HOME VISITING CAMPAIGN Effectively messaging home visiting Aug. 7, - - PowerPoint PPT Presentation

HOME VISITING CAMPAIGN

Effectively messaging home visiting

• Aug. 7, 2015

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RESEARCH WITH POLICYMAKERS AND ENGAGED VOTERS

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Pew Home Visiting—February 2014

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Pew Home Visiting—February 2014

Methodology

Four Focus Groups: Locations:  Suburban Dallas, TX  Suburban Detroit, MI

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Pew Home Visiting—February 2014

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Pew Home Visiting—February 2014

From the Focus Groups The phrase “home visiting” conjures up associations that are much more negative.

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Pew Home Visiting—February 2014

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Pew Home Visiting—February 2014

From the Focus Groups

“Home visiting” implies:  A last resort program  An intrusion into the home in extreme cases  Something punitive  “Big Brother”  Child Protective Services  A program for school truancy

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Pew Home Visiting—February 2014

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Pew Home Visiting—February 2014

Methodology

• Internet Survey
• 802 Adults
• 405 Parents with

Children 18 and Younger at Home

• January 2-9, 2014

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Pew Home Visiting—February 2014

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Pew Home Visiting—February 2014

Naming the Program

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Pew Home Visiting—February 2014 Adults

Family Support

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Family Coaching 55 Parent Education 53 Parent Mentoring 53 Parent Coaching 50 Home Visiting

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Program Names—Mean Scores

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Pew Home Visiting—February 2014

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Pew Home Visiting—February 2014

Bottom Line

Qualitative and now quantitative research strongly indicates “home visiting” should be dropped. Describing the program around the concepts of “family support” or “family coaching” is much better received.

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Pew Home Visiting—February 2014

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Pew Home Visiting—February 2014

Target Population

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Pew Home Visiting—February 2014

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Pew Home Visiting—February 2014

Highest priority people for the program:  Families that do not have the experience or support to provide basic parenting skills (45%)  Low income families (29%)

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Pew Home Visiting—February 2014 Adults

Families that do not have the experience or the support to provide basic parenting skills 45% Low income families 29% Teenage parents 22% Families that live in areas with high rates of domestic violence 21% Families that live in areas with high rates of unemployment 18% Families that live in high crime areas 18% Families that live in areas with a high rate of infant mortality 7% Families where the parents don’t have high school degrees 7%

Which Group Should Receive the Highest Priority

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Pew Home Visiting—February 2014

Which Group Should Receive the Highest Priority Among Parents by Income

But there are sharp differences among parents by income.

Because of limited funding, these programs can only be offered to a certain number of people. Which one or two listed below do you think should be the highest priority for this program to serve?

<$20K $20K- $40K $40K- $60K $60K- $80K $80K- $100K $100K+ Families that do not have the experience or the support to provide basic parenting skills

28% 31% 41% 44% 43% 61%

Low income families

58% 42% 38% 30% 42% 28%

Teenage parents

23% 19% 22% 28% 31% 20%

Families that live in areas with high rates of domestic violence

13% 22% 18% 32% 12% 14%

Families that live in areas with high rates of unemployment

16% 26% 15% 16% 10% 19%

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Pew Home Visiting—February 2014

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Pew Home Visiting—February 2014

Respondents say people would be most likely to want to help at-risk children and the more vulnerable.

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Pew Home Visiting—February 2014

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Pew Home Visiting—February 2014

Program Providers & Administrators

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Pew Home Visiting—February 2014 Adults Parents

Trained educators

72% 74%

Trained providers

71% 70%

Parent educators

67% 68%

Nurses

66% 67%

Community educators

55% 56%

Community workers

42% 43%

More Favorable Toward Program If This Type of Person Was Providing Services

“Training” is what respondents look for in a description of service providers.

They people who provide these in-home services to parents and families are specially trained. Below are some types of people who could provide these services. For each one, please indicate if you would feel more favorable toward this program if you knew this type of person was providing services, less favorable toward this program, or if ti would make no difference to your feelings toward the program one way

• r the other.

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Pew Home Visiting—February 2014 Adults Parents

A government program administered by a local or community organization

40% 38%

A public program

18% 20%

A government-funded program

15% 18%

A government-sponsored program

12% 13%

None of these

15% 11%

Best Way to Describe How the Program is Funded and Administered

But…local administration does make people more comfortable with a description of how the program is funded.

