Implementation Fidelity in Early Childhood Home Visiting: Successes Meeting Staffing Standards, Challenges Hitting Dosage and Duration Targets




Deborah Daro, Kimberly Boller, and Bonnie Hart

Brief Type

Research Brief


  • Healthy Families America (HFA)
  • Nurse-Family Partnership (NFP)
  • Other Models
  • Parents as Teachers (PAT)
  • SafeCare/SafeCare Augmented


This brief summarizes the EBHV fidelity analysis findings and highlights the key policy and practice implications for policymakers and direct service providers. The centrality of  implementation fidelity as a goal of the EBHV initiative focused the national evaluation on this topic and resulted in development of a fidelity framework that guided data collection and analysis and a related design brief (Daro 2010), an interim report on fidelity in the first two years of the initiative based on fidelity data collected from subcontractors and their implementing agencies (Daro et al. 2012), and the analyses presented in the study’s final report (Boller et al. 2014). The EBHV evaluation is the first to collect similar data on fidelity across five different home visiting models operated in almost 50 agencies. The resulting analyses provide a snapshot of the characteristics of almost 400 home visitors, 5,000 families, and 90,000 home visits. This brief provides findings and draws implications that can be used to inform implementation of the Maternal, Infant, and Early Childhood Home Visiting Program and state and local efforts to replicate with fidelity to model requirements and good practice standards. (author abstract)

Data Collection Methods

  • Program administrative record reviews



For More Information

Daro, D., Boller, K., & Hart, B. (2014). Implementation fidelity in early childhood home visiting: Successes meeting staffing standards, challenges hitting dosage and duration targets. Princeton, NJ: Mathematica Policy Research. Retrieved from https://www.mathematica-mpr.com/our-publications-and-findings/publications/implementation-fidelity-in-early-childhood-home-visiting-successes-meeting-staffing-standards


  • Program Quality, Continuous Quality Improvement, and Fidelity