Engagement in Paraprofessional Home Visitation: Families’ Reasons for Enrollment and Program Response to Identified Reasons
Received 24 February 2007; received in revised form 11 October 2007; accepted 11 October 2007. published online 07 January 2008.
Home visitation programs have exhibited modest impact in promoting maternal and child health outcomes; therefore, formative research is necessary to examine whether home visiting program models or actual implementation need to be modified. In particular, client engagement and retention have been identified as areas in which program implementation can be enhanced. This study assessed home visiting clients’ reasons for entering home visiting programs and their perception of programs’ response to these identified needs. We asked newly enrolled home visiting clients (n = 123) to identify reasons for entering their home visiting program, including their first and second most important reasons. The most frequently cited reasons for enrolling were wanting information about job training, completing one’s education, keeping in good health during pregnancy, and learning about infant growth and development. Home visiting programs’ response to clients’ identified needs varied. Needs more closely related to home visiting program goals of providing parenting education and promoting prenatal health were most often met, whereas needs less closely related to program goals (e.g., life course needs such as information about job training or education) were less often met. Our findings suggest that home visiting programs in urban contexts should consider modifying their program protocols to better respond to employment- and education-related issues facing their clients.
aThe Johns Hopkins University School of Medicine, Department of Pediatrics & Johns Hopkins Bloomberg School of Public Health, Department of Population, Family, & Reproductive Health, Baltimore, Maryland
bThe Johns Hopkins University School of Medicine, Department of Pediatrics, Baltimore, Maryland
Correspondence to: S. Darius Tandon, PhD, Johns Hopkins University School of Medicine, Department of Pediatrics & Johns Hopkins Bloomberg School of Public Health, Department of Population, Family, & Reproductive Health, 200 North Wolfe Street, Suite 2025, Baltimore, MD 21287; Phone: 410-614-5281; fax: 410-502-5440.
Supported by the Safe and Sound Campaign of Baltimore, Maryland.
1 S. Darius Tandon, PhD, is an Assistant Professor in the Department of Pediatrics at the Johns Hopkins University School of Medicine with a joint appointment in the Bloomberg School of Public Health’s Department of Population, Family, & Reproductive Health. He is a community psychologist who conducts research on perinatal health as well as adolescent and young adult mental health.
2 Kathleen Parillo, MA, is a graduate of Towson University’s Masters of Arts program in Experimental Psychology. She is currently employed by NOVA Research Company in Bethesda, Maryland.
3 Constance Mercer, BA, has a degree in Early Childhood Education and has worked as a home visitor in Baltimore City and Howard County, Maryland. She is currently a Senior Research Assistant in the Department of Pediatrics at the Johns Hopkins University School of Medicine.
4 Maureen Keefer, BA, has a degree in English and Psychology from the University of Virginia. She is currently a Data Analyst in the Department of Pediatrics at the Johns Hopkins University School of Medicine.
5 Anne K. Duggan, ScD, is a Professor in the Department of Pediatrics at the Johns Hopkins University School of Medicine with a joint appointment in the Bloomberg School of Public Health’s Department of Health Policy and Management. She has conducted extensive research on the effectiveness of home visiting programs for pregnant women and women with young children in preventing child abuse and neglect.
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