School Readiness and Home Visiting: A Scoping Review of Definitions, Outcomes, and Contextual Moderators

Abstract This scoping review examined empirical research on the relationship between participation in home visiting programs and children’s school readiness at the time of school entry. Specifically, we explored how school readiness is defined across studies, which domains are assessed as outcomes, and what contextual factors moderate the effects of home visiting on school readiness. School readiness is a multidimensional construct encompassing physical well-being, social-emotional development, language and literacy, approaches to learning, and cognitive skills. Home visiting programs aim to promote early development and family well-being, yet evidence remains mixed regarding their impact on school readiness and the contextual factors that shape these outcomes. This review addresses these gaps by mapping the scope and characteristics of existing research. A systematic search of CINAHL Plus, Embase, PubMed, and Scopus was conducted for articles published between January 2016 and April 2025. Guided by PRISMA-ScR, studies were included if they examined U.S. based- home visiting or home-based interventions for children from birth through kindergarten and assessed school readiness at school entry. Twenty studies met inclusion criteria. Definitions of school readiness and the developmental domains assessed varied widely across studies, with language and literacy and social emotional development most frequently examined. Evidence of home visiting effectiveness was mixed but generally indicated positive impacts on child language, social emotional development, and early cognitive skills. Five studies identified contextual moderators of program effectiveness, including parent academic expectations, program language, child sex and temperament, implementation fidelity, and home visiting intensity. These moderators shaped the strength of intervention effects on school readiness outcomes. Findings indicate that while home visiting programs can strengthen key domains of early development, variation in the definition of school readiness limits comparability across studies. Contextual moderators at the individual and program levels emerged as important drivers of effectiveness, yet no studies assessed community or structural-level factors despite their known influence on school readiness. These gaps highlight the need for a shared conceptual model of school readiness and for research that incorporates broader ecological contexts to better understand how home visiting achieves its impacts. Overall, home visiting programs show potential to strengthen key domains of early development, but inconsistent definitions and measures of school readiness limit comparability across studies. The evidence base centers largely on individual and program-level moderators, leaving broader ecological and structural influences unexamined. Future research should adopt shared readiness frameworks and incorporate multilevel contextual factors to more fully understand how home visiting contributes to school readiness.