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There’s No Place Like Home

All new moms want to do their best to raise a healthy baby, but may be uncertain or even feel overwhelmed at times after bringing their newborn home. Home Visiting is intended for moms who need more focused help and support in caring for themselves and their newborns.

As part of its Welcome Baby initiative, First 5 LA provides an option for home visits to mothers before and after birth at 13 participating hospitals in its Best Start communities. In addition to maternal screenings for depression and developmental screenings of newborns, professional home visitors provide mothers with advice on positive parenting, child health and development, and links to other community services. The program is voluntary and available to all Los Angeles County families at no cost, regardless of income status.

Just as newborn babies are experiencing the world for the first time, new mothers can undergo a similar experience in the world of parenting, creating opportunities to learn and grow. When a parent chooses to be part of Welcome Baby’s Home Visiting program, they are taking a critical step that will help boost their child’s health and development.

One of the nation’s preeminent experts on Home Visiting is Dr. Deborah Daro, a senior research fellow at Chapin Hall at the University of Chicago. Since 2009, Dr. Daro has worked with First 5 LA’s Program and Development department on the design, rollout, implementation and evaluation of the Welcome Baby program.

"I would love to see the county’s mental health, health and child welfare departments invest in Welcome Baby." - Dr. Deborah Daro

Dr. Daro recently sat down to talk about the benefits of home visiting to new mothers, her work with First 5 LA and the promise of the Welcome Baby program.

Q. What do you like most about working with First 5 LA?

A. I work with the program, research and policy staff and enjoy understanding how these three departments interact. Understanding that interaction maximizes my ability to impact program implementation.

Q. What are the three greatest benefits of Home Visiting that your research has taught you?

A. First, parents can be taught how to ask for help in how to care for their children. Second, parents can change their behavior towards their children. Third, children can benefit from a strong relationship from their parents, and home visiting can strengthen that relationship. Parents still matter in determining child outcomes.

Q. What are your strengths in working with Welcome Baby?

A. I can be an advisor and a sounding board. I take the innovative ideas I hear from staff and I say, “Have you tried this?” I know how to construct an evaluation. I make sure we stay on the right track.

Q. One of the things you will be doing for First 5 LA is providing a Home Visiting landscape review on best practices and emerging home visiting topics. Can you elaborate?

A. In terms of the Home Visiting landscape, one of the things I am doing in June is a presentation for staff and Commissioners on where we are with home visiting and where we will go next. Home Visiting has its own service objectives. One is to ensure that we provide families with an introduction to the array of services they may need going forward. We also have to build a context within communities in which it becomes easier for parents to do the right thing: It should be obvious to parents how to secure quality child care, health care, early education, etc. Home visiting has to be one of a lot of options. It used to be that people thought that Home Visiting was the silver bullet. It’s not that simple. We have to make health care, early childhood education, more available for families and of higher quality.

Q. Why is it important to evaluate Welcome Baby?

A. It’s always important to check on how you are doing and to recognize that as good as you think you are, you have to ask: “Does my idea work?” If you are not being reflective of how a program works, the program is going to have a short shelf life. For the last several years, we have been perfecting the Welcome Baby system in every way. We married the universal piece of home visiting with a more targeted approach to families that are struggling the most. Once we find out who is facing the greatest challenges, we can give them the level of services they need. We can use the knowledge we glean from careful program evaluations and assessments to create the most effective program and then advance its replication through thoughtful public policy.

Q. What does the Welcome Baby program need to be improved?

A. Finding a way to reach more women when they are pregnant in a more consistent way is a major challenge for all early home visiting programs. Prenatal care in Los Angeles County is really diffused. We haven’t developed an outreach system as of yet that allows the program to consistently engage all of these prenatal providers. Part of the way we’re going to do this is getting the word out to the general public. If the public demands it, policy makers will provide it because that’s their job: to be responsive.

Q. What are your hopes for Welcome Baby?

A. To use the knowledge we have gathered creating an effective program and then take it to the policy level. I would love to see the county’s mental health, health and child welfare departments invest in Welcome Baby. In L.A., Welcome Baby is a good idea.

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