Integrating Heart Health Intervention Into Home Visitation: Qualitative Analysis of Home Visitation Staff...

Optimal cardiovascular health during pregnancy and postpartum is critical for reducing maternal morbidity and mortality. Although lifestyle interventions effectively promote cardiovascular health, strategies are needed to reach the maternal populations with the highest prevalence of cardiovascular disease risk factors. Evidence-based home visiting programs, though not initially developed to address cardiovascular health, offer a promising platform for reaching pregnant and postpartum women at high risk for later cardiovascular disease. This study explored home visitor perspectives on integrating cardiovascular health content into home visitation. Guided by the Social Ecological Model, semi-structured interviews (n = 10) and focus groups (n = 8) were conducted with home visitors, supervisors, and program managers (N = 33) from agencies in California and Rhode Island. Thematic analysis identified broad support for including heart health content, with participants emphasizing the value of culturally relevant, engaging, and flexible curricula that could be tailored to family needs. Organizational challenges included staff burden, training gaps, and funding for intervention sustainability. At the community level, strong relationships with healthcare providers and aligned messaging across systems were identified as key facilitators. Findings provide practical insights for the design and implementation of cardiovascular health interventions within home visiting and highlight the importance of addressing multi-level factors to support successful integration.