Theories of change and outcomes in home-based Early Head Start programs

• Theories of change were examined in 10 Early Head Start home visiting programs in RCT.
• All 10 programs prioritized parenting outcomes but only 4 prioritized child outcomes.
• There were impacts on 9 parenting outcomes at 24 months and on 2 child outcomes at 36 months.
• Parenting impacts at 24 months mediated 54% of the impact on 36-month Bayley MDI impacts.
• Parenting impacts at 24 months mediated 47% of the impact on 36-month child engagement impacts.

Programs to promote children's early development are based on a set of assumptions, explicit or implicit, about intended outcomes and how the program will effect change. The “theories of change” were examined in ten home-based programs in the Early Head Start Research and Evaluation Project (EHSREP), using data collected through multiple interviews with program staff. All home-based programs indicated that parenting outcomes were among their highest three priorities, while only 4 of 10 programs said that child outcomes were in their top priorities. The pattern of outcome differences between randomly-assigned program and control group participants reflected the programs’ theories of change in several ways. Early Head Start home-based programs showed positive impacts on 9 of 9 parenting outcomes, including parental supportiveness, home language and learning supports, emotional responsiveness, and family conflict when children were 24 months of age. Significant program impacts on child cognitive skills (Bayley MDI scores) and social behavior (observed child engagement of parent during play) were found when children were 36 months of age. Mediation analyses showed that the 54% of the program impact on 36-month child cognitive scores was mediated by 24-month program impacts on parental supportiveness, language and learning support, emotional responsiveness, and family conflict, and 47% of the program impact on 36-month child engagement of parent was mediated by 24-month impacts on parental supportiveness, language and cognitive stimulation, and emotional responsiveness. Results from mediation analyses were consistent with these home-based programs’ theories of change, supporting the efficacy of focusing on parent change as a mechanism for child outcomes in home visiting programs.