home Program site adheres to a carefully developed and well-tested model to

ensure high quality services and consistent results. Each site is run by a Site Coordinator hired by the

local sponsoring agency and trained by The Parent-Child Home Program's National Center. These Site

Coordinators then recruit and train Home Visitors. Typically, families participate in the two-year program

when their child is 2 and 3-years-old. A child can, however, enter the Program as young as 16 months and

some sites serve families with children up to 4-years-old. A Home Visitor is assigned to the participating

family and visits them for half-an-hour, twice-a-week on a schedule that is convenient for the parents. On

the first visit of each week, the Home Visitor brings a carefully-selected book or educational toy as a gift

http://www.parent-child.org/getinvolved/booksandtoys.html#booksandtoys



to the family. In the twice-weekly home sessions with the parent (or other primary caregiver) and the

child, the Home Visitor models verbal interaction and reading and play activities, demonstrating how to

use the books and toys to cultivate language and emergent literacy skills and promote school readiness.

Over the course of the two years in the Program, families acquire a library of children's books and a large

collection of educational and stimulating toys. A Program Year consists of a minimum of 23 weeks of

home visits (or 46 home visits).

Training in multicultural awareness and the ethics of home visiting are important components of the

Parent-Child Home Program training curriculum for Site Coordinators and Home Visitors. Respect and

understanding are critical for successful home visiting relationships.

THE IMPORTANCE OF PARENT-CHILD INTERACTION

All children's first years should be filled with verbal stimulation to build language and literacy skills. Each

day should be full of discovery and offer opportunities to gain new skills and learn new concepts.

Fostering verbal interaction between parents and their young children is a critical component of healthy

and successful development (Bruner, 1964 and 1966; Vygotsky 1962). The importance of this interaction

has been further validated by recent brain and language development research (Hart & Risley). Formative

research on The Parent-Child Home Program's 1965 pilot project (titled the Mother-Child Home

Program) affirmed that this critical parent-child interaction could be strengthened by modeling reading,

play and conversation for parents and children in their own homes

SCHOOL READINESS: BRIDGING THE PREPARATION GAP

Across the country, millions of children begin kindergarten unprepared. They are "left behind" as early as

the first day of school. These children have not adequately experienced books and quality verbal

interaction. They do not have the language skills they need to successfully interact with their teachers and

their classmates. They may not be able to control their behaviors or emotions as well as other students.

Without the skills they need to successfully adjust to the classroom, they begin their academic careers a

critical step behind their peers. Many of these children will never catch up.

The Parent-Child Home Program bridges this "preparation gap" by helping families challenged by

poverty, limited education, language and literacy barriers, and other obstacles to school success prepare

their children to enter school ready to learn.

THE APPROACH: MODELING VS. TEACHING

The Parent-Child Home Program utilizes a non-directive approach by modeling behaviors for parents that

enhance children's development rather than teaching behaviors. Home Visitors help parents realize their

role as their children's first and most important teacher, generating enthusiasm for learning and verbal

interaction through the use of engaging books and stimulating toys. Parents are never given homework or

assignments to complete but are encouraged to continue quality play and reading between visits with the

books and toys they receive each week. The "light touch" employed by Parent-Child Home Program

Home Visitors is non-intimidating and empowers parents, allowing them to become their child's first and

most important teachers and take pride in their commitment to, and impact on, their child's education.



HIPPY (Neighborhood Service Organization)

HIPPY‟s Guiding Theories

Given the growing awareness of a connection between early educational experiences and adult

success in the social and economic spheres, the importance of early childhood education for children in

families with fewer resources and advantages became a focal point of research and policy in the latter half

of the twentieth century. Considerable research over the past several decades has established a strong link

between home environment and school performance (Bertrand, McCain, Mustard, & Willms, 1999; Chao

and Willms, 2000; Lillie 1975; Mantzicopoulos, 1997), and several studies have suggested the existence

of preconditions that are favorable to school success, such as specific aspects of the home environment

(Vernon-Feagans, Hammer, Miccio & Manlove, 2001; Wasik, Dobbins & Herrmann, 2001); the value of

education in the home and expectations of parents (Fan & Chen, 1999); and verbal interaction patterns

between parents and children (Hart and Risley 1995). Indeed, research on parent involvement has

suggested that the involvement of parents in their children‟s educational activities in the home is an

important predictor of school success (Bennett, Weigel, & Martin, 2002; Fehrmann, Keith, & Reimers,

1987; Ho and Willms, 1996; Parker, Boak, & Griffin, 1999; Snow, Burns, & Griffin, 1998). Despite

recognition of the importance of the home as an educational setting, most programs that have been

developed to address inequities in educational access and attainment have concentrated their efforts

within the school system. HIPPY, however, is designed to target intervention within the family.