Below you will see a list of different ways to describe how this program is funded and administered. From the four options below, please select the one description that gives you the most favorable impression of how this program is funded and administered.

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Pew Home Visiting—February 2014

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Pew Home Visiting—February 2014

Top “Factoids” to Describe the Program

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Pew Home Visiting—February 2014

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Pew Home Visiting—February 2014

• Positive effects on parenting such as

providing a safe and stimulating environment

• Promotes family self-sufficiency; moms five

times more likely to be enrolled in education/ job training

• Families more likely to read aloud, tell

stores, say nursery rhymes, and sing with their children

Program Facts: Top Tier

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Pew Home Visiting—February 2014

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Pew Home Visiting—February 2014

• First graders twice as likely to follow

directions, complete work on time, or work cooperatively

• Parents must volunteer, so they are

committed to becoming better parents

• Every dollar spent saves $1.80-$2.73

because of fewer ER visits, lower health care costs, and less medical and educational assistance

Program Facts: Top Tier

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Pew Home Visiting—February 2014

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Pew Home Visiting—February 2014

A Top Three Choice Across the Political Spectrum:

• Promotes Family Self-Sufficiency

Factoids by Party

#1:

Parents Must Volunteer

31%

#1:

Positive Effect

• n Parenting

32%

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RESEARCH WITH FAMILIES

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Pew Home Visiting—April-May 2015

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Pew Home Visiting—April-May 2015

Methodology

Eight Focus Groups: Locations:  Memphis, TN  Detroit, MI  Los Angeles, CA  Albuquerque, NM

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Pew Home Visiting—April-May 2015

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Pew Home Visiting—April-May 2015

Focus Groups: Moms of Kids 0-4 Years Old Who Meet At Least One of the Following Criteria:

 Less than a high school education  Household income under $30,000 a year  No health insurance, Medicaid/Medi-CAL or covered by the Affordable Care Act

Methodology

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Pew Home Visiting—April-May 2015

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Pew Home Visiting—April-May 2015

Eight Focus Groups: Demographics:  2 - African American Groups  3 - Mixed Ethnicity Groups  1 - White Group  1 – Latina Group (English)  1 - Latina Group (Spanish)

Methodology

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Pew Home Visiting—April-May 2015

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Pew Home Visiting—April-May 2015

In-depth Interviews of 21 Women Enrolled in New Mexico Programs

Online Surveys:  600 Moms  Qualify for Home Visiting

Methodology

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Pew Home Visiting—April-May 2015

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Pew Home Visiting—April-May 2015

Online Bulletin Boards:  23 Home Visitors in 9 States  12 Home Visitors in New Mexico

Methodology

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Pew Home Visiting—April-May 2015

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Pew Home Visiting—April-May 2015

Key Finding #1 These moms are feeling great stress on their time and finances.

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Pew Home Visiting—April-May 2015

In the survey, moms express challenges facing them every day.

% Concerned

Paying bills 91% Affordable health insurance^ 88% Affordable place to live 86%

^Among those who do not have health insurance.

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Pew Home Visiting—April-May 2015

In the survey, moms express challenges facing them every day.

% Concerned Finding a job* 85% Losing health insurance^ 83% Quality daycare 80%

*Among those who are unemployed. ^Among those who have health insurance.

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Pew Home Visiting—April-May 2015

In the survey, moms express challenges facing them every day.

% Concerned Losing your job* 74% Feeling safe 64% Help from family & friends 61%

*Among those who are employed.

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Pew Home Visiting—April-May 2015

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Pew Home Visiting—April-May 2015

Key Finding #2

In drawing moms to the program, outreach should be “mom-centered” to get their attention and interest.

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Pew Home Visiting—April-May 2015

Testing Approach

We tested two narrative approaches in how to reach out to moms.

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Pew Home Visiting—April-May 2015

“Kid-Focused”

In many families, grandparents, friends, trusted neighbors, or church members show a new parent how to care for their child. But, some new mothers and families simply do not have this support or help. Children don’t arrive with an instruction manual. So, voluntary home visiting matches parents with trained professionals who provide information and support during pregnancy and throughout the child’s earliest years – a critical development period. Home visiting programs help with prenatal care and advice about parenting, engage infants in meaningful learning activity, create positive adult-child bonds, and promote family self-sufficiency.

