Online Program

Localizing best practices in home visitation: Perspectives from state administrators and local program directors

Monday, November 4, 2013

Background: Although program models of early childhood home visitation focus strongly on implementation fidelity, public health services benefit when best practices in the home visiting field can be identified beyond program models and tailored at the local level. Little is known about how administrators of home visiting models designated as evidence-based conceptualize best practices in home visitation. Methods: Interviews 90-120 minutes in length were conducted in a large Midwestern state with 34 home visiting program administrators and consultants who used one of two established program models. Interviews and field notes were transcribed by the author and analyzed with NVivo 10. Analytic strategies used included open, intuitive, sequenced coding, assertions analysis (content analysis of transcripts and field notes), and pragmatic compression to focus analysis on the research question at hand and give thick description explanatory power. Results: Three primary themes emerged: 1) Rather than cross-model best practices, many respondents identified best practices with specific aspects of their program models, such as one model's list of critical elements. 2) Others identified best practices as detailed, thorough lists of standards that all home visitors should be expected to know. 3) Some respondents emphasized best practices as extra efforts that went beyond the lowest level of implementation fidelity and were not required. Conclusions: Respondents expressed diverse understandings of best practices and often linked best practices to their own specific program model. Public health education that emphasizes tailoring of best practices to local context may increase the cultural competence and relevance of home visiting programs.

Learning Areas:

Administer health education strategies, interventions and programs
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health administration or related administration
Public health or related education
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Compare best practices in home visitation that primarily informed by public health and other theories to those that are driven by implementation fidelity to an evidence-based program model

Keyword(s): Home Visiting, Evidence Based Practice

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because home visitation is my principal area of research and I have completed extensive qualitative interviews with home visiting program trainers and administrators. I hold a master's degree in health policy and administration from Northwestern University and a master's degree in social work from the University of Chicago. I am a PhD candidate in social service administration at the University of Chicago.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.