HIPPY‟s focus on the parent also follows the growing research base on the importance of the primary

caregiver during early childhood in stimulating early development of young children (Wagner, Spiker,

Linn, Gerlach-Downie, & Hernandez, 2003).

Recognizing that barriers to early intervention within the homes of vulnerable families may

include not only limited access and resources for educational materials but also limited parental awareness

of the home as an educational setting and lack of self-efficacy among parents (Lombard, 1994), the

HIPPY approach has two points of focus: 1) the strengthening of the parents‟ self-efficacy through the

activities he or she does as “an educator in the family setting”, and 2) the educational enrichment of the

child through the provision of curriculum activities, books, and other educational materials (Lombard

1994, p 8). HIPPY addresses these areas through a structured home visitation model that includes the

delivery of instructional materials with a cognitively based curriculum, role play as a teaching method for

the parent, and a staffing plan that encourages community participation and growth.

HIPPY‟s approach to curricular design is based on programmed instruction principles. Early

research in instructional technique has indicated that young children from disadvantaged families can

achieve success with highly structured materials (Lombard, 1994). The HIPPY activities, therefore, are

structured to “progress in simple, planned stages with the objective of providing children with a series of

tasks that they can master easily as they advance to levels of increasing difficulty” (Lombard 1994, p 18).

The content of the HIPPY curriculum responds to early childhood learning goals in seven domains:

literacy, language development, physical and motor development, social/emotional development,

mathematics, science, and creativity (Greene, 2003). Recognizing the range of functioning experienced by

young children, learning activities emphasize the development of a series of concepts over a three year

period; the curriculum is structured to progress by adding and expanding upon a child‟s emerging skills

(Lombard, 1994; Greene, 2003). Lessons are scripted to facilitate use by novice “teachers,” eliminating

the need for the parent to make independent decisions about instruction technique or progress. Parents

become more sensitive to their role as instructor over time as their children‟s mastery of the concepts

grows.



The use of role play in the parent training element of the HIPPY program is grounded in

experiential learning theory, which emphasizes interaction, doing, and reflection (Fenwick, 2003; Shields,

Aaron, & Wall, 2001). According to experiential learning theory, the concrete experience afforded by

role play provides the parent and home visitor the foundation and opportunity for discussion and

reflection about the activity and learning process, through which abstract concepts and generalizations

about learning and teaching are developed (Lombard 1994; Sala, 1986; Shields, Aaron, & Wall, 2001). In

role play, learning occurs through modeling and through the dialogic reflection between the parent and

home visitor. Role play promotes self-efficacy and confidence in a way unique among instructional

techniques by requiring parents to take an active part in the instructional process, either as the teacher or

the learner. Additionally, role play is a desirable method of instruction because it can be easily mastered

by individuals with limited formal education and literacy skills (Willis and Gueldenpfenning, 1981).

HIPPY‟s Target Population

HIPPY is intended for any parent who wants educational enrichment for his or her preschool aged

child. HIPPY, however, was developed to support and foster the active involvement of parents who may

lack the confidence and/or skills to “educate” their children due to their own negative educational

experiences. These parents are often also low income, but socio-economic level is not always an indicator

of the need for HIPPY. The HIPPY model was specifically designed to remove barriers to participation in

early childhood programs caused by poverty, lack of education, or social isolation. Additionally, the

model‟s approach to recruitment of home visitors and parents is designed to engage parents with children

who are at greater risk of school failure because of poverty, parents‟ lower levels of education, and other

risk factors.

HIPPY‟s Guiding Principles

HIPPY is built upon these guiding principles:

1) All parents want what is best for their children;

2) All young children can learn, though each child is unique in his/her rate of growth and

development;

3) All children mature in the same developmental areas;

4) Early learning and development are multidimensional and the developmental domains are

highly interrelated;

5) Parents are the primary and most important educators of their young children; and

6) Knowledge and understanding of child growth and development and age-appropriate materials

and techniques are essential to maximize educational experiences for children and to support

parents in their roles as their children‟s teachers. (Greene, 2003)

The HIPPY Method (Teaching Model)

HIPPY programs are staffed by home visitors drawn from the target population or community,

who are supervised by a professional coordinator who has a background in an area such as early

childhood or social work. The curriculum is delivered (and role play occurs) during home visits

interspersed with bi-weekly group meetings. In the HIPPY teaching model, the home visitor meets with

the parent to role play a lesson and the parent then completes the activity packets in the lesson with his or

her child during daily 15-20 minute sessions. This method both fosters parent-child interaction and

provides parents the experience of teaching their child themselves.

