Background

This project expands an ongoing evaluation of Wisconsin’s Family Foundations Home Visiting Program. The project has three aims. Study Aim 1 is to evaluate whether Wisconsin’s evidence-based home visiting services are associated with expected change in client and program benchmark outcomes. Interpretations of results will be enhanced by evaluating whether programs are implementing services with fidelity to the model.

Extending analyses of model fidelity, Study Aim 2 is to investigate client engagement among families served. Many conventional program fidelity metrics that are often used to represent client engagement (e.g., enrollment; number of visits; program completion) will be measured as behavioral indicators of engagement. However, these indicators alone do not necessarily convey clients’ attitudes toward, investment in, or commitment to services. Therefore, survey data will be collected from clients to assess their motivations to enroll and remain in HV services, involvement during home visits, use of information learned in everyday life, resourcefulness in seeking information and help, and overall satisfaction with services. Additional data will be collected to explore contextual influences that may facilitate or impede engagement. Furthermore, the evaluation will investigate therapeutic alliance, or the degree to which clients and home visitors have developed an affective bond and whether they share similar service goals and objectives.

Study Aim 3 aligns with the State’s plan to enhance screening and assessment practices. Specifically, this project will focus on screening and assessment tools that are designed to gather information on (1) caregiver adverse childhood experiences (ACEs), physical and mental health, and parenting. Survey data also will be gathered from program personnel related to their history of ACEs, current levels of stress, burnout and secondary traumatic stress, as well as their job satisfaction and intentions to leave their current position. This arm of the study will yield new information about the client and staff population, which will be used to inform direct services, training, technical assistance and continuous quality improvement efforts. Furthermore, analyses may inform state-level policy as related to routine screening and assessment practices.