title: Engagement in paraprofessional home visitation: families' reasons for enrollment and program response to identified reasons.
abstract: 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.
authors.affiliation: The Johns Hopkins University School of Medicine, Department of Pediatrics & Johns Hopkins Bloomberg School of Public Health, Department of Population, Family, & Reproductive Health, Baltimore, Maryland 21287, USA. standon@jhmi.edu
authors.forename: S Darius
authors.initials: SD
authors.lastname: Tandon
authors.forename: Kathleen
authors.initials: K
authors.lastname: Parillo
authors.forename: Constance
authors.initials: C
authors.lastname: Mercer
authors.forename: Maureen
authors.initials: M
authors.lastname: Keefer
authors.forename: Anne K
authors.initials: AK
authors.lastname: Duggan
mesh_terms: D000328:Adult; D003150:Community Health Workers / Q000592:standards; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand / Q000592:standards*; D006701:Home Nursing / Q000592:standards*; D006801:Humans; D007231:Infant, Newborn; D008429:Maternal Welfare; D016389:Maternal-Child Nursing / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011247:Pregnancy; D015397:Program Evaluation; D011795:Surveys and Questionnaires; D014481:United States