How to design the next Healthy Start evaluation?

Designing a more comprehensive Healthy Start evaluation


Programs like Healthy Start improve outcomes and reduce racial and ethnic disparities in infant mortality and other perinatal outcomes.

Prior evaluations of Healthy Start demonstrated positive program impact on short-term and intermediate outcomes, such as increased participant satisfaction and knowledge, increased access to and use of services, and strengthened integration of services.

However, these evaluations found mixed evidence regarding an association between the program and improved long-term perinatal health status outcomes. These evaluations were limited by data quality challenges, including inconsistency in the definition and sources of selected measures and missing or incomplete data.

The Health Resources and Services Administration (HRSA) turned to Westat to design an evaluation of the impact of the Healthy Start program and provide insight into future program directions.


Westat is leading a comprehensive evaluation design effort that addresses and builds upon the findings of previous evaluations.

Through in-depth reviews of historical program documents, data, and evaluation findings; grantee discussions; and collaboration with HRSA, Westat will assess the sites’ capacity to provide high quality data for the national evaluation.

We will use lessons learned to recommend a unique approach to the upcoming evaluation that analyzes the impact of Healthy Start activities by key target populations. This approach will examine potential indicators beyond infant mortality rate or preterm birth to assess program effectiveness.


Results of the evaluation design will inform HRSA’s upcoming national evaluation of the Federal Healthy Start Program through developing an evaluation that:

  • Includes input from the HRSA client, Healthy Start grantees, and external stakeholders for the most well-informed, inclusive design possible
  • Is feasible and responsive to known data collection capabilities and barriers
  • Will provide a more complete picture of the effects of the Healthy Start program and will allow HRSA and Healthy Start grantees to better understand best practices to be shared across the grantee community

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