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Exploring Multilevel Factors for Family Engagement in Home Visiting Across Two National Models.

Amanda D Latimore1, Lori Burrell2, Sarah Crowne2

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This study examined family engagement in home visiting programs. Family and home visitor characteristics influenced engagement differently across Healthy Families America and Nurse-Family Partnership programs.

Keywords:
ContextEngagementHome visitingMultilevelRetention

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Area of Science:

  • Maternal and Child Health
  • Family Support Services
  • Program Evaluation

Background:

  • Family engagement is crucial for the effectiveness of home visiting programs.
  • Understanding factors influencing engagement is key to optimizing service delivery.
  • Healthy Families America (HFA) and Nurse-Family Partnership (NFP) are prominent home visiting models.

Purpose of the Study:

  • To examine associations between family, home visitor, and site characteristics and family engagement in the first six months of home visiting.
  • To explore the variation in family engagement within HFA and NFP programs.
  • To identify program-specific strategies for enhancing family engagement.

Main Methods:

  • Utilized data from 1707 families in 21 HFA sites and 650 families in 9 NFP sites in New Jersey.
  • Employed three-level nested generalized linear mixed models to assess predictors of high service dose.
  • Defined high service dose as program activity at six months with at least 50% of expected visits completed.

Main Results:

  • Both HFA (59%) and NFP (64%) programs achieved relatively high engagement, particularly with high-risk families.
  • Home visitor characteristics explained 87% of service receipt variation in HFA.
  • Family characteristics explained 75% of service receipt variation in NFP.

Conclusions:

  • NFP can enhance engagement consistency by focusing retention on mothers with lower education and smoking.
  • HFA sites should consider increasing home visitor job flexibility and adapting visit policies for hard-to-engage families.
  • Tailoring strategies based on program model and influencing factors is essential for improving family engagement.