Why Home Visiting Is More Essential Than Ever

In this open letter, Dr. Meghan López focuses on how relationship-based home visiting supports families by building trust, addressing complex needs, and strengthening systems around them.

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Between birth and age three, a child’s brain forms more than one million neural connections every second. During this extraordinary period, emotionally nourishing relationships help lay the foundation for lifelong health and well-being.

That is why supporting young children also means supporting the parents and caregivers raising them.

As the ZERO TO THREE community convenes this fall, families are facing increasingly complex and interconnected challenges. A parent may be managing a difficult pregnancy while worrying about housing. A caregiver concerned about their child’s development may also be experiencing depression, trauma or financial instability. Our systems often address these needs separately. Families experience them all at once. That’s one reason why home visiting is more essential than ever.

Care That Sees the Whole Family

A family’s well-being cannot be understood through a single appointment, diagnosis or referral. When home visitors enter a family’s life, they can see how circumstances connect: how a child is developing, how a caregiver is coping, what pressures the household is facing and what strengths already exist within the family.

And, importantly, home visiting creates time and space for trust.

Trust doesn’t come from a single visit. It grows when families feel heard and respected. It comes from showing up consistently, listening closely and recognizing parents and caregivers as the experts on their own lives. I’ve seen the difference that can make.

Courtney’s Story

During her second pregnancy, Courtney was experiencing serious health challenges, depression and intimate partner violence. She connected with a Child First care team that took the time to listen, help address her mental health, and connect her family with practical resources.

As Courtney described it, they “lifted the load” so she could begin to heal. Courtney’s story illustrates something important about this work. Families don’t always need another system to navigate. Sometimes they need someone to walk alongside them.

I found myself and I found my way back to the unstoppable mom that I always was.

Courtney, Parent

Evidence Brought to Life Through Relationships

Home visiting works when it combines proven, data-driven approaches with trusted relationships built over time. At Changent, this approach is central to the two evidence-based home visiting programs we support and scale: Child First and Nurse-Family Partnership®. Each program supports families in different ways at critical moments in their lives, but both recognize that the well-being of children and their caregivers is deeply connected. Together, our programs contribute to a broader continuum of care across maternal, early childhood, and mental health.

Nurse-Family Partnership pairs families with specially educated registered nurses during pregnancy and through a child’s second birthday. Backed by nearly 50 years of research, Nurse-Family Partnership has demonstrated improvements in pregnancy and child health, child safety and family economic stability. In 2025, among participating families, 88% of pregnancies reached full term, 89% of children were up to date on immunizations at 12 months and 59% of mothers were employed or enrolled in school when their children reached 12 months.

Child First brings that same relationship-based philosophy to early childhood and family mental health. The program connects families with a two-person care team, including a licensed mental health clinician and a care coordinator, to help parents and caregivers navigate challenges and trauma; build strong, loving relationships with their children; and connect with other resources and services in their communities. In 2025, 70% of participating caregivers experienced improvement in depression symptoms, 72% experienced improvement in post-traumatic stress symptoms and 72% demonstrated improved caregiver-child interaction.

These outcomes affirm a powerful truth: when caregivers have the support and space to heal, children and entire families thrive. When unaddressed, trauma and poor health can span generations – but so can healing. This is the deeper promise of care built on trust that meets families where they are: not just healthier pregnancies or stronger early development, but a measurable break in cycles that would otherwise repeat.

Proven Programs Require Strong Public Policy

Strong evidence may establish that home visiting works, but evidence alone does not sustain a program. Public investment does.

Both Child First and Nurse-Family Partnership are designated as evidence-based models under the Maternal, Infant, and Early Childhood Home Visiting program (MIECHV), the federal funding engine supporting voluntary, evidence-based home visiting nationwide.

Congress’s bipartisan 2022 reauthorization put MIECHV on a path to double annual federal funding from $400 million to $800 million in fiscal year 2027. That investment is delivering results. In 2025, MIECHV-funded programs provided more than one million visits and reached 158,000 children and parents. Yet only about one in five eligible families is currently reached.

With MIECHV’s authorization expiring in September 2027, Changent is working alongside families, home visitors and local partners to help policymakers understand what home visiting accomplishes — and how much unmet need remains. Congress must build on this progress with another strong reauthorization and increased investment. This summer, Changent Parent Ambassador Shemya Wilson shared her stirring, inspirational story before Congress on why this investment is essential.

Courtney and Shemya are proof of what’s possible for the thousands of families reached by evidence-based home visiting. Both experienced serious challenges. Both received care that met them where they were. Both are raising children in homes shaped by healing, not the hardship that came before, and both now do that same work for others: Courtney as a doula, Shemya as a social worker. Now they’re the ones extending that care outward, to other parents, to Congress, to the families still waiting for someone to show up.

Strengthening the System Together

No single model, organization or policy can meet every need a family faces. Home visiting shows us what becomes possible when care is built around the family, rather than the system: listening first, building trust over time, and responding to each family’s goals, strengths, and daily life.

Building a stronger, more connected continuum of care will require families, practitioners, community organizations, advocates, researchers and policymakers to work together across traditional boundaries. As we gather this fall, Changent invites the ZERO TO THREE community and everyone working alongside families in these earliest years to build this connected system together – one in which our work complements, rather than competes. Because families deserve every option that can support them, not the one that happens to reach them first.

Meeting families where they are is not only about where the care happens. It is how we build healthier futures for children, caregivers and communities.

Changent champions the lives of children and families with its evidence-based, two-generation home visiting programs, Child First and Nurse-Family Partnership®. Learn more about Changent and the programs behind our work.

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