TIER researchers regularly serve as evaluation partners for non-profit and government organizations. TIER’s evaluations are designed in collaboration with program and policy leads, reflecting TIER’s commitment to conducting accessible and useful evaluations that simultaneously satisfy funders, help programs improve practices and build their own evaluation capacity, and advance the research field.

Evaluation of Early Intervention Parenting Partnerships (EIPP) Program

TIER is conducting a mixed methods evaluation of the Early Intervention Parenting Partnerships (EIPP) program funded by the Massachusetts Department of Public Health (MDPH). EIPP provides home visiting and group services to pregnant and postpartum women and infants with identified risk factors that heighten their vulnerability to poor health and development. The purpose of EIPP is to provide early identification of maternal and infant risk, and linkage to services that prevent or mitigate poor health and developmental outcomes. Each EIPP is staffed by a Maternal Child Health (MCH) Team that includes a maternal and child health nurse, a mental health clinical professional, and a community health worker. The three-year evaluation includes a quasi-experimental evaluation of EIPP on maternal and infant health and development outcomes and linkages to Early Intervention services, a qualitative study of EIPP services, and a social return on investment analysis.

Evaluation of the Healthy Families Massachusetts Partnership with Medical Legal Partnership Boston 

The purpose of this study is to evaluate the Healthy Families Massachusetts (HFM) partnership with MLPB (http://www.mlpboston.org/). MLPB seeks to equip HFM home visitors with information and resources that they can use to assist families with potential legal issues, and to increase families’ access to a range of services and legal protections. This mixed methods study aims to describe how MLPB shapes the work of home visitors, and how that work impacts the broader systems of care in which families are situated.  

Evaluation of the Massachusetts Essentials for Childhood Project (MA EfC)

In collaboration with colleagues at Child Trends, TIER is conducting a participatory, mixed-methods evaluation of MA EfC, an initiative funded by the Centers for Disease Control (CDC) and administered by the Massachusetts Department of Public Health. MA EfC brings together stakeholders from multiple sectors to address the problem of child abuse and neglect (CAN) by promoting safe, stable, nurturing relationships and environments. The five-year evaluation comprises a process evaluation component assessing EfC progress toward meeting its implementation goals, and an outcomes evaluation component using use state- and community-level data to assess the extent to which MA EfC CAN prevention efforts appear to have affected changes in practices at the municipal and agency levels, as well as population-level changes in key areas. Framed by an understanding that families and communities exist within systems in which advantages are conferred based on race, our evaluation includes questions that ask how members of the communities most affected by CAN have been included in EfC decision-making, what the barriers are to more equitable outcomes and how EfC is addressing these barriers, and how EfC strategies are decreasing (or inadvertently worsening) racial inequities.

Evaluation of the Medford Interconnected Resiliency Network 

TIER is partnering with the City of Medford Office of Prevention and Outreach (OPO) to evaluate OPO’s new Interconnected Resiliency Network funded by the Massachusetts Department of Public Health (MDPH), Bureau of Substance Addiction Services (BSAS) Massachusetts Collaborative for Action, Leadership, and Learning 3 (MassCALL3) Substance Misuse Prevention Grant Program.   

FIRST Steps Together Evaluation

TIER is contracted by the Massachusetts Department of Public Health (MDPH) to evaluate FIRST (Families In Recovery SupporT) Steps Together, a home visiting program available to people 18 years of age or older who have used opioids and/or stimulants in the past or present, and who is pregnant or expecting a child, or has at least one child age 5 or younger. FIRST Steps Together currently operates in seven sites across Massachusetts and is delivered by a peer recovery workforce cross-trained in parenting support. The first year of the evaluation focuses on measuring program engagement and short-term outcomes.

Massachusetts Healthy Families Evaluation—Phase 2 (MHFE-2)

The statewide Healthy Families Massachusetts (HFM) newborn home visiting program promotes positive and effective parenting among young parents and their firstborn children. For the past decade, TIER has conducted several independent evaluations of HFM funded by the Children’s Trust of Massachusetts and the Massachusetts Department of Public Health. The Massachusetts Healthy Families Evaluation-Phase 2 (MHFE-2) is a longitudinal randomized controlled trial (RCT) that began in 2008 with over 700 mothers and their children. The evaluation was designed to determine the extent to which HFM achieved its five stated goals, understand mothers’ experiences with parenting, and explore program implementation across HFM sites. Beginning when mothers were pregnant or newly parenting, MHFE-2 participants completed telephone and in-person interviews, and granted access to state administrative data. Data were first collected about one month following HFM enrollment (Time 1, T1), with follow-ups completed one (T2), two (T3), five (T4), six (T5), and seven (T6) years later.

Massachusetts Maternal, Infant, and Early Childhood Home Visiting (MA MIECHV) Program Coordinated State Evaluation (CSE)

The MA MIECHV program administered by the Massachusetts Department of Public Health (MDPH) contracted with TIER to design and lead the CSE. MDPH and TIER are part of a small group of MIECHV awardees working with the MIECHV Evaluation Coordinating Center (MECC) to develop an evaluation focused on family engagement and health equity. By collaborating with other awardees to develop complementary evaluations, the CSE will amplify the work of awardees’ evaluations through collective impact and enhance knowledge of what works in home visiting.

