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Health Visiting in the United Kingdom: What Can We Learn?


Eighth National Summit on Quality in Home Visiting Programs

Session Detail

One of the challenges facing home visiting in the United States today is how to best create a service system that reaches the most people while still being able to effectively address the needs of those most at-risk. This plenary will present an overview of the health visiting system in the United Kingdom, a universal model of home visiting for all families with young children. The presenters will examine what universalism looks like as a system, including the challenges of offering these services. Particular attention will be paid to how the role of health visitors have changed over time, and what is needed to ensure high-quality service delivery. Recent research will highlight developments in proportionate universalism as a framework for health visiting, which combines universal contacts for all families with more targeted or intensive home visiting for higher-risk families. The plenary will conclude by exploring the extent to which this model can be exported and adapted to other countries, including the United States. Emphasis will be given to what is needed in order to fully meet the needs of all young children and their families.


Dr. Cheryll Adams CBE   + See Bio

Founder & Executive Director, Institute of Health Visiting

Cheryll has had a portfolio career – working overseas as a volunteer nurse, as a hospital and community nurse, in research, as a health visitor for many years and nationally as a strategic lead for health visiting for the past 20 years. Her national roles have included Research Lead and Lead Professional Officer at the Community Practitioners and Health Visitors Association, Safeguarding Advisor for the Department of Health, England and Health Visiting consultant. She led the establishment and launch in 2012 of the Institute of Health Visiting, a UK wide academic and professional body for health visitors, becoming its first Director. She secured investment from the then prime minister, David Cameron to do so. The Institute is now an established organization driving leadership and service improvement in health visiting.

Cheryll’s research and specific professional interests are in infant, perinatal and family mental health. She is passionate about the role of high quality universal health visiting in improving children’s life trajectories. Cheryll has sat on many influential national committees and is currently a professional advisor to a cross government taskforce established by the prime minister to look at strengthening outcomes in the very early years. She has the published extensively and is a section co-editor for the latest national almanac for child health promotion – ‘Health for All Children 5’, which will be published later this year. She is a professional advisor to UNICEF, Europe and a Professorial Fellow of the Royal Society for Public Health. Cheryll was awarded the CBE by the Queen in 2006 for her service to health visiting, and has recently been chosen as Alumna of the Year by the University of Surrey for her work with the Institute of Health Visiting.

Deborah Daro, Ph.D.   + See Bio

Senior Research Fellow, Chapin Hall, University of Chicago

Deborah Daro, (Ph.D., Social Welfare, University of California, Berkeley) has played a key role in the development and assessment of evidence-based home visitation programs for the past 30 years and has worked with Federal administrators and Congressional leaders in crafting guidelines for the Federal Maternal, Infant and Early Childhood Program (MIECHV) passed as part of the Affordable Care Act of 2010. Prior to joining Chapin Hall in January 1999, Dr. Daro contributed to the development of Healthy Families America (HFA), one of the 17 evidence-based national home visiting models supported under MIECHV. She currently co-facilitates the National Alliance of Evidence-Based Home Visiting Programs, a collaborative of six national home visiting models committed to improving practice and creating effective networks of supports for new borns and their parents.

Dr. Daro developed and currently chairs the Doris Duke Fellowships for the Promotion of Child Well-Being, funded by the Doris Duke Charitable Trust. Established in 2010, the fellowship’s ongoing implementation is guided by three core operational objectives: (a) selecting individuals with the skills, passion, and institutional support necessary for sustaining long-term professional involvement in the field; (b) selecting cohorts of fellows that collectively represent a diverse group of scholars in terms of their backgrounds, disciplines, research interests, and technical expertise; and (c) creating an active, self-generating learning network among the fellows through ongoing web-based conferences, annual meetings and other opportunities for informal meetings at related national conferences, and shared research projects. During its initial six years, the fellowship has selected 90 young scholars from across the country, with plans to select an additional 30 fellows by 2018.

