Early Childhood Home Visitation to Prevent Violence

Home visitation to prevent violence includes programs in which parents and children are visited in their home by:

• Nurses
• Social workers
• Paraprofessionals
• Community peers

Some visits must occur during the child’s first two years of life, but they may be initiated during pregnancy and may continue after the child’s second birthday.

Summary of Task Force Recommendations & Findings

The Community Preventive Services Task Force recommends early childhood home visitation programs based on strong evidence of their effectiveness in reducing child maltreatment among high-risk families.

Task Force Finding

There is insufficient evidence for the effects of these programs on:

• Violence committed by children participating in the program (based on a small number of studies with inconsistent effects)
  • Task Force Finding
• Intimate partner violence (based on one study with no significant effect)
  • Task Force Finding
• Violence committed (other than child maltreatment) by parents participating in the program (based on too few studies)
  • Task Force Finding

About the Intervention

Home visitors convey information, offer support, and provide training. Programs may include the following components:

• Training for parent(s) about prenatal and infant care and parenting skills
• Development of problem-solving and life skills for parents
• Assistance with educational and work opportunities
• Linkage with community services
• Provision of daycare
• Parent group meetings for support and/or instruction
• Transportation

 Results from the Systematic Reviews

• Child maltreatment in high-risk families: median reduction of 38.9% in episodes (interquartile interval: -74.1% to -24.0%; 21 studies, 26 study arms)
  • Longer-duration programs produced larger effects; programs of less than 2 years duration did not appear to be effective.
  • Professional home visitors may be more effective than trained paraprofessionals, but longer-duration programs with trained paraprofessionals can also be effective.
• Violence by the visited children: findings are inconsistent (4 studies)
• Intimate partner violence: lack of statistically significant results (one study)
• Violent behavior by visited parents (other than maltreatment): lack of statistically significant results (one study)
• All programs reviewed were directed at families considered to be at high risk of child maltreatment (e.g., single or young mothers, low-income households, families with low birth weight infants).

These findings were based on a systematic review of all available studies, conducted on behalf of the Task Force by a team of specialists in systematic review methods, and in research, practice and policy related to violence prevention.

Supporting Materials

• Analytic framework - See Figure 1 on page 14
• Research gaps
• Summary evidence table [PDF - 402KB]
• Included studies

Publications

Bilukha O, Hahn RA, Crosby A, et al. The effectiveness of early childhood home visitation in preventing violence: a systematic review. [PDF - 273KB] Am J Prev Med 2005;28(2S1):11-39.

CDC. First reports evaluating the effectiveness of strategies for preventing violence: early childhood home visitation: findings from the Task Force on Community Preventive Services. MMWR 2003;52(RR-14):1-9..

Task Force on Community Preventive Services. Recommendations to reduce violence through early childhood home visitation, therapeutic foster care, and firearms laws. [PDF - 71KB] Am J Prev Med 2005;28(2S1):6-10.

Task Force on Community Preventive Services. Violence. [PDF - 340KB] In : Zaza S, Briss PA, Harris KW, eds. The Guide to Community Preventive Services: What Works to Promote Health? Atlanta (GA): Oxford University Press;2005:329-84.

More Community Guide publications about Youth Violence Prevention

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Sample Citation

The content of publications of the Guide to Community Preventive Services is in the public domain. Citation as to source, however, is appreciated. Sample citation: Guide to Community Preventive Services. Early childhood home visitation to prevent violence. www.thecommunityguide.org/violence/home/homevisitation.html. Last updated: MM/DD/YYYY.

Review completed: February 2002