Poster #101 - COVID Impacts on Facilitating Parent-Child Interaction in Home Visiting

• In Event: Poster Session 14

Abstract

One of the central goals of infant home visiting is promoting positive parent-child interaction. Infant home visitors typically do this by using curriculum materials related to parent-child interactions and, more generally, acting as a parent coach while on home visits. COVID-19 has disrupted home visit delivery significantly, however, forcing most visits to occur via video or audio call. Via home visitor self-report, our study is the first to address how COVID changes have impacted parent coaching.

Method. This study used an explanatory, sequential mixed-methods approach that involved online surveys followed by individual interviews with a portion of the survey sample. Questions focused on staff’s beliefs, attitudes, and experiences with coaching, their existing and desired training and support in this area, and changes in practice during COVID. Forty-one home visitors and supervisors from Early Head Start and Healthy Families America programs throughout Maryland completed online surveys in October & November 2020, and 15 subsequently completed virtual interviews.

Quantitative Results. Most home visits were being done via video call (46%) or phone call (32%), while only 20% of visits were completed in-person. COVID had large effects on many aspects of parent-child coaching. We asked home visitors to rank order how often they planned to do different home visit activities, including parent coaching, and how often each activity actually occurred. Two Wilcoxon signed-ranks tests for related samples, in which lower median values indicated more time spent, found participants rated parent coaching significantly higher in both their plans/expectations for visits prior to COVID (Mdn = 3.00) than during COVID (Mdn = 6.00); Z = -4.56, p < .001, and in their reports of what actually occurred during home visits [before COVID Mdn = 5.00; during COVID Mdn = 7.00; Z = -3.32, p < .001].

Table 1 presents home visitor ratings (on a 5-point scale) of how frequently they engaged in parent coaching activities prior to COVID vs. during COVID. Home visitors reported large significant decreases in three coaching-related activities—observing parent-child interactions, creating opportunities for parents to practice new skills, and providing feedback to parents on their infant interactions—but no significant difference in discussing parenting in general.

Qualitative Results. We used an inductive approach to qualitative analysis, which allows codes to emerge from the data rather than prescribing codes a priori. The results presented in the poster will reflect one of six themes, COVID impacts, that emerged from our qualitative analysis. Table 2 presents the code categories that emerged. Here we provide a few examples of some of these, but the poster will describe them more fully and provide example quotes: COVID onset shifting home visiting away from parent coaching and toward family “check-ins” and resource provision (e.g., food stamps); challenges to engaging parent and infant simultaneously and free from distraction; challenges moving from “check-ins” back to parent coaching; home visitor feelings of disconnection from both families and the work due to less involved home visits.

Discussion will focus on the implications of these challenges to the home visiting field moving forward.

Authors

• Lisa M. Shanty
  Presenting Author

• David Schultz, University of Maryland, Baltimore County

• Brenda Hussey-Gardner, University of Maryland School of Medicine