Session: Home Visiting for Prevention: Evidence from 9 Countries (Society for Prevention Research 23rd Annual Meeting)

Home visiting is the preventive intervention with the strongest data generated over the last 30 years, typically implemented by nurses. Yet, in low and middle income countries (LMIC) the workforce will not have a workforce to implement such programs at least for the next 50 years. In the United States, extended home visiting by nurses for new mothers has substantial and significant improvements in adjustment for up to 15 years. The effects of this program are so impressive that nurse home visiting is being nationally diffused in the U.S.. More than 20,000 new parents receive nurse home visits for up to 18 months. When the nurse home visiting programwas mounted by paraprofessionals in the U.S., it significantly improved outcomes, but was not as effective as when nurse-delivered.  Delivering home based interventions at scale in low and middle income countries will require task shifting and the use of community health workers.  There are significant differences in health and human service systems globally, and the often dramatically different cultural and historical factors that have affected vulnerable populations in these other societies require different approaches to implementation and testing.  In addition, international replication of interventions designed and implemented in the USA requires commitment to delivering the program with essential fidelity to the core elements of the programme.  In this symposium we will present findings from home visiting programmes in 9 countries in order to outline lessons on adaptation, training, implementation, evaluation and scale up globally.