Impact of Fan in Home Visiting

BACKGROUND AND PURPOSE

Home visitation is a major preventative intervention to decrease risk and promote the early development of young children and their families. The federal government through its Maternal, Infant and Early Childhood Home Visiting Program (MIECHV) funds states, territories, and tribal entities to develop and implement home visiting programs for pregnant people and parents with young children who live in communities that face greater risks and barriers to achieve positive maternal and child health outcomes. FAN was originally developed as a part of the Fussy Baby Network, a home visiting program for parents who were struggling with their baby’s crying, sleeping, or feeding. As it became apparent that the FAN was applicable beyond infant fussiness, other home visiting programs wanted to infuse the FAN into their models. This presentation will present the results of a MIECHV federally funded, external evaluation of the FAN as implemented in two evidence-based home visiting models in programs in Illinois: Healthy Families America (HFA) and Parents as Teachers (PAT). The research was conducted by evaluators at Chapin Hall at the University of Chicago.

METHODS

The study included home visitors and supervisors from 17 HFA or PAT programs in Illinois. Participants received team-based FAN training over 6 months. Home visitors and supervisors completed pre- and post-structured interviews and surveys assessing FAN skills, and validated measures of supervisor relationship, mindfulness, and burnout. The home visitors were interviewed twice to assess reflective capacity as measured by the Provider Reflective Process Assessment Scales.

RESULTS

The surveys and interviews revealed that the home visitors had significantly improved skills: they were better able to read parents’ cues and match interactions based on their cues, asked parents more questions and explored concerns with parents, were more collaborative and felt less responsible for “fixing” parents’ problems, and became more aware of and able to manage their own emotions during visits. There was a significant increase in the home visitor’s reflective capacity in 4 of 6 areas: more able to self-regulate, collaborate, attend to process in relationships, and more accepting of the client. They reported decreased burnout in two areas: emotional burden and depersonalization. Supervisors were better able to support home visitors around matching their interactions based on parents’ cues, recognize and regulate their own feelings during visits with families, and encourage home visitors to reflect about themselves and families on their caseload. Supervisors were also more able to manage their own emotions in supervision.

CONCLUSIONS AND IMPLICATIONS

The impact of the FAN in this study led to dissemination of the FAN to other national evidence-based home visiting models and to the incorporation of the FAN in state home visiting systems. The values of social work as re-imagined in the FAN are now a part of services for families across the country.