Parents' Perceptions of Quality in Early Childhood Home Visiting

Introduction:

Mixed results on effectiveness of home visiting point to a need to identify the elements of home visiting programs that yield positive outcomes (Korfmacher et al., 2019). While there is some research that identifies elements of home visiting program quality, how parents involved in home visiting programs define quality for themselves is under-examined. This project describes how parents’ perceive quality in home visiting programs, as well as how program directors use feedback from parents to improve program quality.

Methods:

This research project aimed to provide a comprehensive picture of parents’ perceptions of quality in home visiting programs using a qualitative descriptive methodology coupled with thematic analysis by sampling both home visiting program directors and parents. First we surveyed 23 program directors representing diverse program models and service populations across one state. The results of this survey helped us develop topics for follow-up interviews with a subset of survey respondents (N = 10). Program directors then helped identify a sample of current and former parents involved in home visiting programs to approach for interviews. Efforts were made towards maximum variation of the sample, including interviewing families who had disengaged from programs. We conducted qualitative data collection and analysis simultaneously, allowing us to assess appropriate sample size.

Results:

Surveys showed that home visiting program directors generally engaged families in opportunities to lend their voice to program development or planning and generally viewed these efforts as important to program quality. Follow-up open-ended conversations further described how program directors defined “family participation” and how that participation shaped program practices. Subsequent individual interviews documented that parents’ experiences of home visiting program quality and “family participation” differed from program directors’ understandings.

Conclusions and Implications:

Families are the consumers of home visiting services and there is an increasing recognition of the need to include them in our understanding and evaluation of programs (Kleinman et al., 2023). Parent recruitment, engagement, and retention are all challenges facing programs. The diversity of parents’ voices in home visiting program evaluation is an under-examined area of research even though how parents understand quality likely determines family participation. As one of the first studies to comprehensively examine parents’ perceptions of quality, this study takes important step towards incorporating family voice in the evaluation and delivery of home visiting services.

References

Kleinman, R., Del Grosso, P., Harding, J. F., Hsu, R., Kalb, M., O’Brien, J., Rosen, E., Ayoub, C., Gaither, M., Mondi-Rago, C., Roberts, J., & Rosengarten, M. (2023). Understanding Family Engagement in Home Visiting: Literature Synthesis [OPRE Report #2023-004]. Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services

Korfmacher, J., Frese, M., & Gowani, S. (2019). Examining program quality in early childhood home visiting: From infrastructure to relationships. Infant Mental Health Journal, 40(3), 380–394. https://doi.org/10.1002/imhj.21773