Perspectives of home visiting providers on internal factors that promote enrollment and continued participation for families

Background

Home visiting is an evidence-based service to reduce child abuse and neglect while providing parental information and resources. Despite strong empirical evidence for the benefits of home visiting, most eligible families do not enroll in services when offered and those who do enroll tend to drop out before completing the full dosage of visits.

Objective

To expand our understanding of enrollment and continued participation in home visiting programs from the perspective of providers.

Participants and setting

Providers (N = 19) from three federally funded home visiting programs in Oklahoma participated.

Methods

Qualitative interviews were developed using the Cross-Model Collaboration and Data Sharing (MODS) framework and focused on three aspects of internal states that have not been extensively considered: (1) perception of compatibility or fit, (2) readiness for change, and (3) confidence in ability to achieve outcomes.

Results

Home visiting programs were generally perceived to be highly compatible with parents' goals for their children, but other basic needs and priorities (e.g., work, food insecurity) may keep them from enrolling or continuing in services. Additionally, while parents are generally motivated to make changes that better support their child's development, they may be hesitant to discuss deeply personal topics (e.g., substance use, violence in the home).

Conclusions

Findings highlight the importance of considering how families view their compatibility with home visiting, how ready they are to change, and how confident they are in their ability to achieve positive outcomes. Moreover, findings indicate strategies home visiting providers and programs can employ when interacting with families.