The HIPPY model includes the use of a unique and developmentally appropriate curriculum, with

role play as the method of teaching the parent the skills needed to implement the curriculum with their

child. Each of the three HIPPY curricula (for ages three, four, and five) contains 30 weekly activity

packets, nine storybooks for each year as well as a set of 20 manipulative shapes. The HIPPY curriculum



focuses on exposing children to skills, concepts, and experience with books that together constitute school

readiness for young children (Lombard 1994; Greene 2003). Skills and concepts are developed and built

on sequentially through completion of the weekly activities. In addition to the core HIPPY materials,

HIPPY USA has developed enrichment materials to enhance the curriculum and provide additional

learning opportunities for children.

Group meetings, interspersed with home visits, are an integral part of the HIPPY model. During

group meetings, parents come together to learn as a community with a focus on topics relating to school

involvement, community involvement, child learning, and personal development. Group meetings are

considered an important element because they are a means for breaking the social isolation frequently

experienced by low income and low education populations and an opportunity for parents to develop

social networks.

Each HIPPY program is supervised by a professional coordinator whose primary responsibilities

are to recruit parents, hire and train home visitors, organize parent group meetings, track family progress,

link families to other services, and ensure program sustainability. The coordinator and the home visitors

meet weekly to role play the materials, to discuss the previous week‟s activities, and to share experiences

and problems. Supervision of home visitors by coordinators occurs largely through these weekly

meetings.

HIPPY home visitors are members of the participating communities and are also current or former

parents in the program. The home visitors‟ knowledge of their unique communities facilitates the

development of rapport and trusting relationships with families, and, by having used the HIPPY materials

with their own children, home visitors identify with the challenges parents face. Because home visitors

and parents speak the same language both literally and figuratively, they interact as peers.

The HIPPY Logic Model

The HIPPY Logic Model diagram presents a series of activities and outcomes that are expected to

occur for parents and children who are enrolled in the program for at least curriculum years 4 and 5, but

preferably for all three years. The model progresses linearly, and presents a chain of events that may be

read as a logical progression using “if… then” statements. However, as with most complex systems

involving behavior change and skill development, the events and stages in the logic model are recursive

and will experience feedback and possibly reversion before moving forward. Below is a narrative

description of the stages in the HIPPY Logic Model describing the chain of events that links the activities

of the HIPPY program to the final outcomes for children and parents who participate in the program.

HIPPY Activities

HIPPY USA has published a list of required and recommended program practices, which outlines

the guidelines for operating programs. Programs seeking certification are assessed annually during on-

site visits by HIPPY USA trainers. Once certification is obtained, programs are assessed every 3 years.

HIPPY USA trainers use the comprehensive Self-Assessment and Validation Instrument (SAVI) to assess

programs. The SAVI contains indicators for practices in the program areas of Home Visiting, Group

Meetings, Role Playing, Curriculum, Staffing/Training/Supervision, Administration, Outreach and

Collaboration, and Documentation.

Home visits are employed as the primary means of contact with participating families, and are

conducted at least biweekly. Home visits last at least 30 minutes with the bulk of the time devoted to role

play. The parent is the focus of the home visit, and home visitors are required to individualize the home

visit to the family‟s language needs, including parent literacy level. During home visits, parent educators



set the stage for parent instruction by helping parents set goals for themselves and their child. Home

visitors also model teaching behavior for the parent and provide support and encouragement to the parent

throughout the HIPPY year. Home visitors are trained in strategies for building rapport and begin each

visit with a short period of conversation meant to build connection and engage parents.

The structured home visit activities include:

- Review the previous week‟s completed activity packet with the parent;

- Discuss the educational objectives of the current activities or review the Parent Skill Boxes (new

home visitors);

- Share child development activities and concepts;

- Share activity related information discussed during the previous staff meeting;

- Role play the current activity packet with the parent;

- Provide the parent with other educational materials, extension activities or resources, if

appropriate; and

- Inform the parent of program, school or community events.

In addition to home visits, programs are expected to hold a minimum of ten group meetings on a

biweekly basis during the program year. Group meetings must be held at a time and place convenient to

parents, and parents select topics for group meetings.

