Parent Perspectives on Home Visiting Participation: A Qualitative Study

Introduction: Evidence-based home visiting programs improve parenting, maternal well-being, and child health and development. Since 2010, Maternal, Infant, and Early Childhood Home Visiting (MIECHV) funding has supported expansion of home visiting services to high-risk families. Successfully enrolling families into services is an important step to ensuring service delivery to families in need.

Methods: Data come from a mixed methods evaluation of the PA MIECHV funding. The study team conducted individual, in-depth interviews with key stakeholders from 11 MIECHV funded home visiting programs across the state. In total, 76 clients participated, representing 4 program models in both urban and rural locations. Transcribed interviews were entered into NVivo 10 for analysis. Using Modified Grounded Theory, coding was based on content discussed by participants, as well as research priorities identified by the Home Visiting Applied Research Collaborative. Understanding of how clients decide to join a home visiting program represents one of our a priori research questions. Once all interview content related to this aim was captured, it was subjected to a grounded analysis, where sub-themes were identified through a process of coding, memoing, and group discussion by the qualitative research team.

Results: Parents described being motivated to join their home visiting program to gain access to information and resources. For a large subset, this need was directly related to their status as a first-time parent. They described feeling uninformed, unsure, or scared about pregnancy and parenthood. A number of clients, whether having a first or subsequent child enrolled, valued the assurance they felt from having someone closely monitor their child’s development. For parents with a specific concern about their child’s development or behavior, this was their primary motivation for joining. Clients were also initially attracted by programming that would help academically and socially prepare children for school. Additional factors cited by parents were endorsements from peers and program accessibility.

Conclusions: When recruiting new parents, stressing the range of information and supports programs provide throughout pregnancy and infancy is likely to be persuasive. Communicating the ongoing developmental assessment programs provide, with a focus on school readiness, is likely to engage all parents, whether for first or subsequent children. Intentional partnerships with healthcare, education, and early intervention services to coordinate referrals for families with a developmental or socioemotional concern are likely to be successful. Engaging current clients, to gather testimonials or speak with interested families, might also be an effective recruitment strategy.