An estimated 3000 or more home visiting projects are under way across the United States, operating through local initiative or under the more than 70 state-based efforts in progress in 2009.1 Most provide in-home support from nurses and paraprofessionals to new and expecting parents, primarily those who have 1 or more social risk factors (eg, parents who are younger than 20 years, have less than a high school education, have below poverty income, or are otherwise considered vulnerable or at risk). Participation in these programs is purely voluntary and most families choose to continue for a period of 1 to 3 years. Their goals generally are to reduce child abuse, promote optimal child health and development, strengthen parent skills, and improve family economic and psychosocial well-being.
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