Abstract
The associations of family, home visitor and site characteristics with family engagement within the first 6 months were examined. The variation in family engagement was also explored. Home visiting program participants were drawn from 21 Healthy Families America sites (1707 families) and 9 Nurse-Family Partnership sites (650 families) in New Jersey. Three-level nested generalized linear mixed models assessed the associations of family, home visitor and site characteristics with family receipt of a high dose of services in the first 6 months of enrollment. A family was considered to have received a high dose of service in the first 6 months of enrollment if they were active at 6 months and had received at least 50% of their expected visits in the first 6 months. In general, both home visiting programs engaged, at a relatively high level (Healthy Families America (HFA) 59%, Nurse-Family Partnership (NFP) 64%), with families demonstrating high-risk characteristics such as lower maternal education, maternal smoking, and maternal mental health need. Home visitor characteristics explained more of the variation (87%) in the receipt of services for HFA, while family characteristics explained more of the variation (75%) in the receipt of services for NFP. At the family level, NFP may improve the consistency with which they engage families by increasing retention efforts among mothers with lower education and smoking mothers. HFA sites seeking to improve engagement consistency should consider increasing the flexible in home visitor job responsibilities and examining the current expected-visit policies followed by home visitors on difficult-to-engage families.
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Evaluative research activities carried out by the Johns Hopkins team were funded under the following federal grant initiatives: The US Department of Health and Human Services (HHS), Administration for Children and Families, Children’s Bureau, Office of Child Abuse and Neglect, and Supporting Evidence-Based Home Visiting to Prevent Child Maltreatment (EBHV) (2008-2011: Contract No. HHS-2008-ACF-ACYF-CA-0130), as well as the US Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), and Maternal, Infant, Early Childhood Home Visiting Program (MIECHV) (Current NJ 2015 Formula Grant Award X02MC23235; Current NJ 2015 Competitive Grant Award D89MC28268).
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The authors declare that there are no conflicts of interest.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of Johns Hopkins School of Medicine Institutional Review Board and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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All home visitors included in the study provided informed consent.
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Latimore, A.D., Burrell, L., Crowne, S. et al. Exploring Multilevel Factors for Family Engagement in Home Visiting Across Two National Models. Prev Sci 18, 577–589 (2017). https://doi.org/10.1007/s11121-017-0767-3
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DOI: https://doi.org/10.1007/s11121-017-0767-3