Prenatal Care and Home Visiting

Setting the stage for positive outcomes for children begins before birth. Iowa has long been committed to the health of children and families and has led the nation in home-visiting programs to support families. Home visiting services support children and families through prenatal, birth, and early childhood, but services are fragmented across different provider types, funding streams, and even administrative authorities. This means the data about families served is also siloed. I2D2 was identified to help integrate these data to better understand the needs of Iowa families with young children and guide program leaders and policymakers in identifying challenges and creating solutions for prenatal care and home visiting programs.

In 2019, I2D2 began collaborations to integrate home visiting records with other public administrative datasets as part of the work of ECI 2019 Statewide Needs Assessment. Subsequently, with funding from Iowa’s Maternal Infant Early Childhood Home Visiting program (MIECHV), the team has explored a host of projects investigating prenatal needs, care, and service use among Iowa families with young children, including:

• Expanding on the needs assessment work to create community-level data capable of informing strategic planning, the team prepared the . Mapping Vulnerability in Iowa’s Early Childhood Systems 2020 Report.This report used indicators from Iowa’s 2010 Title V MIECHV Home Visiting Assessment (part of the federal requirement for MIECHV funding) and the 2019 National Center for Children in Poverty Report to study trends and outcomes for children, which in turn informed subsequent funding applications and expansion work for MIECHV programs in Iowa.
• In 2021, I2D2 collaborated on the “Technical Report: Birth Risks and Timing of Enrollment in Home Visiting” to understand more about families served in home visiting programs across the state. The evaluation happened in partnership with Iowa’s Department of Public Health and MIECHV and aimed to provide insight on the birth risks, co-occurrence of birth risks, family characteristics in home visiting programs, and how birth risks and program enrollment relate to home visiting program completion.
• A 2022 update to Iowa’s Statewide Needs assessment included a family survey designed to understand patterns in social services use for families with young children (Iowa Families with Young Children: 2022 Statewide Family Survey Report. This report identified program usage and knowledge for families and their children from 0-5 in age. The report revealed the knowledge of existing information, family experience with programs such as home visiting, and identified barriers to service that existed that kept families out of programs.

• Since 2000, 41 birthing units have closed and attention to the potential impact was heightened through Iowa’s Obstetrician Summit bringing together stakeholders from across the state.  Home visiting leadership was interested in how home visiting services might support families living in closure areas (see Access to Care, Outcomes, and Birthing Unit Closures). I2D2 studied the birthing hospital closures and presented findings in October 2023 at the Maternal Health Symposium on Prenatal Care, Birth Outcomes, and Hospital Closures.  
• Building from previous work on birth characteristics and access to birthing units, another line of inquiry is examining whether prenatal enrollment in home visiting programs could mitigate negative outcomes for children and families, focusing on how family stressors (e.g., poverty, low social support, teen parenthood, low education) and characteristics (e.g., rurality, language access, and neighborhood characteristics) relate to caregiver behaviors, parent-child attachment, and early childhood developmental outcomes. In January of 2024, I2D2 presented a poster featured by the Home Visiting Applied Research Collaborative at the National Home Visiting Summit.

In 2022, I2D2 collaborated with Early Childhood Iowa, MIECHV, and state and local funded programs to pull aggregated data from the DAISEY data collection system to inform decision-makers. Then, beginning in 2024, the work has expanded into an integrated project that brings together home visiting records and vital statistics birth records to provide annual reports of investments and outcomes for families in home visiting have been completed. The FY24 Family Support Annual Report was the first time that family support data were presented with population-level data about all children 0-3 in Iowa to help advance programming improvements.

Expansions currently underway as we build reports and dashboard integrations into the IA Data Drive to guide decision-making. Join our newsletter for updates!