During group meetings the following activities occur:

- Parents role play the weekly activity packet

- Parents are presented with additional parenting information

- Parents receive additional educational materials, information, and resources

- Parents learn about school culture and organization

- Parents are exposed to a variety of topics that support their personal growth

The role play and instruction parents receive during home visits and group meetings are designed

to encourage and support parents to complete the weekly activity packets with their children. After role

playing activity packets during home visits and group meetings, parents work with their children to

complete the assigned activity packets. Parents are expected to spend approximately 15 minutes per day,

five days per week working on the activity packets with their child. Parents may also complete the

supplemental extension activities with their child if they choose to do so. Activity packets include

explicit directions for parents to use in instructing their child. Role play models appropriate instructional

and interactive behaviors and also assists parents with creating a learning environment conducive to

positive interactive exchanges including establishing a work setting in the home and a routine and

schedule for completing the activities. Through these activities, parents provide their children with

developmentally appropriate pre-academic instruction.

Stage 1 Outcomes

Stage 1 outcomes are the changes in children and parents that are expected to occur during the

time the family is enrolled in HIPPY.

In the course of reviewing and role playing the weekly activity packets with home visitors, parents

gain knowledge in child development as well as a better understanding of age appropriate expectations for

their child‟s development. They learn HIPPY teaching principles and techniques (repetition of words,

positive correction, and appropriate encouragement) as well as skills for initiating, monitoring and

directing educational activities with their child. Parents are encouraged to find new ways to become

involved in their child‟s pre-academic learning and apply skill building techniques learned in HIPPY to

daily interactions with their HIPPY child and other children. Through participation in HIPPY it is also



expected that parents will progressively improve their time management skills, become more responsive

and responsible (as they are coached in the use and care of HIPPY materials) and thereby establish habits,

routines and schedules for interacting with their child around educational activities.

At the same time that parents are increasing the time they spend on educational activities with

their child, the HIPPY activity packets are increasing in complexity and length, thus providing further

learning opportunities for HIPPY children. These educational opportunities and learning activities will

foster children‟s development across domains and the acquisition of pre-academic skills.

HIPPY is designed so that parents develop more empathy for their child and gain a better

appreciation of their child‟s skill level and progress. As parent and child complete the weekly packets,

they will naturally spend more time in quality interactions, thereby increasing the bond, on-going

communication, and the confidence levels and feelings of achievement for both parent and child.

Parents are instructed using developmental concepts and terminology. Therefore, they acquire

knowledge of the professional language used by educators that allows parents to be more effective

communicators and advocates for their children with teachers, physicians and other professionals.

Through HIPPY parents develop increased understanding of their responsibility in guiding their child‟s

preschool instruction and their academic support role once the child is in school, leading to involvement

in school activities.

A goal for parents attending group meetings with other parents from their community is an

increased level of comfort participating in social interactions and group learning. As a result, parents often

form new social networks and interact in a cooperative manner with other parents (e.g. joint outings,

trading child care services etc.). Group meeting topics inform parents about parenting skills; community

resources and events; and school events, personnel, policies, and procedures thus reinforcing information

distributed by staff during home visits. This exposure translates over time into an increased connection

between the parent and the child‟s school (once the child begins formal education) and between the parent

and the community. This provides the foundation for parents to become active members of the home-

school-community partnership, often volunteering within and advocating for, the schools and related

activities (e.g. parent-teacher organization, classroom volunteer, holiday parties, little league etc.).

Stage 2 Outcomes

Stage 2 outcomes are the changes in children and parents that are expected to have

occurred by the time the family has completed the HIPPY 3, 4 and 5 curricula or HIPPY 4 and 5

curricula.

After completing a minimum of two years of HIPPY with their children, parents will have

acquired skills and habits necessary to teach academic skills to their children and to guide their

educational experiences in the home and the community. Through the addition of the HIPPY materials

and the new knowledge and skills learned by both parents and children, the general home literacy

environment will also have improved, and the level of parent-child interaction will have increased.

Through completing HIPPY activities with their parents, children will have acquired the pre-academic

skills and knowledge in HIPPY‟s seven key learning domains that enable them to be successful in

kindergarten. This should be reflected in successful performance on standardized tests of school readiness

and academic progress.

Through the skills and information conveyed during the home visits and group meeting activities

parents will have become comfortable as their children‟s teachers and will have the language, knowledge,

experience and confidence to assume an active role as their child enters a formal academic environment.



