Strengthening family retention and relationships in home visiting programs through early screening and assessment practices

•Discovering active ingredients is a tenant of precision home visiting.•Multilevel modeling revealed that screening practice helped retain families longer.•Screening practices may help build relationships with families. Evidence-based home visiting (EBHV) programs for pregnant women and families of young children prevent child maltreatment and improve maternal and child health outcomes. However, home visiting programs often struggle to retain families long enough to achieve positive outcomes. The current study (N = 1,032) sought to understand how home visitor relationship building skills and screening practices predict families’ duration in EBHV. Multilevel modeling revealed that screening practice helped retain families in EBHV programs longer. Interactions between screening practices and home visitors’ relationship building skills further showed screening practices were associated with longer duration in services when home visitor relationship building skills with families were weak. However, when home visitor relationship building skills were strong, screening practices were less influential on duration. Results suggest that screening practices may help build relationships with families which then enhances retention in services and increases the likelihood of achieving positive maternal and child outcomes.