Poster #64 - Provider Behaviors Potentially Impacting Enrollment, Engagement, and Attrition in Home-Based Parenting Programs: A Qualitative Analysis

• In Event: Poster Session 11

Abstract

Introduction: Home-based parenting programs can reduce risk factors commonly associated with child maltreatment by providing parent education, promoting healthy child development, and targeting family safety (Chen & Chan, 2015; Edwards & Lutzker, 2008; Gershater-Molko et al., 2003; Maher et al., 2011; Mytton et al., 2014; Olds, 2006). The success of home-based parenting programs relies heavily on the family's enrollment, engagement, and retention (Beasley et al., 2014; Beasley et al., 2017; McCurdy & Daro, 2001). However, there are common provider barriers that hinder the success of family outcomes (Beasley et al., 2017; Damashek et al., 2010; Whittaker & Cowely, 2010). Researchers have focused on the causes of enrollment, engagement, and attrition in these programs to enhance family outcomes (Mccurdy & Daro, 2001; Wagner et al., 2003). The current project was a qualitative study that explored the ways in which provider behavior relates to enrollment, engagement, and reduced attrition for families in home-based parenting programs.
Method: Twenty-one providers were recruited from three home-based parenting programs, including Nurse Family Partnership, Parents as Teachers, and SafeCare. All the providers identified as female, and the median age range was 40-49 years old. The sample was mostly White/Caucasian (71.42%), and included some Black/African American (14.28%) and Hispanic/Latino (4.76%) providers. A semi-structured interview guide was developed to ask specific questions into the thoughts and behaviors of providers that impact enrollment, engagement, and attrition with families. Individual interviews were conducted by trained data collectors and lasted approximately one hour. Qualitative data analysis was conducted using a template approach with NVivo 11 software to identify broad themes within all individual interview data. All data were analyzed by at least two qualitative researchers with inter-rater reliability being 85% or higher for all transcripts.
Results: Findings indicated differences in provider behaviors across stages of enrollment, engagement, and attrition. Specifically, for enrollment primary themes were provider approach and outreach, for engagement themes emerged around providing support and effective communication, and for retention main themes were providing resources and setting goals (see Figure 1). Across all three stages, providers emphasized the importance of building rapport, specifically through active listening, providing support, tailoring their approach, and checking in on families. The providers shared several personality traits that promoted rapport building, including being non-judgmental, reliable, empathic, genuine, and relatable.
Discussion: This study demonstrates a myriad of provider behaviors that impact the continuum of engagement. Given that provider approach and rapport building emerged as major themes, this research holds relevance to the hiring and training of home-visiting program providers. Overall, workforce structure and training that includes behavioral strategies to improving enrollment, engagement, and retention in home-based parenting programs is paramount in achieving program success, and therefore family well-being.

Authors

• Devin Rae Barlaan, Oklahoma State University - Tulsa
  Presenting Author

• Salena King, Oklahoma State University - Stillwater

• Jens E Jespersen, Oklahoma State University - Center for Health Sciences

• Lana Beasley, Oklahoma State University - Stillwater

• Helen Milojevich

• Stormie Fuller

• David Bard, University of Oklahoma Health Sciences