They establish a routine and conducive environment for homework and use their skills to effectively

monitor and assist their child with homework. They advocate for their child and communicate regularly

and successfully with their children‟s teachers. They attend school events, participate in school-based

parent activities, and volunteer in their children‟s classrooms.

Stage 3 Outcomes

Stage 3 outcomes are the changes in the child and parent that are expected to occur after the family

has completed HIPPY.

In the long term it is expected that the training and experiences parents receive through HIPPY

and the resulting early educational experiences their children receive will result in sustained parent

involvement in the school system and in assisting their children with homework, providing learning

activities for their children at home and in the community, increased family involvement in local

communities, stronger parent-child relationships, and long-term academic success for children.

Health Families America (Oakland County)

1) Eligibility assessment completed anytime during pregnancy or by the 75th

day of the birth of the child.

2) Eligibility determination is made based on a score through the validated rater reliable Kempe Family

Stress Checklist.

The Kempe Family Stress Checklist is the assessment toll required by Healthy Families Indiana to assess

the needs of all families. The Kempe assesses for the presence of factors including increased risk for child

maltreatment or other poor childhood outcomes.

3) Home-based services that include:

Focus for the first 3-6 months will be basic childcare including; infant/child development, bathing,

nutrition, and activities to do with the baby.

Promoting positive parent/child interaction and bonding

Use of parent child interaction curriculum

Child‟s health care needs

Linkage to medical provider/medical home

Immunizations – acceptable rate is 90%

Family‟s health care needs

Financial management

Linkage to community resources

Transportation issues/needs

Appropriate relationship issues

Assessment issues

4) Tools for assessing child development needs:

Individual Family Support Plan (IFSP) – is used as a guide for services through the use of curriculum,

literature, and referrals to community resources.

Denver II Development Screen – Monitors healthy growth for the child and insures proper referrals to

such programs as First Steps when a child demonstrates delays or fails on the Denver II. The Denver II is

completed at 3, 6, and 12 months, and every 6 months after year one up through age three on the child of

focus. The Denver II is then completed yearly after age three.



H.O.M.E. Inventory – used to assist in evaluating the impact of a child‟s surroundings on later cognitive

growth.

Community Life Skills Scale (CLSS) & Difficult Life Circumstances (DLC) – Both the CLSS and DLC

are used to measure the existence of chronic family problems and the family‟s ability to negotiate in the

community.

5) Curriculum

Indiana Healthy Families uses curricula and other appropriate materials that are representative of our

target population, and considers the culture, race, ethnic and linguistic make of families. Curriculum

included, but not limited to; PIPE, Help at Home, San Angelo, Resource Mother, Middle of the Night,

Great Beginnings, First Steps with Your Baby, Parenting the First Year, Gymboree, Partners for a Healthy

Baby, Prenatal Curriculum, and Growing Child.

6) Training for Family Support Specialist

130 initial required hours

Ongoing in-service training (30 hours per year)

Advanced training for supervisors

CPR and First Aid certification required

8) Quality Assurance

To insure that families are receiving best practice, the supervisor is required to do Quality Assurance

Calls/Shadowing on a specific number of families on their FSS staff:

Supervisors do quality assurance calls on new employees at the end of the 90-day introductory

period.

15% of the FSS‟s total caseload is contacted

Supervisors do quality assurance calls on all FSS staff one time every six months on 50% of

the caseload or a minimum of 10 clients, whichever number is great or more frequently as

determined by the supervisor and program manager.

All new employees are shadowed a minimum of three (3) times within their first 90 days of

employment

Supervisors shadow all new sign on visits with new employees until they reach 75%

Supervisors shadow sign on visits with established staff that fall below 75% and who exhibit a

pattern of low sign rate as detected by reports, supervision, etc.

9) Graduation from Program

Graduation from the program occurs when the target child has reached at least three (3) years

of age, has been on Level IV for at least three months, the family has maintained stability in the

home for a minimum of three (3) months, the child of focus is in a stable and nurturing

environment that may include pre-school, Head Start, or childcare, the child‟s growth and

development are age appropriate, immunizations are current, and the family agrees to end

services.

If the supervisor and FSS determine the participant is eligible for graduation, they fill out a

Graduation Level Form and submit this to Data Entry for entry into the DATATUDE system.

The participant, FSS, and supervisor decide what type of graduation ceremony will take place.

This may include a presentation at a Group function, at an Advisory Council meeting or privately.

Some participants will never qualify to graduate from the program for a variety of

reasons. These participants will receive a certificate of participation but no formal graduation

procedure.



