Service Coordination in Early Childhood Home Visiting: a Multiple-Case Study

Area of Science:

• Public Health
• Social Work
• Early Childhood Education

Background:

• Early childhood home visiting is a crucial preventive service promoting child and parent well-being, development, and family economic stability.
• Service coordination, linking families to community resources, is vital for home visiting programs to meet diverse family needs.
• Understanding facilitators and barriers to service coordination is essential for optimizing early childhood systems of care.

Purpose of the Study:

• To identify and describe facilitators and barriers to service coordination in early childhood home visiting programs.
• To explore the perspectives of home visiting program staff and families on service coordination processes.
• To inform strategies for enhancing service coordination within the early childhood service system.

Main Methods:

• A multiple-case study design was employed, analyzing data from four diverse home visiting programs in the eastern USA.
• Interviews were conducted with program managers, supervisors, home visitors, and participating families.
• Qualitative data analysis focused on identifying common themes related to service coordination facilitators and barriers across cases.

Main Results:

• Facilitators included strong interagency relationships, collaborative teamwork, dedicated staff, effective supervision, and trusting relationships with families.
• Key barriers comprised limited local resource availability and accessibility, stigma associated with certain services, and families' hesitancy towards some referrals.
• Both staff and families highlighted the critical role of multi-level relationships and the intensive nature of effective service coordination.

Conclusions:

• Robust relationships and collaboration across multiple levels are fundamental to successful service coordination in home visiting.
• Addressing complex barriers requires systemic approaches, potentially through state and local coalitions involving diverse stakeholders.
• Investing in coordination support can strengthen the early childhood service system and improve outcomes for families.