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Tribal Maternal, Infant, and Early Childhood Home Visiting: A report to Congress

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Description:
The Tribal Home Visiting Program, part of the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV, the Federal Home Visiting Program), is an unprecedented expansion of culturally responsive services for vulnerable American Indian or Alaska Native (AIAN) families and children, strengthens tribal communities, and contributes to more comprehensive and integrated systems of care for families and young children. Since 2010, the Tribal Home Visiting Program expanded home visiting services in tribal communities, serving a total of 1,523 families and providing nearly 20,000 home visits. The Tribal Home Visiting Program serves some of the most vulnerable families who experience multiple challenges--such as substance abuse, domestic violence, and poverty--often attributed to historical trauma. Required grant activities are based on implementation science and closely mirror the high expectations of State Home Visiting grantees. These requirements ensure program services are responsive to unique community and family challenges and support high quality program implementation. This is evidenced by a majority (77 percent, n =10) of the 13 Cohort 1 grantees demonstrating overall improvement in the six legislatively mandated benchmark areas. Key predictors of positive child and family outcomes, such as increased prenatal care and screening rates for maternal depression and decreased rates of child maltreatment have improved. In addition to program improvements in benchmark areas, grantees built capacities for developing, implementing, and evaluating home visiting services. Capacity building efforts translate well beyond immediate home visiting services, benefitting the broader community through enhanced systems of care, workforce development, greater data collection capacities, and increased ability to advocate for and serve families and young children. Additionally, new ground is being broken in testing adaptations and enhancements to national home visiting models through locally designed rigorous evaluations that expand and strengthen the evidence base on home visiting with tribal communities. This report focuses primarily on the efforts of Tribal Home Visiting grantees. A separate report provides more details on the activities of State Home Visiting grantees. (author abstract)
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Executive Summary

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