Parents as Teachers (Guidance Center and Leaps & Bounds)



Women’s Initiative Logic Model

Despite different program models and curricula, there are several universal features of the home visiting

programs funded by the Women‟s Initiative. The basic logic model across program type is provided in

the figure below.

Women’s Initiative Universal Logic Model

These commonalities are now being recognized as a value by home visiting advocates at a National level

as indicated by the common statement of purpose released by the five major home visiting prevention

programs in the summer of 2009.

Shared Vision Statement Rationale

• Prevention services in general are underfunded and a low priority on our nation’s domestic policy

agenda. The complexity and volume of need among families and young children in this nation far exceeds

the capacity of any one of our programs. Therefore, we will work together to advocate for a greater

investment in effective prevention programs for children and families.

• Home visitation is a service delivery strategy that is essential to better support our country’s youngest

children. We are unified in our view that building relationships with parents and children in their home

environments is a uniquely valuable approach to nurturing parental competence and successful early

childhood development. Together, we intend to make this type of service delivery practice more broadly

accepted and a welcome and trusted approach in family development.

• Communities require a strong continuum of effective programs for children and families in need of

support throughout their life spans. There are many communities that are successfully implementing

multiple home visiting programs in an integrated approach to building that continuum of care. We

applaud those communities for successfully collaborating to meet the varied needs of families.

• Different programs may be eligible for different sources of funding and those differences can be helpful

in reducing competition and improving collaboration. We each will work to expand existing and build

new funding streams for home visiting services from all possible sources and support funding streams that

allow states and communities to choose among quality programmatic options.



• We are all committed to ensuring each of the local implementations of our respective national models is

strong and effective. We are all working to provide guidance and support that will enable local agencies

to adhere to the quality standards set by each model.

• All of our programs commit to maintain and enhance our capacity to use solid and rigorous research

and evaluation to implement our programs effectively and to assess and strengthen outcomes for children

and families. We recognize that each program contributes its own experiences and perspectives to the

discussion on program efficacy. We will continue to support one another’s commitment to continuous

quality improvement and ongoing program evaluation to better meet the needs of the families we serve.

National Home Visiting Programs' Shared Vision Statement

The senior programming, advocacy and executive leadership of five of the leading national home

visitation programs (Healthy Families America, HIPPY, Nurse-Family Partnership, Parents as Teachers

and The Parent-Child Home Program) have developed a shared vision to nurture the healthy, secure

development of our nation‟s children and families. These organizations are committed to maintaining an

on-going, direct and honest dialogueand improved communication among our programs. Each

organization shares a passion for and a commitment to improving the well-being of our nation‟s children

and families and focusing national attention on home visiting as a critical service delivery strategy for

strengthening America‟s children and families. While each program is uniquely designed, they all have a

valuable role to play in meeting the complex needs of families and communities across the country. The

organizations have determined that they have a great deal in common and endorse this, as their common

vision:

Core Program Beliefs

Communities are Best Served by a Range of Quality Home Visitation Program Options

Families Nationwide Need Access to Early Childhood Home Visitation Services

Continuous Quality Improvement is Essential

The Universal Logic model of the programs funded through the UWSEM Women‟s Initiative illustrates

an additional innovation that has undergirded much of the success of the Women‟s Initiative programs

over the last four years. Unlike many of the large scale evaluations that have been conducted on the

effectiveness of home visitation prevention interventions, this program emphasizes a uniform and well-

defined outcome in early childhood literacy. This focus has afforded several key advantages.

1. It is an objective, tangible outcome that can be directly linked to intervention activities. In many

large scale evaluations the outcomes are too broad and not directly impacted by the program

services, thus leading to mixed evaluation findings.

2. We have developed a measurement tool that links program activities to program outcomes in a

demonstrable way. Because the constructs used in defining outcomes in many evaluation studies

are too broadly conceptualized, measurement concerns limit the degree to which program impact

can be observed.

3. The parent and child outcomes have the potential for rapid improvement and are highly evident to

both home visitation specialists and families, thus increasing the likelihood for family engagement

and lower levels of home visitor burn-out. They can both see the difference the program makes.



The primary outcomes in many evaluations of home visitation programs are so distal to the

program activities that neither the parent nor the home visitor get much immediate reinforcement

and as a result families often disengage prematurely and there is high home visitor turn over due to

burn out.

In keeping with the core value of the shared home visitation vision statement, providing high quality

continuous quality improvement evaluation is central to the work of the Women‟s Initiative. The

evaluation philosophy and conceptual models employed in the evaluation of the Women‟s Initiative

partner programs is provided below.

