ABSTRACT
This chapter examines randomized trials of home-visitation services from the standpoint of three factors that we believe are critical in determining their success. The factors are the underlying causal model of influences on maternal and child outcomes; the corresponding content and structure of the services; and the degree to which the population served is at environmental, behavioral, or psychosocial risk for the particular problem under consideration. The models of nursing study in Seattle examined the impact of the different programs on maternal social skills and a variety of other maternal and child psychosocial outcomes. Experience suggests that programs replicated in the real world may not resemble their experimental models. Consequently, it will be important to test the effectiveness of such programs as they are transported into health care institutions and to examine the resources necessary to support them, such as the home-visitors' educational preparation, ongoing training, and other support services.