%80-100 Among Moms: 40%

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Pew Home Visiting—April-May 2015

“Mom-Centered”

Every new mom could use the support and guidance of someone trained and trusted to help them along the way. Moms face lots of new and sometimes unexpected pressure in their new role as mother. Having additional support and someone who understands their needs helps a mom face the challenges of parenthood. While learning skills to help raise her baby or young child, a mom will also have a resource she can rely on for support and advice. Just this little bit of extra help would go a long ways to ensuring the success of the whole family.

%80-100 Among Moms: 45%

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Pew Home Visiting—April-May 2015

The favorite when asked to pick

• ne statement was mom-centered.

Most Favorable Kid-Focused 38% Mom-Centered 55%

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Pew Home Visiting—April-May 2015

Reasons respondents selected the “mom-centered” message:

• Program will provide help, support,

guidance and advice

• Friendly/warm tone, more inviting than

the other statement

• Focused on the needs of new moms

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Pew Home Visiting—April-May 2015

Reasons respondents selected the “mom-centered” message:

• Reminded of own experience/Can relate to

the statement

• Acknowledges that new moms face stress

and challenges

• Will help moms without a support system
• Support from someone trained/trusted

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Pew Home Visiting—April-May 2015

In our focus groups, we shared program literature with participants, and the findings reinforced the “mom-centered” language.

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Pew Home Visiting—April-May 2015

Here is the brochure that tested well in

• ur focus

groups:

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Pew Home Visiting—April-May 2015

This more successful brochure worked well because:

• Mom-centered.
• More personal.
• “Real life support” (talking about

problems).

• Basic and to the point.

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Pew Home Visiting—April-May 2015

A copy line from this brochure that worked especially well was…

“We will meet you at your house or at a place you choose.”

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Pew Home Visiting—April-May 2015

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Pew Home Visiting—April-May 2015

Key Finding #3 Perceived benefits of the program are also focused on meeting moms’ needs.

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Pew Home Visiting—April-May 2015

In the Focus Groups

Greatest Benefits:

• Personal and

emotional support.

• Referrals to other

services like day care.

• Help setting

education or career goals. Ranked near the bottom:

• Providing a

stimulating environment for your child.

• Information on

emotional bonding with your child.

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Pew Home Visiting—April-May 2015

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Pew Home Visiting—April-May 2015

While the home visitors said they try to help both child and mother in their interactions, they recognize that by helping the mom, they help the baby.

“When you meet the needs of the mother, you empower HER to meet the needs of her child.”

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Pew Home Visiting—April-May 2015

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Pew Home Visiting—April-May 2015

Key Finding #4

Prospective participants have real concerns about the negative judgment they might be exposed to, and the time required to participate.

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Pew Home Visiting—April-May 2015

% Reasons Already have support 35% Feel uncomfortable with it at house 33% Negative judgment 31% Won’t understand needs 24%

Survey: Top Reasons NOT to Participate

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Pew Home Visiting—April-May 2015

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Pew Home Visiting—April-May 2015

Home visitors are very sensitive to the point that practitioners must be compassionate and non-judgmental.

“The population I work with have enough people constantly telling them what to do or what they're doing

• wrong. To create a strong foundation to the relationship,

I believe it is important for our clients to understand that

• ur job as home visitors is not to judge them.”

“If a parent tells me something a little different, I act like I've heard it a million times.”

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Pew Home Visiting—April-May 2015

Another concern we heard from moms:

The home visitor might report me to a government agency and that could have an impact

• n child custody or

government benefits.

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Pew Home Visiting—April-May 2015

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Pew Home Visiting—April-May 2015

Key Finding #5 Building personal bonds is critical to partnership success, and overcoming initial hesitations.

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Pew Home Visiting—April-May 2015

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Pew Home Visiting—April-May 2015

Home visitors stress the importance of developing a strong relationship with their client.

Building Personal Bonds

“I may self-disclose a piece of information that's currently going on with the family to normalize their situation…I've found this method really breaks down those barriers. The truth is, I may be a professional coming into their home but I'm human as well and I've dealt with similar challenges as they're currently

• experiencing. They feel accepted and understood.”

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Pew Home Visiting—April-May 2015

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Pew Home Visiting—April-May 2015

Key Finding #6

Shared ethnic or cultural identity can help foster a deeper bond.

