Form 1 Maternal, Infant, and Early Childhood Home Visiting (MIE

Maternal, Infant and Early Childhood Home Visiting (MIECHV) Program Competitive Grant Final Report Instructions

Public Burden Statement:  An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.  The OMB control number for this project is 0915-0356.  Public reporting burden for this collection of information is estimated to average 25 hours per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 10C-03I, Rockville, Maryland, 20857.

Grantees should report on activities funded with [specify FY11, FY12, FY13, FY14 or FY15 Competitive Grant funds] during the specified project period [specify project period]. Activities supported by other MIECHV or non-MIECHV grant funds should not be included. The total page limit should not exceed 40 pages.

1. Executive Summary*

*Note: It is suggested that grantees complete the Executive Summary section last, as it provides an overview of other sections.

Provide a brief (2-5 pages) summary of the purpose of the competitive grant, implementation of the competitive grant within the statewide home visiting program, and the evaluation findings. At a minimum, the summary should include the following:

Program Summary:

• Purpose and rationale for grant: A brief description of the purpose of the project. Please be specific about your efforts surrounding infrastructure building and/or high-quality home visiting program services supported by grant funds.

• For the period between [Note project period here], provide a description of infrastructure building and other activities funded by the grant.

If home visits were funded by the grant:

Summary of Home Visiting Services Provided:

• For the period between [Note project period here], provide the progress towards meeting the needs of each community identified in the needs assessment, and as proposed in the competitive application. For each community, include (also see optional format on page 6¹):

  • The name of the entity(ies) providing services in each community served

  • The MIECHV-funded evidence-based model(s) or promising approach(es) implemented by the entity

  • The number of new and continuing families served for each model implemented by entity

  • The maximum caseload for each model implemented by entity

  • The cost per family served by the current home visiting program

  • A brief explanation of how cost per family was calculated

• If applicable, describe promising approaches or enhancements to evidence based models. For example, if implementing a promising approach model, provide a brief overview of the elements of the promising approach model. If implementing an enhancement to an evidence-based home visiting model(s), provide a brief overview of the home visiting models and the enhancement. If the purpose is to improve the home visiting infrastructure, describe the key elements for improving the system.

Evaluation Summary:

• Evaluation questions and study design: What are the primary research questions this evaluation sought to address? What study design was utilized to address these questions?

• Population assessed: Describe the primary population(s) that was targeted in the evaluation.

• Major findings: What did the evaluation show? Were there changes in knowledge, attitudes, or behaviors among the target population assessed? What did your evaluation accomplish?

• What were the limitations identified in this study?

• Implications: How has this program and/or intervention impacted the community/families/individuals?

• What are some lessons learned from the evaluation findings? How can the evaluation findings be used to enhance effectiveness of the home visiting program in the future?

2. Introduction and Background

This section should include detailed information about the focus of the MIECHV competitive grant. This should include information such as:

• Overview of competitive grant goals and objectives

• Purpose and rationale for the grant

• Population(s) targeted by the home visiting program

• Community context in which the home visiting program is being implemented

• Detailed information about the home visiting models, interventions, adaptations, or development activities associated with implementing the grant (this may include information on dose and content as relevant)

• As appropriate, identify meaningful support and collaboration with key stakeholders in planning, designing, implementing, and evaluating all activities, and, further, the extent to which these contributors reflect the cultural, racial, linguistic, and geographic diversity of the populations and communities served

• Challenges that were encountered in designing and implementing the activities described in the Work Plan, and approaches used to resolve such challenges

• Strategies to enhance sustainability beyond federal funding (e.g., public/private partnerships, Medicaid reimbursement, Medicaid/CHIP partnerships, etc.)

