Family Economic Self-Sufficiency

Maternal Health

Linkages and Referrals

Child Development and School Readiness

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This model does not meet the criteria established by the Department of Health and Human Services (HHS) for an “evidence-based early childhood home visiting service delivery model” for the general population or for tribal populations because the findings from high- or moderate-rated effectiveness studies of the model do not meet all required criteria.

16

The MOM Program is designed to address gaps in the use of health and early intervention services for developmental issues for children under age 5, to improve their developmental and behavioral outcomes at kindergarten entry. The program targets low-income, postpartum mothers of healthy infants. Home visits, conducted by a nurse or community worker, typically last 15 minutes and are offered until children reach age 5. Until age 3, the program provides mothers with home visits and telephone reminders before planned well-child health care visits to prepare them for their appointments, telephone calls to follow up after their visits, and developmental screenings when children are 18 and 36 months old. Home visits conducted after age 3 focus on preschool and kindergarten enrollment and, when applicable, the transition from early intervention to special education services.

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For more information, see the research database. For more information on the criteria used to rate research, please see details of HomVEE’s methods and standards.

103

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The MOM Program was developed to address gaps in the use of health services and early intervention services for developmental issues for children under age 5. It is designed to provide professional support to help low-income mothers identify the need for early intervention and access appropriate services for their children.

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The MOM Program is implemented by researchers and staff from the Children’s Hospital of Philadelphia, the City of Philadelphia, and the University of Pennsylvania. It was originally implemented as a demonstration program from 2001 to 2006.

The program director provides ongoing technical assistance to ensure that all materials are available and that all staff understand and adhere to data-tracking requirements.

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The MOM Program is offered to postpartum mothers of healthy infants until their children’s fifth birthdays. Mothers are recruited from an urban academic hospital and reside in high-poverty neighborhoods in Philadelphia, Pennsylvania.

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The program aims to increase mothers’ use of child health care services and promote receipt of early intervention services for their child in order to improve developmental and behavioral outcomes at kindergarten entry.

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Until children reach age 3, the MOM Program provides home visits to mothers before planned well-child health care visits to prepare mothers for their appointment. Home visitors, consisting of both nurses and paraprofessional community workers, are not assigned to specific mothers, but instead alternate visiting participants.

Well-child visits are planned according to American Academy of Pediatrics guidelines. During the visits, home visitors:

• Ask mothers whether they have concerns about their child’s development;
• Show mothers checklists of age-specific developmental milestones and ask how their child compares;
• Encourage mothers to ask about their child’s development at the upcoming well-child visit;
• Discuss expectations for the upcoming well-child visit in terms of procedures and immunizations;
• Inform mothers of appropriate early education services;
• Conduct developmental screenings when children are ages 18 and 36 months.

Home visitors also call mothers to remind them of their scheduled well-child appointments. They call again after the scheduled visit to check that the mothers went to their appointment and received all recommended services. If one home visitor encounters persistent nonresponse from a mother, another home visitor takes over. In addition to varying the home visitor attempting communication, home visitors also vary the days and times of contact efforts.

The MOM Program offers two additional visits to mothers of children with developmental delays before they reach 33 months. During these additional visits, home visitors inform mothers about the procedures for enrolling their children in early intervention services and obtaining missing documents, such as their children’s birth certificates.

When children are 36 to 60 months of age, home visits are offered to all mothers to support enrollment in preschool and kindergarten and, when applicable, to facilitate the transition between early intervention and preschool special education services.

The curriculum is based on Hospital and American Academy of Pediatrics’ guidelines for the care of children’s health. Developmental milestones are based on guidance from The Children’s Hospital of Philadelphia’s Neonatal Follow-Up Program.

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The MOM Program offers most mothers nine visits before planned well-child appointments until children are 3 years old and two visits per year when children are from 3 to 5 years old. The target dosage for the first 3 years is completion of 75 percent (seven of nine) of planned visits. For mothers of children with developmental delays, the program offers two additional visits before the children reach 33 months. Visits typically last 15 minutes. The MOM Program avoids frequent or long visits to avoid seeming intrusive or burdensome and to foster positive relationships with the mothers.

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No information is available.

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Implementing agencies must be able to provide adequate oversight of a team composed of lay and professional staff. No other details are available about the type of organizations that implement the program.

No information is available about the ongoing fidelity guidelines that implementing programs or home visitors are required to meet.

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Home visitors include nurse practitioners and community workers.

A supervisory group of health professionals and a program manager oversees the home visitors.

Nurse practitioners have masters’ degrees. Community workers must have completed high school.

Supervisory group members include a pediatrician, two Ph.D.-level clinical psychologists, a Ph.D.-level director of a nurse practitioner training program, and a program manager.

Throughout the program, weekly, 90-minute supervision meetings are held with all home visitors and the supervisory group. During the meetings, the supervisory group reviews home visitors’ detailed records of attempted contact with mothers, briefly discusses each mother’s progress, and recommends strategies to engage unresponsive mothers. Strategies include varying the timing and type of outreach, as well as having a different home visitor conduct the outreach.

During the supervisory group meetings, home visitors receive trainings tailored to each home visit. The trainings are designed to help visitors prepare mothers for each specific well-child health care appointment. Please contact the model developer for additional information about the pre-service training requirement.

Home visitors are also trained to administer the Ages and Stages Questionnaire (ASQ) to screen for developmental problems and the need for early intervention services.

Weekly supervisory group meetings also include ongoing cross-discipline training. Nurse practitioners receive ongoing training in the culture of the families and the neighborhoods, and community workers are trained to discuss health and development issues with families. Staff meetings also discuss system-wide issues, such as barriers to accessing services. Please contact the model developer for additional information about the ongoing professional development requirement.

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Jerilynn Radcliffe
The Children’s Hospital of Philadelphia
3400 Civic Center Blvd.
CHOP North 1461
Philadelphia, PA 19104

Phone: 215-590-7446
Email: Radcliffe@email.chop.edu