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"We're the Constant": Navigating Resource Scarcity and Relational Depth in Rural and Urban Home Visiting Programs
Aislinn Conrad1, Armeda Stevenson Wojciak2, Megan Ronnenberg1
1School of Social Work, University of Iowa, Iowa City, IA, USA.
Child Maltreatment
|June 5, 2026
Summary
Home visitors in Iowa face systemic barriers, including fragmented services and limited resources, particularly in rural areas. They adapt by providing consistent support and creative solutions to aid families in maltreatment prevention efforts.
Area of Science:
- Social Work
- Public Health
- Family Studies
Background:
- Home visiting programs are crucial for child maltreatment prevention.
- Navigating structural barriers and fragmented services presents challenges for home visitors.
- Understanding these challenges is vital for effective service delivery in diverse contexts.
Purpose of the Study:
- To explore how home visitors in Iowa navigate structural barriers and fragmented service systems.
- To understand how these systemic issues impact child maltreatment prevention work.
- To identify adaptive strategies used by home visitors.
Main Methods:
- Qualitative focus group study involving 34 home visitors.
- Participants represented multiple evidence-based models across rural and urban Iowa.
- Thematic analysis was used to identify key themes.
Main Results:
- Four interconnected themes emerged: structural barriers, service fragmentation, workarounds, and role expansion.
- Home visitors described functioning as a constant for families amidst unstable systems.
- Rural contexts exacerbated challenges due to distance and limited service availability.
Conclusions:
- Home visitors employ workarounds and role expansion to overcome systemic challenges.
- Relational constancy and frontline adaptations are key to sustaining family engagement in maltreatment prevention.
- Policy and systemic improvements are needed to better support home visitors and the families they serve.
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