Home Visitation Programs Can Help More Families if They Address Domestic Violence

With Congress considering a substantial investment in home visitation programs, they should be refined to more purposefully address the needs of mothers and children at risk for domestic violence, as well as the link between domestic violence and child abuse/neglect. That is the conclusion of Realizing the Promise of Home Visitation: Addressing Domestic Violence and Child Maltreatment, a new brief released at a Capitol Hill briefing in February. It was written by  Futures Without Violence, formerly Family Violence Prevention Fund  in partnership with the National Child Abuse Coalition and Safe Start Center, with sponsorship from the Avon Foundation for Women.

Home visitation programs have been used for some 30 years to improve maternal and child health, early childhood development, and family safety and stability. Quality home visitation programs can identify and prevent health, social and economic problems before they become family crises, according to the new brief, but to have maximum impact, they should integrate domestic violence identification, assessment and prevention into all aspects of their work.

At the February 3rd congressional briefing, a Baltimore-based domestic violence survivor spoke powerfully about how a home visitation program helped her. Anna* came to the home visitation program after seeking treatment for injuries caused by an assault by her then-partner. She was pregnant at the time. The doctor referred her to a social worker, who told her about the Domestic Violence Enhanced Home Visitation Intervention (DOVE) Project.

“After my first meeting with the nurses and social worker from the home visitors program, I started to want to talk about my life,” Anna said. “People from the home visitors came to see me and it was different. It was different than calling a shelter. It was different than calling the police. They didn’t make me feel that I was at fault. They helped me see that violence is a cycle and helped me get out. By me changing my life, it’s changing my children’s lives,” she added. “Now anything is possible.”

“By integrating domestic violence in all aspects of these programs, the investment of federal dollars can go even further in achieving home visitation’s intended outcomes for millions of families,” Futures Without Violence Public Policy Director Kiersten Stewart said at the event. The new brief recommends funding research to determine the most effective methods for integration and collecting additional data, especially in updating the Pregnancy Risk Assessment Monitoring System, to measure the ways violence impacts families. See more of Futures Without Violence's policy recommendations on home visitation here.

Body of Research

Researchers emphasized the effects of intimate partner violence on children’s development. “If we’re talking about keeping kids healthy,” said Dr. Megan Bair-Merritt, Professor of Pediatrics at Johns Hopkins University, “then we need to think very thoughtfully about how intimate partner violence affects kids.” She called home visitation programs, “a good way to intervene.” See Dr. Bair-Merritt’s complete presentation here.

Dr. Linda Bullock, a University of Missouri School of Nursing Professor, presented her work evaluating domestic violence interventions in home visitation programs. “The main ingredient of home visitation is the support and education that these women are getting,” she said. See Dr. Bullock’s complete presentation here.

The new brief is designed as a resource to help policymakers enhance the effectiveness and reach of home visitation programs by outlining best practices and offering recommendations for integrating domestic violence into existing programs. It recommends that federally funded programs offer comprehensive training for home visitors with specific strategies to:

  • Prevent domestic violence in at-risk families;
  • Identify and respond safely when violence occurs;
  • Understand the impacts of domestic violence on children’s health and well-being; and
  • Work with men and fathers, when it is safe to do so, to link them with community resources and help them understand the importance of being non-violent parents and partners.


Futures Without VIolence is providing an additional resource for home visitors – a safety card. In addition to providing safety resources for women, this card also functions as a prompt for home visitors by providing quick phrases to improve discussions with women about the impact of domestic violence on their parenting and children. It outlines questions women may ask themselves about their relationships, birth control use and parenting, while offering supportive messages and referrals to national support services for help. View the safety card here and order from Futures Without Violence's store here.

More than 15 million children in the United States live in families in which partner violence has occurred at least once in the past year, and seven million children live in families in which severe partner violence has occurred. Dr. Bair-Merritt noted in her remarks that children in homes in which intimate partner violence occurs have twice the risk of developing asthma as other children, and that this risk goes down when battered mothers are helped to engage with their children.

The brief was developed under grant number 90EV0377/04 from the U.S. Department of Health and Human Services (HHS). The points of view expressed are those of the authors and do not necessarily represent the official position or policies of HHS. Read the complete brief here.

NOTE: *The Family Violence Prevention Fund is withholding Anna’s name to ensure her safety and the safety of her children.

Dr. Bair-Merritt and Dr. Bullock sitting at the panel during the Capitol Hill briefing.

Deidra Henry-Spires with the Senate Finance Committee and Iye Kamara with the Baltimore-based Domestic Violence Enhanced Home Visitation Intervention (DOVE) Project at the Capitol Hill briefing.

Futures Without Violence Public Policy Director Kiersten Stewart at the podium, giving opening remarks at the Capitol Hill briefing.