The report reviews home visiting as an early intervention strategy to provide health, social, education, or other services to improve maternal and child health and well-being. The report describes: (1) the nature and scope of existing home-visiting programs in the United States and Europe; (2) the effectiveness of home visiting; (3) strategies critical to the design of programs that use home visiting; and (4) federal options in using home visiting. Among conclusions concerning effectiveness are various lasting indicators of improved child well-being and development, and reduced need for more costly services. Critical program design components such as developing and utilizing clear program objectives are identified. Improved federal coordination is encouraged, as is Congress's consideration of amending Title XIX of the Social Security Act to provide home visiting services for high-risk mothers and infants as an optional Medicaid service. Recommendations to the Secretaries of Health and Human Services and of Education include: making existing materials on home visiting more widely available; encouraging the systematic evaluation of costs and benefits associated with home visiting services, and charging the Federal Interagency Coordinating Council with coordinating home-visiting initiatives. Five appendixes include a description of programs visited and comments on the report. (DB)