Positive influences during early childhood—especially attentive, supportive, and stimulating relationships with parents or caretakers—can strengthen brain development and promote positive long-term outcomes in learning, behavior, and health.¹ Home visiting (HV) is a well-established, evidence-based approach to promoting these positive relationships.² As the Texas Department of Protection and Early Intervention’s (PEI) most prominent strategy for preventing child maltreatment, HV programs will be an integral part of a community-focused twenty-first century child welfare system.^a HV programs provide expectant parents and parents of young children with in-home parenting support, information, and connections to additional services. Texas currently offers multiple evidence-based HV programs (e.g., Home Instruction for Parents of Preschool Youngsters, Nurse-Family Partnership, Parents as Teachers, Healthy Families America) that serve approximately 16,000 families annually.³

Many stakeholders across Texas are seeking to expand HV to serve more families throughout the state. Texas has approximately 1.8 million families with children under age 6. Among these families, there are about 413,000 that research suggests may particularly benefit from HV.^4,b This means that less than 4 percent of families who could benefit from HV currently receive it.

PEI, which houses most Texas HV programs, released a Five-Year Strategic Plan in 2016 that details the agency’s approach to expand and improve HV.⁵ However, expanding and improving HV in Texas will require overcoming several hurdles, including the need to reach families in rural communities, grow and support a stable HV workforce, improve connections to community resources, and access additional funding. This brief describes the research base around innovative, efficient, and cost-effective approaches that Texas could implement to expand HV and help more families thrive. The innovations described below align with PEI’s goals to increase funding for prevention services, enhance program implementation, integrate community-level resources, rely on research, and incorporate a public health framework.⁵