Home visiting programs are one of the most effective ways of providing valuable services to families with young children. The home visiting programs come in a variety of flavors, with some sending nurses and others sending other types of trained professionals into the home to support child development. Some start prenatally and continue through the school years. According to a rigorous study by MDRC, such programs
- Improve outcomes for parents and children across a wide range of child ages, outcome areas and national models
- Appear to be cost-effective in the long term
- Reduce spending on government programs and increase individual earnings
But what can be done when home visits become difficult or impossible? On September 7, the Hunt Institute webinar titled “Supporting Families: COVID and the Future of Home Visiting Programs” explored how four leading programs have answered that question.
The webinar featured:
- Constance Gully, CEO of Parents as Teachers (PAT)
- Kathleen Strader, Director of Healthy Families America (HFA)
- Sarah Walzer CEO of Parent/Child+
- Frank Daidone, President & CEO of Nurse-Family Partnership (NFP)
These four leaders know each other well and have stayed in regular contact throughout the pandemic. In his introductory remarks, Hunt Institute President and CEO Javaid E. Siddiqi, Ph.D., noted that all four programs proved themselves to be nimble during these extraordinary times, adapting quickly and efficiently to circumstances that challenged the underlying assumptions of their models. This observation permeated the entire dialogue, which was moderated by Hunt’s Senior Director of Early Learning Dan Wuori, Ph.D..
Here are our takeaways:
1. The people served by these programs were already experiencing poverty and other severe challenges. Walzer’s organization, which conducted 400,000 virtual visits in the last year, serves a largely immigrant population, with over 40 languages spoken. Even before Covid, many of these families were enduring a political climate that made it harder than ever for them to access supportive services, and it has been well documented that the pandemic disproportionately affected immigrant workers, whether or not they were considered to be frontline.
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2. Pre-pandemic preparation helped organizations to weather Covid. In the words of Louis Pasteur, “Chance favors only the prepared mind.” Leaders and staff of these programs were well positioned to adapt to Covid because they were in the habit of assessing and reassessing how they deliver services.
Daidone noted that NFP was already in the midst of revamping their materials, so the pandemic accelerated shifts that were already under way. Similarly, PAT was already undergoing a randomized control trial (which had to be modified) and piloting virtual visits. Strader said the “quality of the learning experience” had to be maintained throughout the Covid pivot.
3. Home visiting staff adapted and proved resilient. All of the participants credited their mostly female teams for sustaining a grueling pace of work even as Covid disrupted their personal and family lives. Gully summarized PAT’s strategy as “being attentive to the voice and choice of families”; these organizations also listened carefully to what their own team members were saying.
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4. Technology can increase equity. Since March 2020, Gully said, about two-thirds of the PAT affiliates reported conducting 700,000 video and telephone visits. According to Strader, HFA has 7,000 team members supporting 70,000 families, for about a million visits a year.
The availability of virtual training and virtual visits removes scheduling and transportation obstacles. Video and phone conferences make it easier for parents (dads, too, significantly) to participate, and this improved access might well translate into more of the social and economic equity that these programs yield.
Some families still want in-real-life home visits when possible, but the flexibility is key. In the past, when a client moved out of the catchment area (for example, to attend college or because of housing instability), visits would be discontinued. Virtual visits are portable. Dr. Wuori noted that the virtual option has been very good for engaging certain families.
5. Evidence is driving public and private support. The Maternal, Infant and Early Childhood Home Visiting program (MIECHV, a joint federal effort between the Health Resources & Services Administration and the Administration for Children and Families) provided $341 million in funding last year to 55 states, territories and nonprofits and recently added $40 million for expansion into virtual visits.
To amplify the impact of these investments, foundations such as Heising-Simons, Robert Wood Johnson and Kellogg fund visiting programs and evaluations, which will further understanding of the effectiveness of virtual accommodations.
Mark Swartz writes for Early Learning Nation and the Stanford Center on Early Childhood about efforts to improve early care and education. He lives in Takoma Park, Maryland, with his wife and two children.
