Are Home Visiting Programs Serving Military Families? Results from a National Survey Using a Practice-Based Research Network

Introduction: Home visiting (HV) is a critical component of the Affordable Care Act and a viable mechanism to enhance the health of vulnerable families with young children. While military families have been identified as a priority population by the Maternal Infant Early Childhood Home Visiting (MIECHV) program at the federal level, little is known about the extent to which HV programs serve military families and their experiences of doing so. As many military families reside on/close to military installations, it is likely that HV programs located in close proximity to installations serve military families, and that those that are closer are significantly more likely to do so.

Methods: Patterns of HV service provision to military families were examined using a practice-based research network (PBRN) of 244 HV programs. Programs located within 50 mile radii of active installations were invited to participate in a web-based survey. Driving distance to the nearest installation was calculated for each program. Correlations were computed between driving distance and 1) HV provision to military families 2) military family residence within HV provision areas. HV programs were subsequently categorized into two groups based on median distance from program to installation; chi square tests examined between-group differences. Survey questions also assessed capacity of HV programs to serve military families, barriers to reaching them, and outreach strategies used for engagement.

Results: 81 of 244 programs met inclusion criteria. The survey yielded a 56% response rate. 60% of participating programs reported that military families reside within their catchment areas but only 38% of these programs serve military families. Neither correlation reached statistical significance (p=.89; p=.17). Chi square tests results were consistent with correlation findings, revealing no statistically significant differences between groups on either outcome (p = .53; p=.36). The most common barriers to serving military families that were reported by respondents were 1) lack of specific referrals for military families and 2) lack of awareness of military families residing within their service provision area.

Conclusions: Findings suggest that HV agencies, regardless of proximity to installations, are underutilized by military families. As over 70% of military families reside in civilian communities, military families might benefit from increased communication and/or coordination between HV programs and military-centered organizations besides installations. In addition, the use of the PBRN as platform for research is a valuable and innovative data collection strategy that has potential to maximize translation of research to practice and policy.