Eco-cultural Family Interview: Building upon a community-based home visiting program's demonstration of improved birth and child outcomes by enhancing family care-planning

Empowering Families of Milwaukee (EFM), an intensive, and comprehensive home visitation program utilizing evidenced-based curriculum, was implemented within the City of Milwaukee in 2006 to address startling racial disparities in infant mortality. Pregnant women and their children, living in a high-risk area of the city that encompasses six zip codes, are visited by a team of nurses, social workers, and community health workers. Women living in this high-risk area have a 14% to 18% rate of low birth weight and prematurity, respectively. Since its inception, EFM has demonstrated a 50% decrease in these adverse birth outcomes for women enrolled in the program.

To further reduce health disparities, EFM implemented the use of the Eco-Cultural Family Interview (EFI) to help better identify the social, economic, and mental health needs of our families. The Eco-cultural Family Interview is a guided conversation with parents or caretakers about how they run their daily routine – how they plan, implement, and sustain family activities. It has been found that the information revealed in a family's daily routine is what matters most in children's lives and serves as the best indicator of family well-being. The EFI is based on a family's “ecology,” or their resources and constraints, and the family “culture,” which is their beliefs and values. The EFI's goal is to uncover how the family creates and implements their daily routine, and why. The information ascertained is subsequently turned into better care plans, and therefore better outcomes for families.