About this srcd poster session

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Panel information
Panel 16. Prevention and Interventions

Abstract

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Home visiting programs provide parents with tools and resources to create the nurturing environments that are so important for children’s cognitive, language, and social development in the first years of life (Shonkoff & Phillips, 2000; NSCDC, 2004). However, home visiting programs vary substantially in intensity and duration, and while clearly beneficial for families (e.g., Michalopoulos et al., 2019), intensive programs are costly and may feel overwhelming for some families (Foulon et al., 2015). In addition, communities with historically negative experiences with social services may be reluctant to accept in-home visits (Alonso-Marsden et al, 2015; Metzger et al., 2023). Remotely-delivered parenting programs hold promise for reaching a broader audience and have begun to show some benefits for families (Solís-Cordero et al., 2022). This study explores the following research questions: 1) Does the availability of virtual visits increase accessibility and engagement in home visiting services? 2) Do virtual visits support positive outcomes for parents, children, and families?

We draw on data from a study of the Welcome Baby (WB) program, a universal, light-touch home visiting program that transitioned to virtual visits during the COVID-19 pandemic. For this study, 607 WB participants and 306 parents in a comparison sample (i.e., parents who gave birth in LA County within one year of the WB participants but who did not receive WB), were surveyed when their babies were 14 weeks and 10 months old (one month after program completion). The study team used OLS and logistic regression to estimate relationships between WB participation and parent, child, and family outcomes, controlling for demographics. We also analyzed administrative records from the WB program.

After switching to virtual visits in March 2020, average monthly enrollment in WB increased 34% compared to the two years prior to virtual implementation. Program completion rates increased, too—from 42% in the pre-virtual period to 53% when virtual visits were offered (Figure 1). The increase in completion rates was even steeper for participants who identified as Black (increasing from 29% to 46%). In addition, 54% said they preferred virtual visits when asked, noting that virtual visits were more convenient and meant they did not have to worry about having someone in their home. Only 7% would have preferred in-home visits; 38% had no preference.

We also found more positive outcomes for WB participants, relative to the comparison sample, on several measures, including having access to a medical home, breastfeeding support and duration, and parenting confidence. Additionally, by the end of the 9-month program, babies of WB participants had significantly stronger social and emotional development, as measured by the Devereaux Early Childhood Assessment (DECA), than the comparison sample (Figure 2). We did not find significant differences in other outcomes, such as parenting practices and well-care visits.

Overall, these findings suggest important benefits of a light-touch virtual home visiting model. The observed increase in participation rates may reflect an overall increased need for home visiting, but it also suggests that virtual implementation may make home visiting more accessible and acceptable, especially for Black families.

Author information

Author	Role
Lori Downing, American Institutes for Research	Presenting author
Heather Quick, American Institutes for Research	Non-presenting author
Mona Kilany, American Institutes for Research	Non-presenting author
Iliana Brodziak de los Reyes, American Institutes for Research	Non-presenting author
Jennifer Anthony, American Institutes for Research	Non-presenting author
Deborah Perry, Georgetown University	Non-presenting author
Stephanie Davis, American Institutes for Research	Non-presenting author

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