Friday, 14 January 2005 - 12:00 PM

This presentation is part of: Poster Session I

Meeting the Needs of Families with At-risk Infants and Toddlers: Service Coordination Practices in Home Visiting Programs

Purpose - Preventive home visiting developed over the last several decades to support families of infants and toddlers who are at risk for developmental delays or maltreatment. Many of these programs are based on the ecosystems perspective that supports a strong parent component of services as essential for positive child outcomes. Research on early intervention for families with at-risk children is moving from large-scale effectiveness studies to studies that examine specific processes of service delivery. This study examined parents’ experiences with service coordination (i.e., case management). Service coordination was conceived as having three interrelated components: a help-giving approach on a continuum of professional- to family-centered, the parent-service coordinator relationship, and specific interventions. The research measured aspects of parents’ experiences with their home visitor that may affect the intensity of services received, as well as parents’ perceptions of assets and barriers for effective service coordination. It was hypothesized that families would desire more intensive services than they received and that a greater level of family need and a family-centered approach would predict more intensive services

Methods - Ninety mothers served by Help Me Grow (HMG) home visiting in two adjacent Ohio counties were surveyed regarding interventions received and desired, amount of contact hours, the approach to the parent-service coordinator relationship, level of need, and assets and barriers to effective practices. Parents were interviewed by phone or in their homes. Previously validated instruments measured the approach to help-giving and level of family need. An instrument developed as part of this research measured the intensity of service coordination interventions received and desired. The Service Coordination Interventions Scale was field tested with 99 parents in HMG programs in five Ohio counties. Data reduction and factor analysis resulted in an instrument with a coefficient alpha of .91. Open-ended questions assessed assets and barriers. Quantitative analysis involved descriptive statistics, t-tests, correlations, and linear regression. Content analysis was used for the responses to open-ended questions.

Results - Parents generally desired more intensive interventions than received, especially inter-professional service coordination and strategies to promote informal support networks. Results indicate that parents who perceive services to be more family-centered receive a higher intensity of interventions. Level of need did not predict intensity of interventions received. Parents valued interventions involving a service coordinator-parent relationship that was responsive to parent-identified goals and characterized by frequent contacts.

Implications - This study supports a trend to use more formalized assessment measures. In the programs surveyed here, the use of a needs assessment tool might enhance the service coordinator’s ability to target interventions to family needs. The study suggests that increased program emphasis on strategies to assess and promote informal support networks may be helpful for some families. Hiring practices, training, and program policies that support the development of family-centered relationships are recommended. This study challenges policy-makers, as they trim budgets, to work to preserve program components vital to the needs of at-risk families. Policies that promote relationship building by allowing flexibility for frequent contacts are particularly important.

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