Dr. Daro served as a member of the Institute of Medicine’s (IOM)’s) Committee on Child Maltreatment Research, Policy and Practice for the Next Decade. This study, released in September 2013, provides research recommendations aimed at improving the public policy and programmatic response to child maltreatment.

With over 40 years of experience in evaluating child abuse treatment and prevention programs and child welfare reform efforts, her program assessments blend quantitative and qualitative components, resulting in findings that have both statistical and program relevance. Most recently, Dr. Daro’s research and writing have focused on developing reform strategies that embed individualized, targeted prevention efforts within more universal efforts to alter normative standards and community context. She also is examining strategies to create more effective partnerships among public child welfare agencies, community-based prevention efforts, and informal support systems. For the past several years, Dr. Daro has assisted a number of state and local entities in developing more integrated systems of early intervention that build on a system of universal as well as targeted home-based interventions. Current and past clients include Children’s Services Council of Palm Beach County, FL , the Nebraska Children and Families Foundation, Thrive by Five Seattle and the Bill & Melinda Gates Foundation, and the Community Action Project in Tulsa, OK.

Dr. Daro is currently working with the First 5 Commission in Los Angeles County to identify a system of home based interventions and related services for implementation in 14 of the county’s highest risk communities. This process has involved the articulation of a set of best practice standards to guide all direct service investment decisions, the development of a universal assessment and referral process to reach all new parents within the target communities, and the development of appropriate data management systems to track implementation and to foster continuous program improvement.

Dr. Daro received the 2016 APSAC William Friedrich Memorial Award in recognition of her significant contributions to improving child abuse prevention policy and practice and commitment to supporting emerging scholars addressing child maltreatment. In 2004, Dr. Daro received the Anne Cohn Donnelly Child Abuse Prevention Leadership Award from Prevent Child Abuse America in recognition of her success in translating research finding into measureable improvements in service delivery and public policy reforms. She has served as President of the American Professional Society on the Abuse of Children and as Treasurer and Executive Council member of the International Society for the Prevention of Child Abuse and Neglect.

Dr. Karen Whittaker   + See Bio

Reader/Associate Professor Child & Family Health, University of Central Lancashire, England

Dr. Karen Whittaker leads the Child and Family Health research theme group referred to as SEaRCH,  (Supporting Evaluation and Research in Child and family Health) within the School of Nursing, University of Central Lancashire, England. Her research is within the field of parenting, family support, health visiting and child health using realist evaluation methods. Her post-doctoral work was with The National Nursing Research Unit, Kings College London. Karen has worked internationally with UNICEF-CEE/CIS and International Step by Step Association (ISSA) supporting knowledge exchange and translation for nurse home visitors promoting early child development. The work with ISSA has resulted in the development of educational resources for nurse home visitors promoting early child development. As part of this she has co-delivered nurse home visiting training in Serbia, Bulgaria and Turkmenistan She is an Institute of Health Visiting Trustee and Fellow of the Higher Education Academy. She also  contributes to the advisory boards for children’s centres and the home visiting  charity, ‘Home Start.  Karen’s professional background is in nursing and health visiting/public health nursing previously practicing as a health visitor in Salford and later in Lancashire, UK. She has held a number of academic roles as a research assistant, research fellow, senior lecturer and now working within the School of Nursing as a Reader in Child and Family Health. She originally joined the University of Central Lancashire in 1998 as a senior lecturer to deliver educational programs for health visitors and community nurses. She gained experience as a course leader for undergraduate and post-graduate Specialist Community Public Health Nursing programs, as a Research Degrees Tutor and currently supports doctorate students within the Faculty of Health and Wellbeing at UCLan. She also has undertaken external examining duties at universities across the UK and internationally. Karen is an editorial board member of the Journal of Health Visiting and she peer reviews submissions for a number of health and social care journals. She is a committee member of the Global Network of Public Health Nurses and has previously chaired the UK Standing Conference on Specialist Community Public Health Nurse Education. In 2018 Karen was presented with an special award by the Journal of Health Visiting for her contribution to health visiting and international work.