The Tennessee Early Connect (TEC) initiative was created to identify pregnant women and connect them with evidence-based home visiting (EBHV) services. During its first two years, TEC generated more than 4,500 referrals of pregnant women to home visiting agencies across Tennessee and helped establish a new statewide pathway for connecting families with support before birth. This brief examines changes in home visiting enrollment, retention, and maternal and child outcomes following TEC implementation.

Why This Matters

Home visiting programs can improve outcomes for parents and young children, but first, families must learn about available services and enroll. Earlier enrollment, especially during pregnancy, gives home visitors more time to build relationships, provide education, and connect families with resources before a child is born. TEC was designed to strengthen those early connections by using centralized outreach to identify and refer pregnant women to home visiting services.

What We Found

• TEC successfully created a statewide referral pathway for pregnant women. Between March 2024 and February 2026, TEC’s centralized outreach process generated 4,592 referrals to home visiting agencies across Tennessee.
• Home visiting enrollment increased substantially during the study period. Annual enrollments grew by 58 percent between 2022 and 2025, during a period that included both TEC implementation and expansion of Tennessee's home visiting system.
• Following TEC implementation, families were more likely to enroll in home visiting services during pregnancy. The adjusted share of enrollments occurring prenatally increased by 7.2 percentage points.
• Several maternal and child outcomes improved after implementation. Breastfeeding rates increased significantly, particularly among families who enrolled prenatally. Findings for depression screening, postpartum care, and well-child visits generally moved in a positive direction, though results were mixed across measures.
• Although our findings do not demonstrate a causal effect of TEC, the consistency of improvements across maternal and child outcomes suggests that TEC became an important component of Tennessee’s home visiting infrastructure and likely contributed to meaningful progress across multiple domains of participant outcomes.

How We Did It

We analyzed statewide evidence-based home visiting administrative data covering enrollments from March 2022 through February 2026. We compared enrollment patterns and outcomes before and after TEC implementation while accounting for differences in participant, program, agency, and geographic characteristics. We integrated insights from our implementation study, including from interviews and focus groups with home visiting leaders, staff, families, and TEC implementation partners to help interpret the findings. The findings presented in this brief are descriptive, meaning we cannot say whether TEC caused any of the findings. However, we observe whether significant changes occurred in the post-TEC implementation period and integrate what we learn with what we heard in our conversations with home visitors and families across the state about the TEC implementation.