What’s Wrong with “Home Visiting”? New Research Says . . .

POSTED BY: MARILEE COMFORT ON WED, MAY 20, 2015

The Pew Charitable Trusts held the Fifth National Summit on Quality in Home Visiting Programs in Washington, DC this month.  It offered an abundance of information on cutting edge home visiting research and interventions.  Like last year (if you missed it, see our blog), one of the most thought-provoking sessions was about the messages conveyed to moms by the words Home Visiting.

At this year’s Summit the same public opinion research and communication strategists, Bill McInturff and Michael Bloomfield, presented another series of studies on Language to Engage Families (Select Presentation Materials tab; Scroll down to Morning Plenary: Language to Engage Families).  Like last year, they concluded that Home Visiting is the wrong term for what many of us do, and especially for engaging families in valuable, much-needed services.  The researchers emphasized that Home Visiting sends the wrong message to gain support for funding from adults in the general community (surveyed last year), as well as to enroll moms who are prospective home visiting program participants.

 

Who Says It’s the Wrong Message?

The research teams conducted 5 focus groups in Memphis, Detroit and Los Angeles of moms with diverse racial/ethnic backgrounds (e.g., African American, White, Latina, Mixed Ethnicity) who had similar characteristics to those enrolled in many Home Visiting programs (e.g., children under 4 years old, low income, Medicaid recipients). They also collected information from 600 moms eligible for services using online surveys and from 23 Home Visitors across 9 states through an online bulletin board.  For more in-depth qualitative responses, the research teams went to New Mexico to conduct 2 focus groups, interviews with 21 Moms enrolled in New Mexico Home Visiting programs, and an online bulletin board with 12 NM Home Visitors. 

Family Support Trumps Home Visiting

After reading a paragraph describing home visiting services for families with young children, moms were asked to rate the most favorable terms.  This is how the votes turned out:

  • Family Support (41%)

  • Family Support Partnership (36%)

  • Family Support and Coaching (35%)

  • Parent Education (35%)

  • Parent Coaching (9%)

  • Family Coaching (8%)

  • Home Visiting (7%)

(Language to Engage Families, McInturff and Bloomfield, slide #41)

The resounding favorite at the top of the list was Family Support.  Did you notice what’s way at the bottom of the list?  In the focus groups participants explained that they objected to the term Home Visiting because it reminded them of Child Protective Services, sounds unfriendly or impersonal, or it sounds like being watched/judged. There were mixed reactions to the words Education and Coaching.  Some felt they were code words for the ‘right’ way to parent. However, Support suggested a nonjudgmental, therapeutic, equality between parent and staff (Language to Engage Families, McInturff and Bloomfield, slides #46, 47).

Among the 10 Key findings McInturff and Bloomfield reported about Home Visiting, I was struck by the following:

  • Outreach should be “mom-centered” rather than “kid-centered” (e.g. provide help, support, advice to parents).

  • Building personal bonds is critical to partnership success, and overcoming initial hesitations.

  • Flexibility is a guiding principle for home visitors (i.e., addressing each family as unique; building plans around differing needs).

(Language to Engage Families, McInturff and Bloomfield, slides #11, 16, 29, 37, 38)

Just as children need support from nurturing parents, parents need support from Family Supporters (formerly called Home Visitors), who build trust, strong relationships and help them see their strengths and overcome their challenges.  To do all of this, Family Supporters need the training and tools, such as a valid and reliable parenting assessment.  An observational parenting assessment can guide the Family Supporter in tailoring the services to meet the specific needs of the parent.  A parenting assessment tool is ‘mom-centered” (or “dad-centered”) and helps move the focus from the child to the adults in the family.  After all, it is the adult who most influences the family environment.  Thus, the Family Supporter meets each family where they are, and facilitates their unique path to improving parenting.

So What’s Wrong with “Home Visiting”?  

The research shows calling it something else like Family Support can go a long way in increasing understanding and acceptance. A focus on strengthening parenting within Family Support can improve child outcomes (see our Heckman blogs – 1, 2).