Coordination of early childhood home visiting and health care providers

Although early childhood home visiting (HV) programs and primary care often have overlapping goals for child health and family well-being, little is known about the extent of coordination between HV and medical providers for women and children. The current study sought to measure coordination between HV and primary care medical providers, and to identify factors that influence its achievement. We developed and administered a web-based survey of HV providers who are members of the Home Visiting Applied Research Collaborative (HARC), a voluntary national network of HV programs, networks, and researchers. Program managers reported on coordination activities, health outcomes of the HV program, and supports for coordination. The 80 respondents indicated that nearly all HV programs ask whether and where participants receive primary medical care. However, less than half hold memoranda of understanding (MOU) agreements or regularly communicate with medical providers. Regular communication of HV programs with medical providers for women or children was positively associated with selected eligibility requirements (teenage mother, low-income family), having performance standards for one or more health related outcomes, favorable coordination perspectives by HV supervisors, and HV program supports for coordination (policies for training and supervision regarding coordination, MOU, and participation in medical visits) (all p < 0.05). Despite recent efforts to improve coordination between HV and medical providers, the extent of coordination remains limited.