Home visiting for the prevention of child maltreatment: lessons learned during the past 20 years.

For nearly two decades, home visitation has been promoted as a promising strategy to prevent child maltreatment, but reviews of the literature on home visiting programs have been mixed. This article examines how home visitation for the prevention of child maltreatment has evolved during the past 20 years. It reviews several home visitation programs focused on preventing child maltreatment and highlights the Nurse-Family Partnership home visitation program. It discusses how advocacy and public policy for prevention of child maltreatment have shifted from a general call to promote universal home visitation programs to a more refined emphasis on promoting programs that are evidence-based, targeted to those most at risk for maltreatment, and with infrastructure in place to ensure implementation with fidelity to the model tested in trials. Finally, it discusses how primary care providers may advocate to ensure that their patients have access to evidence-based home visiting programs that meet their needs.