Evaluation Conceptualization Model

Developmental Science & Community Partnerships

Service

Providers

Families in

the

Community

Developmental

Science

Philanthropy &

Development

Continual

Discourse



Action Oriented Evaluation ModelProcess

Evaluation

Outcome

Evaluation

Needs

AssessmentProgram Design

Monitoring &

Accountability

Quality

Review /

Program

Clarification

Defining Need and

Scope

Mediating

Outcomes

Program

Community

Impact



Process Evaluation Outcomes

Overall Units of Service:

Catholic Social Services o 38 families were served o 363 home visits were made – an average of 10.5 per family

The Guidance Center o 35 families were served o 92 home visits were made – an average of 3 per familiy

There were 402 total contacts with families, however; because the Parents as Teachers model uses center based activities and regular phone contact follow-up in addition to home visits.

Leaps and Bounds o 47 families were served o 98 home visits were made – an average of 3.1 per family

Healthy Families Oakland o 23 families were served o 253 home visits were made – an average of 11 per family

Neighborhood Service Organization o families were served o 384 home visits were made – an average of 12 per family

Number of Visits/Contacts significantly predicts: o Family Engagement

These programs are only effective when the family fully participates. o Quality of Relationship with Home Visitor

Across all four agencies home visitor quality is very high and retention of the home visitor is well above national trends in home visitation programs. There has been no turn over in home visitors across the three funding years. The National average rate of home visitor turn-over is approximately 9-months.

o Effectiveness of the Intervention o Long-Term Maintenance of Effects

Having access to social service referral sources and home visitor training in social service referral systems is associated with increased focus on literacy during the home visit and improved family participation. All home visitors would benefit from having full 211 training.

Mother feeling that she can “relate” to the home visitor strong predictor of program success

Shrinking resources for early intervention services such as Early On & Even Start have a negative impact on program effectiveness for highest risk children facing multiple social and cognitive risks.

Lack of availability and resources for high quality child care negatively impact program performance. Fostering greater communication and partnerships between home visitation programs, quality child



care sources, local school systems, and additional early childhood services would greatly increase the scope of coverage, the program efficiency and maintenance of effects through out the child’s development. Perhaps the biggest need in early-childhood services is improved coordination and integration of programming.

Secondary Influences of Home Visiting

One innovation from the current program year in terms of evaluation is that we used a snowball

recruitment technique to assess the degree to which home visiting services were reaching families beyond

the target families. This methodology asks caregivers receiving direct home visitation services to identify

the number of other caregivers with whom they discussed the literacy knowledge and skills they were

acquiring in the program. This is an indicator of secondary or ripple effect influences of home visitation

programs. We found that across the program participants were transferring their knowledge to an average

of 2.3 other adults who were primary caregivers for children under the age of 5. Thus the program does

have substantial ripple effects in the community beyond those being served directly.

Measurement Tools

We have conducted a validation study on the literacy survey used in the Women‟s Initiative. The findings

demonstrated that the survey developed for the Women‟s Initiative evaluation has very strong

psychometric properties and fills an important gap in the measurement of early childhood literacy skills

and supportive literacy environments. The manuscript stemming from the validation study is currently

under review for the academic journal Applied Developmental Psychology. Support from the UWSEM

Women‟s Initiative is acknowledged and will bring National and International attention to the work of the

Women‟s Initiative following publication. Specifically we found that the reliability of the early childhood

literacy assessment (ECLA) was .93 and the individual sub-scale reliabilities ranged from .76 - .91. The

industry standard for acceptable measurement reliability is .70. So the early childhood literacy

assessment developed for the Women‟s Initiative evaluation has demonstrated a high degree of reliability.

Further, the ECLA was correlated with the verbal subscales of the ASQ at .53, but it was not significantly

correlated with non-verbal subscales such as fine and gross motor scales. This indicates that the ECLA

has substantial construct validity.



The following figures present the measurement model for the ECLA assessment tool.

Measurement ModelsParent Attributes

Reading a Habit

How Often Reads to Child

Designated Reading Time

Reading Environment

Provides Books of Interest

Number of Books


Amount of T.V.

