Moving Toward Evidence-Based Preventive Interventions for Children and Families

Abstract

Dr. Henry Kempe was an early advocate of paraprofessional home visiting as an approach to preventing child abuse and neglect. Over the nearly 40-year period since Dr. Kempe promoted home visiting, a number of home-visiting programs have been tested in randomized controlled trials in which the visitors were either nurses and other professionals or paraprofessionals. In a well-respected review of this evidence, the two programs with the strongest evidence of effectiveness, reflected in impacts on injuries revealed in medical records and child abuse records, were delivered by either nurses or by a mixture of nurses and other professionals. Program models make a difference in producing impacts, and the background of visitors is likely to be an important component of those models, especially when they focus on families enrolled during pregnancy or soon after the delivery of the child.