To date, MHFE-2 has demonstrated favorable HFM program effects on mothers’ mental health, substance use, housing stability, and economic well-being, and children’s physical health. MHFE-2 reports are available on the Publications page.

Massachusetts Maternal, Infant, Early Childhood Home Visiting Program (MA-MIECHV)

The Massachusetts Maternal, Infant, Early Childhood Home Visiting Program (MA MIECHV), a federal-funded program administered by Massachusetts Department of Public Health, is an expansion and enhancement of home visiting services in 17 high-need Massachusetts communities. Since MA-MIECHV’s inception in 2011, TIER has worked with MDPH and other university partners to evaluate the statewide initiative at the community, program, and individual levels, with a focus on understanding the ways in which MA MIECHV sites are embedded within, and contributing to, comprehensive early childhood systems of care at the local levels.

In 2018, TIER began a new evaluation of MA MIECHV aimed at understanding the early impacts of MA home visiting programs on maternal and infant health and development outcomes and linkages to Early Intervention services.

National Initiative to Address COVID-19 Health Disparities Award

The Massachusetts Department of Public Health (MDPH) contracted TIER to design and direct a 2-year evaluation and needs assessment project as part of MDPH’s National Initiative to Address COVID-19 Health Disparities Award from the CDC. The goals of the grant are to reduce pandemic-related health disparities, improve rural community health outcomes, and improve data collection and reporting capacity for populations experiencing the disproportionate burden of COVID-19. Using a community-based participatory research (CBPR) approach, TIER is recruiting, hiring, training, and supporting a cohort of community evaluators (CEs) to ensure Massachusetts residents with lived experience in the communities prioritized in the grant are an active part of the evaluation process and public health response. The team will implement policy analyses, needs assessments, and evaluation projects in response to MDPH’s priorities and work with MDPH to translate findings into program recommendations. To learn more about the TIER CE model click here.

SAFE Child Communities

The Children’s Trust of Massachusetts is developing a comprehensive model of the primary prevention of child maltreatment in Massachusetts: Stop Abuse for Every (SAFE) Child Communities. Using a place-based, multiservice approach, SAFE Child Communities will create community hubs across the state to enable coordination of child and family support services across different programs. The starting point for SAFE Child Communities is an expansion of the Children’s Trust Family Centers, family-focused, community-based centers where families access a range of on-site family support services and off-site referrals. Since 2016, the Children’s Trust has partnered with several of its existing Family Centers and TIER to conduct a needs assessment to inform the design, implementation, and evaluation of SAFE Child Communities. We are currently focused on piloting and designing a streamlined Family Center data system.

Smart from the Start (SMART)

TIER is working with Smart from the Start (SMART) to evaluate their programs in Boston and Washington, DC. Smart is a place-based family support, community engagement and school readiness organization with a mission to prevent the achievement gap, and to promote the healthy development of children living in the most underserved communities. TIER is working with Smart to evaluate their implementation processes, program outcomes, and extent to which the program has had an impact on the housing developments and wider communities in which Smart programs are situated.

Study of Criminally Prosecuted Pregnant and Postpartum People

The Massachusetts Department of Public Health (MDPH) was contracted with TIER to undertake a mixed methods study focused on the criminal prosecution of pregnant and postpartum people with earmarked state funding that was legislatively mandated. TIER plans to analyze a range of secondary data sources to estimate the prevalence of parents and children affected by the criminal justice system and undertake a literature scan to identify effective interventions to support families who experience criminal justice involvement.

Supporting Parents in Recovery: Joining Together Home Visiting and Recovery Support 

Using funding from the Tufts Initiative on Substance Use and Addiction, this small qualitative study examined how two unique home visiting programs administered by the Massachusetts Department of Public Health integrate recovery support for substance use disorder and parenting support. FIRST Steps Together is a homegrown program that began in 2019 that is currently operating in seven sites. Its primary services are delivered by a peer recovery workforce cross-trained in parenting support. The Parents as Teachers (PAT) pilot is an enhancement to PAT, an evidence-based home visiting program that operates internationally. The PAT pilot (currently in three sites) is led by a PAT parent educator with lived experience as a person in recovery who is trained in both the PAT model and recovery coaching. The study explored the unique needs of parents in recovery, home visitors’ techniques to support parents with recovery and parenting, perceived outcomes for parents, and recommendations to strengthen both programs.

The Role of Home Visiting in Supporting Families Involved with Child Protective Services (CPS) 

TIER is working with the Parents as Teachers (PAT) National Center and the Massachusetts Department of Public Health to understand the role the PAT home visiting plays in the lives of families who are involved with child protective services (CPS). Comprising a national survey of PAT affiliates, program data analysis, focus groups and interviews with providers, families, and CPS workers, this evaluation will provide the National Center with information needed to adapt policies and program guidance to enable affiliates to better support this unique population of families.

To learn more about our projects, contact us.