Tufts research team helps evaluate local support program

A research team with the Eliot-Pearson Department of Child Study and Human Development has been providing feedback to Healthy Families Massachusetts (HFM), a publicly funded program run by the Children's Trust Massachusetts to support young, first-time mothers.

The researchers are part of the Tufts Interdisciplinary Evaluation Research (TIER) group, according to Dr. Ann Easterbrooks, one of the four principal investigators at TIER.

Easterbrooks, who is a professor in the Eliot-Pearson department, explained Tufts' involvement in evaluating HFM.

“As independent evaluators, we provide feedback to the HFM program about the way in which the program is operating across the Commonwealth, how participants experience the program, and the program outcomes and impact,” Easterbrooks told the Daily in an email. “We are gratified that the Children's Trust utilizes our research finding in fine-tuning program goals and practices, training home visitors, and working to enhance the lives of children and families.”

Tufts is doing longitudinal research to see the long-term effects of the HFM program, which serves parents and families from a mother's pregnancy until the child's third birthday,according to Dr. Rebecca Fauth, a project director at TIER.

“We currently are conducting a longitudinal investigation, following the children into their primary school years, in order to examine the potential for long-term effects of program participation,” Fauth told the Daily in an email. “We also have other research and evaluation projects housed within TIER.”

Rogers added that they expect to see that children whose parents were in their program are still doing well in the long run.

“We are quite pleased with the results and are still looking at ways to continue strengthening our program," she said. "This is also why we are committed to looking at the longitudinal effects of the program -- we expect that we’ll see that children whose parents were in HFM are still thriving.”

Director of Newborn Home Visiting at the Children’s Trust Sarita Rogers explained that young mothers and fathers face many of the same challenges as older parents, as well as a unique set of needs that come with their own development as adults.

“Programs like HFM connect young parents to a caring, well-trained professional who can provide information and other support that helps strengthen their parenting and their ability to meet their own health and other goals, link them to other services in the community and set their families off on a great start,” Rogers told the Daily in an email.

She added that home visiting programs like HFM are not just for young parents, with many other countries like England providing home visiting to parents of all ages and backgrounds in order to ensure that all families get the support they need.

“Children don’t come with instruction manuals, and most of us struggle as we take on the challenge of nurturing and caring for this new, tiny being we love so much,” she said.

Over the course of almost 20 years, the Tufts team has used a developmental approach to the evaluation designed by Francine Jacobs, a professor within Eliot-Pearson and the Department of Urban and Environmental Policy and Planning, according to Fauth.

Fauth explained that TIER employs several methodologies to address its research questions, including quantitative, observational and ethnographic methods of data collection.

“We use standardized questionnaires and observational assessments, participant interviews, information provided by the HFM home visitors and administrative data from state agency records (e.g., Department of Elementary and Secondary Education, Department of Children and Families, Department of Public Health and Department of Transitional Assistance) to address the research questions,” she said.

Rogers explained that the cooperation with Tufts came about because the authorizing environment for social services programs, especially federal funders, was moving to prioritize funding programs that had been evaluated by Randomized Control Trial (RCT).

“We were interested in being able to definitively attribute the results we were seeing to the program as well," she said. "To meet all of these needs, we chose to do the RCT to see the progress that HFM was (and wasn’t) making on achieving its goals. We were very proud to have partnered with Tufts/Eliot-Pearson Department of Child Study and Human Development to complete the Randomized Control Trial (RCT) on HFM."

Fauth explained that the TIER team firmly believes in the importance of an effective feedback loop between research and practice.

“If our research demonstrates a finding that could have immediate relevance to improve HFM programming, we discuss it with the Children’s Trust, Massachusetts before any formal findings are released,” she said. “We meet with them regularly to discuss the research questions that they want answered and that will help them improve program services for families; we send them bimonthly updates on emerging findings.”

Easterbrooks explained that HFM used the evaluation feedback to include a broad programming focus on parental mental health and well-being, which was as an additional goal of the program after the first phase of the evaluation.

Fauth said that one of the benefits for Tufts from working with HFM is the enormous amount of training for involved students -- from undergraduates to post-docs -- across multiple disciplines.

“Providing opportunities for students to be part of a large research effort that has direct implications for children, youth and families, and to understand the policy and program implications of their work, is a real benefit,” she said.

During the last few years, the TIER team has consisted of approximately 30 to 60 members per year and consisted of faculty, staff, postdoctoral associates, graduate students and undergraduate students, according to Easterbrooks.

“We have established a successful mentoring model in which, for example, graduate students learn how to mentor through their relationships with faculty and postdoctoral associates, and then they also participate in the mentoring of undergraduate students,” she said. “Since 1998, approximately 27 Ph.D. students, 100 M.A. students, 150 undergraduates, five Tufts Summer Scholars and six undergraduates from other institutions participating in the Leadership Alliance/Mellon Scholars program have worked with us on our research and evaluation.”

According to Rogers, the Children’s Trust has 10 staff members who work directly with the HFM program staff in various capacities, with Rogers acting as the liaison to the evaluation project for budgeting and management, among other responsibilities.

“We do also have an infrastructure here at Children’s Trust where we are doing ‘evaluation lite’: we have an extensive data system and use these data to gauge programs’ performance on the 28 measures in their contracts and to provide technical assistance, disseminate best practices, continue to develop a culture of quality,” Rogers told the Daily in an email. “We deliver a subset of data points to our network each quarter, with a full annual report at the end of each year.”

Rogers said she feels that the Children’s Trust’s programs have gotten better at understanding and using their data to improve their program's practice and to instill a sense of accountability and excellence in their staff.

“Tufts has been able to do the in-depth analyses, using tools that may be too invasive to use with participants in a home visiting relationship and strategies like interviews, but also follow participants after they have exited the program,” Rogers said. “As partners, we think that the results Tufts generates in evaluation build on what programs have seen in their program specific data.”

According to Rogers, all of the participants, mothers and fathers of HFM are residents of Massachusetts and come from all across the state. Data provided by Rogers shows that in the last fiscal year, the HFM population was distributed as follows: 17 percent in the greater Boston area, 19 percent in central Massachusetts, 20 percent in northeastern Massachusetts, 24 percent in southeastern Massachusetts and 20 percent in western Massachusetts.

Rogers said that Children’s Trust will continue to partner with the TIER team to further analyze current data, as well as continuing data collection at additional time points to have longitudinal data on the HFM participants and children.

“We hope to keep learning how HFM is working and with whom, how the program can be refined and what can we learn that matters not just in HFM but in home visiting across the country,” she said.