Community-Based Approach Improves Retention in Home Visiting Programs

Published January 2016
Prevention Science

Home visiting programs, known to support positive parenting and stress reduction during early child development, often face challenges in high-risk neighborhoods.

Families tend to be low-income. They move a lot. They often endure numerous crises, making it difficult for home visitors to sustain relationships.

A study by the Division of Biostatistics and Epidemiology, in collaboration with Every Child Succeeds, finds that explicitly designed community-based enrichment approaches can boost parental engagement and increase retention in home visiting programs. The findings appeared January 2016 in Prevention Science.

The program in Cincinnati’s low-income Avondale neighborhood was designed with involvement from Avondale community, faith-based and business leaders, says epidemiologist and lead author Ted Folger, PhD. Starting in 2006, participating families received access to child care to attend regular support groups for mothers and fathers and a weekly free “pantry” to supply needed diapers, clothing and developmental toys for children. The program also hired neighborhood mothers to serve as community liaisons.

Compared to families in other high-risk Cincinnati neighborhoods, the Avondale families experienced on average 166 more enrolled days and seven additional home visits. The Avondale program also reported higher retention rates at 12 months (55 percent vs. 41 percent) and at 24 months (33 percent vs. 24 percent).

“This is about developing community-level influences that improve outreach and ensure a more optimal level and duration of support for the developing child,” Folger says. “If we can improve community-level engagement and support, we have a better chance of family buy-in and success.”

Further studies will examine how the community-based approach affects other measures of child health, safety and development.