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Pew Home Visiting—April-May 2015

There was a shared sense and some concern in our focus groups among African American and Latina participants that “they won’t understand me.”

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Pew Home Visiting—April-May 2015

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Pew Home Visiting—April-May 2015

The home visitors told us some clients have an easier time opening up and trusting a visitor who shares their same culture and beliefs.

“Because I am Hispanic they find it easier to be more open with me. We lived in the same cultures and shared some similar ways of how we were raised as children.”

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Pew Home Visiting—April-May 2015

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Pew Home Visiting—April-May 2015

Sometimes even a shared experience

• f being a minority helps to

foster a deeper bond with a client.

“I'm Indian so I know people have made comments to me before about us both being minorities. They feel connected to the fact that neither of us are Caucasian.”

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Pew Home Visiting—April-May 2015

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Pew Home Visiting—April-May 2015

Key Finding #7

Flexibility is a guiding principle.

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Pew Home Visiting—April-May 2015

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Pew Home Visiting—April-May 2015

• Addressing each family as unique.
• Building plans around differing needs.
• Quality of visit matters.
• Families have urgent need.

Home visitors tell us they must demonstrate flexibility by…

“If a family is losing electricity [or their boyfriend is] going to jail it is impossible to sit and focus on potty training.”

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Pew Home Visiting—April-May 2015

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Pew Home Visiting—April-May 2015

Key Finding #8 “Home visiting” is not the right phrase for the program and it should be changed.

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Pew Home Visiting—April-May 2015

Rating the Phrase “Home Visiting” From the Surveys

Mean Score

Moms 46 Adults 34

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Pew Home Visiting—April-May 2015

From the Survey

Most Favorable (Top Two) Family Support 41% Family Support Partnership 36% Family Support and Coaching 35% Parent Education 35% Parent Coaching 9% Family Coaching 8% Home Visiting 7%

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Pew Home Visiting—April-May 2015

What’s wrong with “home visiting?” Our focus group participants say:

It sounds like Child Protective Services. It is not friendly or personal. It sounds like you’re being watched or judged.

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Pew Home Visiting—April-May 2015

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Pew Home Visiting—April-May 2015

Key Finding #9

Consider a range of names that incorporate the concepts

• f “Support,” “Partnership,”

and “Coaching.”

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Pew Home Visiting—April-May 2015

Rating the Phrase “Family Support”

From the Surveys Mean Score Moms 66 Adults 65

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Pew Home Visiting—April-May 2015

From the Survey

Mean Score Family Support 66 Parent Education 62 Family Support and Coaching 62 Family Support Partnership 61 Parent Coaching 56 Family Coaching 56 Home Visiting 46

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Pew Home Visiting—April-May 2015

Language: “support” vs. “education” vs. “coaching”

There were divided feelings about “education” and “coaching” in our groups, with generally more consistently positive reaction to “support.”

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Pew Home Visiting—April-May 2015

Language: “support” vs. “education” vs. “coaching”

Support suggests…

• A more level playing field between parent and provider.
• Non-judgmental.
• Support sounds more therapeutic.

For some, education or coaching suggests…

• A “right” way to parent.

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Pew Home Visiting—April-May 2015

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Pew Home Visiting—April-May 2015

Key Finding #10

What to call providers? The “support” theme has relevance here as well.

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Pew Home Visiting—April-May 2015

From the Survey

More Favorable

Family Support Providers 71% Family Support Coaches 68% Parent Support Providers 68% Nurses 68% Trained Providers 65% Social Workers 37% Home Visitors 36%

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Pew Home Visiting—April-May 2015

In focus groups we heard the phrase, a “support provider”…

 Suggests that this person will help them work through their problems.  Is less judgmental.

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Pew Home Visiting—April-May 2015

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Pew Home Visiting—April-May 2015

Among home visitors we heard the phrase, a “support provider”…

 Provides information and guidance, but allows moms to make their own decisions.  Is open-minded/non-judgmental.  Serves as a “listening ear” and safe space for moms to share their fears and concerns.  Allows moms to guide the interaction/tailors curriculum to each family’s needs.

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WHAT SHOULD WE CALL IT?

• Family support and coaching
• Family support and coaching programs, often called “home

visiting” because they take place in the homes of vulnerable families

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Jennifer Stapleton jstapleton@pewtrusts.org 202.540.6466