A Survey of Environmental Health Interventions in the Maternal, Infant, and Early Childhood Home Visiting Program in the United States

Home-based interventions in children ages 0–4 years have successfully reduced environmental health problems, yet the burden persists and disproportionately affects low-income families. Our study describes the extent to which home visiting models approved for federal funding included these home-based interventions and evaluated them. A survey was administered to key representatives at each of the 21 home visiting models eligible for Maternal, Infant, and Early Childhood Home Visiting Program funding that were being implemented in May 2023 in the U.S. The respondents were based across the U.S. and in other countries. All respondents returned completed surveys ( n = 21, 100% response rate). Slightly more than one half ( n = 12) of the respondents reported that their models included some environmental health content. Models on average covered 3 out of the 15 topics listed, with lead poisoning being the most covered ( n = 11). The services used most often to address environmental health were risk assessment ( n = 10) and referral to other organizations ( n = 8). Only one respondent reported that their model evaluated the outcomes of their environmental health services. Home visiting programs represent a promising approach to mitigating harmful environmental exposures during early childhood but further incorporating comprehensive home assessments, safety device provision and installation, and linkages to healthy homes organizations would amplify their positive impact.