3. Maintenance of Effort Chart

Applicants must complete and submit the following information:

NON-FEDERAL EXPENDITURES

FY Prior to Report Submission (Actual) Actual prior FY non-Federal funds, including in-kind, expended for activities proposed in this application. If proposed activities are not currently funded by the institution, enter $0. Amount: $ _________________

Current FY (Estimated) Estimated current FY non-Federal funds, including in-kind, designated for activities proposed in this application. Amount: $ _________________

4. Evaluation Design

This section should provide an overview of the evaluation, rationale and considerations for the evaluation design, and the methods used to address evaluation questions. Elements should include:

• Organizations responsible for collection and reporting evaluation data

• Evaluation framework and logic model of the evaluation (this may be different from the program logic model)

• Immediate, intermediate, and long term outcomes

• Population(s) targeted in the evaluation

• Evaluation questions and rationale (include relevant literature if applicable)

• Hypotheses examined by the evaluation

• Evaluation design and rationale for design selection

• Description of timeline for evaluation activities

• Description of measures and instruments

• Description of data collection methods and schedule

• Sample size(s) and sampling plan (if applicable)

• Estimated power to detect impacts (if applicable)

• Analytic methods or analysis plan

• Cost of evaluation including salary and benefits for program and home visiting staff who were involved, funds to pay an external evaluator, cost of relevant data collection, travel, communication tools (postage, telephone, internet, fax, etc.), printing, supplies and equipment, etc. Do not include in this figure any costs associated with the collection, analysis, or reporting of benchmark performance measure data.

*Note: If the evaluation consists of multiple study components, the above information should be repeated for each study component as appropriate.

5. Evaluation Results

This section should provide information about the results generated from the grant evaluation efforts. Results should be presented for each evaluation question. Elements should include:

• Description of the sample and relevant sample characteristics

• Description of control groups (if applicable)

• Detailed presentation of results relevant to each evaluation question and hypothesis (include any relevant data tables or graphs and levels of significance as applicable)

• Discussion and interpretation of findings:

  • What do findings mean to you? What factors contributed to findings?

  • Were there unintended findings? What do unintended findings mean to you? What factors influenced findings?

  • Limitations of findings

*Note: If the evaluation consists of multiple study components, the findings should be categorized by study component.

6. Evaluation Successes, Challenges, and Lessons Learned

Discuss the successes, challenges, and lessons learned from conducting your evaluation.

• Strategies that facilitated the implementation of the evaluation

• Other successes that resulted from the evaluation

• Challenges encountered in conducting the evaluation (e.g., evaluation design, target population, and other relevant contextual variables)

• Deviations from approved evaluation plan

• Lessons learned about conducting rigorous evaluations under MIECHV

7. Conclusions, Implication of Findings, and Recommendations

Discuss the implications of the evaluation findings and the relevance of the findings to stakeholders and provide any recommendations based on the findings.

• Summarize key evaluation findings and discuss implications of those findings as applicable:

• Describe key findings related to children and families (if being addressed by evaluation) and implications of those findings

• Describe key findings related to the individual agencies and organizations involved (if being addressed by evaluation) and implications of those findings

• Describe key findings related to the community (if being addressed by evaluation) and implications of those findings

• Discuss any recommendations based on the evaluation:

• Present recommendations to program administrators and other social services agencies for future implementation of similar programs

• Present recommendations to program funders on how to better support programs like yours in the future

• Present recommendations to the general field

8. Plan for Dissemination of Evaluation Findings

Discuss the plan for disseminating findings.

• With whom, how and when will findings be shared? For example, how and when will findings be shared within the organization and with local implementing agencies? How and when will findings be shared with external stakeholders including community and state partners, state legislatures, other grantees, etc? Are there plans to publish in peer reviewed journals, through presentations at conferences, etc?

¹OPTIONAL FORMAT: If grantees prefer to provide the information in table format, an example follows for reporting on activities for the period between [Note project period here].

Models and Number of Families Served between [Note project period here].

At-risk community

MIECHV Site: Please provide name of entity providing services with grant funds .

# new and continuing families served by Model #1: [fill in your model here] and maximum caseload (CL)

# new and continuing families served by Model #2: [fill in your model here] and maximum caseload (CL)

# new and continuing families served by Model #3: [fill in your model here] and maximum caseload (CL)

# new and continuing families served by Model #4 [fill in your model here] and maximum caseload (CL)

Total # families and

Total # of slots available

New

Cont.

Max. CL

New

Cont.

Max. CL

New

Cont.

Max. CL

New

Cont.

Max. CL

[Name of community here]

[Name of LIA or grantee/organization]

[Name of community here]

[Name of LIA or grantee/organization]

[Name of community here]

[Name of LIA or grantee/organization]

TOTALS

COST PER FAMILY

OMB # 0915-0356 Expiration date XX/XX/201X