Age Began Reading to

Child Attitudes About Reading

Importance of Reading




Play Rhyming Games

Teach Letter Sounds

Use Contextual Print

Reading Quality

Snuggle

Change Expression

Emphasize Rhymes

Use Pictures to increase Vocab

Encourage Repeating

Encourage Active Reading

Read Same Stories

Measurement ModelsChild Outcomes

Interest in Newspapers

Asks to be read to

Interest in books

Interest in Reading

Asks for help reading in context




Fills in Narrative

Points to Pictures

Ask Questions about

Characters Reading Engagement

Identifies Words in Environment


Makes up Stories

Pretends to Read

Narrative Skills




Notices Rhymes

Plays Rhyming Games

Produces Independent

Rhymes Language Awareness

Tells Nursery Rhymes


Number Letters ID

Tries to Name Letters

Attempts Letter Sounds

Letter Recognition /

Phoneme Awareness

Number Letter Sounds ID




Asks for Help Writing

Child Draws

Attempts to Write Letters

Emergent Writing

Asks for Help Spelling


Role of Title

ID Front of Book

ID Title of Book

Print Awareness

Words Tell Story

Directionality



Impact Evaluation Outcomes

Literacy Outcomes

The pre-post test findings on each of the 8 dimensions measured by the Early Childhood Literacy

Assessments indicate significant improvement over the course of the program. Table 1. Below provides

the mean scores for each dimension of the ECLA for pre and post tests. The following graphs display the

degree of improvement for each subscale. All sub-scales demonstrated statistically significant

improvement using paired-sample t-tests.

Report

Administration

Number

Supportive

Reading

Environment

Adult

Reading

Quality

Child

Interest

in

Reading

Child

Reading

Engagement

Child

Narrative

Skills

Child

Language

Awareness

Letter

Recognition

and

Phoneme

Skills

Child

Emergent

Writing

Pre-

Test

Mean 2.4716 2.6650 2.4609 3.3750 3.5312 2.2424 2.5455 3.1136

Std. Error of

Mean

.08578 .08155 .09984 .16725 .21409 .18851 .22818 .18267

Post-

Test

Mean 2.8718 3.3671 3.2333 4.2333 4.4000 3.8750 3.9167 4.0417

Std. Error of

Mean

.08688 .10808 .09280 .21749 .16330 .32755 .23863 .18727



One-year follow-up

One-year after participating in the program, children whose families participated in the Women’s Initiative programs:

Had school readiness scores consistent with children from low-risk families

Were significantly more prepared to enter Kindergarten than a comparison group of children whose families had risks for poor academic achievement similar to their own family’s

Improved support for reading in the home, increased parent knowledge and expectations about early childhood reading, and improved basic reading readiness skills combined to have a fundamental and lasting impact on the child and his or her family.

71%

53%

86%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Women's Initiative 1-

year follow-up

High Risk Control

Group

Low Risk Contrl

Group

Percent of Children Ready for School at 1-year post intervention



Summary and Conclusions

With this second, three-year cycle of funding the Women’s initiative has added two new partners; Leaps and

Bounds Family Services and Healthy Families Oakland. With the addition of these two programs, the

UWSEM Women’s Initiative has a unique opportunity to contribute to the National dialogue regarding the

impact of home visitation programs on early childhood development. The four most prominent and well-

developed home visitation approaches; Parent-Child Home, Parents as Teachers, Home Instruction for

Parents of Preschool Youngsters (HIPPY), and Healthy Families, are included as a part of the Women’s

Initiative evaluation. This summer these programs issued a shared vision statement. Yet, there is, at present,

no other single evaluation study, which includes all four of these intervention approaches. Because of this

unique situation, the UWSEM Women’s Initiative is in a position to make an important contribution to our

understanding of what makes home visitation programs effective. This is going to be even more important

given the growing recognition of the importance of positive early-childhood development.

In addition to this unique compilation of home visitation programs, the women’s initiative partner

agencies have demonstrated a remarkable level of commitment from their families and staff. Much of the

success of home visitation programs depends upon the skills and abilities of the home visitor. Unfortunately,

on a National level, there is tremendous turnover in home visitor staff. But, among the women’s initiative

programs there has been no turnover across the last three-and-a-half years. This is an astounding level of

consistency. This commitment on the part of the home visitors is reflected in the commitment of the

families. Just as an example, the Neighborhood Services Organization HIPPY program has retained 100% of

their families across two years. One of the consistent findings across all home visitation programs is that the

key to their success is getting families to become engaged in the program process. It is clear that the

Women’s Initiative partner agencies are quite successful in this often difficult task. As a result, not only are

we seeing impressive program impacts, we are now able to track the progress of these children and families

across early childhood and into the critical primary grades. The Women’s Initiative partners have

demonstrated a substantial positive effect on the early reading achievement of the children living in the

Metro-Detroit area.

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