“When You Care about Families, You Are Always Willing to Try Something New”: Social Innovation in Home Visitation

Background and Purpose

While home visiting programs have rapidly expanded in the USA due to both research and policy support, research findings and policy directives have not always been well aligned.  Recent research suggests that home visiting program managers may be ill-equipped to encourage innovation supported by research evidence in home visitation because the nature of their task emphasizes policy compliance over following research leads that support new innovations (Innocenti, 2016).  Little is known about how home visiting program managers conceptualize social innovation for home visitation and what they see as important for new innovative practices to take root in home visiting.  This paper uses interviews with administrators in a statewide network of home visiting programs in a large Midwestern state to explore their perspectives on how social innovations develop in home visitation.

Methods                                                                                   

In-depth, semi-structured, qualitative interviews approximately 90-120 minutes in length were conducted with 34 program administrators in a Midwestern, statewide network of home visiting programs.  Interviews were transcribed, coded thematically, and subjected to content analysis.

Results                              

A total of 549 references to innovation or new practices across interviews were manually screened to remove irrelevant or redundant references to “new” things which were not home visitation innovations, resulting in 71 relevant references which were collapsed into six reference groups, from which four primary themes emerged: 1) the importance of organizational champions within home visitation; 2) the importance of program enhancements as the most frequent form social innovations were likely to take within existing home visiting programs; 3) the potential for for-profit home visiting sites to promote entrepreneurship and innovation within home visitation; and 4) the power of research as an ongoing driver of social innovation for home visiting.  Organizational champions were framed as those administrators who could both “transfer knowledge and spirit experience to other” managers and staff who would grow their own sense of ownership of the new practice or innovation in the home visiting program.  Respondents also suggested that successful innovations often addressed daily challenges in home visiting programs with specific program enhancements, such as pilot programs to engage fathers who were rarely served by services as usual or doula services that provided perinatal education to new mothers.  For-profit child care centers were also noted as incubators for innovative practices because of the potential for rapid return on investment: “These are entrepreneurs—time is money!”  Finally, research was framed as a consistent driver of innovation, such as when new research on child brain development was publicized in the news media and offered an opportunity to pitch to funders on why a prospective innovation was worth supporting. 

Conclusions and Implications

Respondents emphasized that social innovation within home visitation was an important ideological commitment motivated by caring about the families they served.  These findings are important because business innovation may be framed as self-interested or incompatible with social services.  Organizational champions, pilot programs and program enhancements, and financial incentives should be further researched as key components in social innovation for social programs such as home visiting.