Home visiting is a strategy used by public health nurses and, more recently, by community health workers (CHW’s) to engage low-income families in programs, to address racial disparities and to improve maternal and infant health. In highly visible and well funded home visiting programs, approximately 10-25% of the women refuse participation and only 50% of the intended services are able to be delivered to participants (Gomby, Culross, & Behrman, 1999). Studies have identified several individual barriers to engagement such as language, literacy skills and basic social skills. Past experiences and current circumstances may interfere with individuals' abilities/willingness to develop and sustain social networks.
Further, barriers for home visiting are often dependent on care providers who only have access to women when they begin prenatal care. The ability to complete thorough and culturally sensitive assessments and referrals is dependent on the skill of prenatal providers, the time demands, the perceived need for referral and other client needs at the time of the clinic visit.
Participation data from a randomized trial (n=613) that explored the differential effects of nurse or nurse-chw team home-visiting services will be presented. Information will be presented on the characteristics of women that chose not to participate and for those clients that were enrolled, the extent of participation. Based on the data analysis, strategies to improve engagement and participation will be recommended.
Learning Objectives: At the completion of this session, participants will be able to: 1. Identify 6 barriers to engaging low-income families in home-visiting services 2. Recognize the differences in characteristics of women who chose not to participate in home-visiting services as compared to those clients who enroll 3. Describe 4 strategies to improve engagement and participation in home-visiting services
Keywords: Home Visiting, Barriers to Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.