This study was conducted to compare the participation and outcomes of multiparous mothers (those with previous children) in Healthy Families (HF) home visitation programs in Virginia to those of primiparous (first-time) mothers in the same programs. The purpose of these comparisons was to examine the longstanding assumption that multiparous mothers do not do as well as primiparous mothers in home visiting programs. Targeting services based on this untested hypothesis denies services to more than 60% of the American families who deliver each year, based solely on the fact that they have previous children. The first phase of the study was a quantitative analysis of participation and outcomes, and the second phase was qualitative interviewing of the HF programs' managers. (author abstract)