enrollment and retention in voluntary home visiting programs n.
Skip this Video
Loading SlideShow in 5 Seconds..
Enrollment and Retention in Voluntary Home Visiting Programs PowerPoint Presentation
Download Presentation
Enrollment and Retention in Voluntary Home Visiting Programs

Loading in 2 Seconds...

play fullscreen
1 / 18

Enrollment and Retention in Voluntary Home Visiting Programs - PowerPoint PPT Presentation

  • Uploaded on

Enrollment and Retention in Voluntary Home Visiting Programs. Deborah Daro. Challenges in attracting and retaining families in voluntary prevention programs is long standing.

I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
Download Presentation

PowerPoint Slideshow about 'Enrollment and Retention in Voluntary Home Visiting Programs' - neviah

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.

- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
main points
Challenges in attracting and retaining families in voluntary prevention programs is long standing.

As policy interests shift to achieving measurable population level change in critical outcome areas, greater emphasis is being placed on successfully engaging a broader segment of the at-risk population.

Research on the issue has identified a number of participant, provider and contextual characteristics that impact enrollment and retention.

Programs need intentional strategies to improve performance in this area.

Main Points


Engagement and Enrollment

the enrollment engagement problem
Roughly one-third of participants drop out of voluntary home visiting services.

Poor retention rates limit a program’s overall impacts and compromise their ability to “go to scale”.

Research often does not adequately consider the multiple decision points in determining a participant’s service levels.

Research does not fully examine the unique impacts of related factors operating at different conceptual levels.

The Enrollment/Engagement Problem
daro mccurdy research approach
Built an integrated theory of parent enrollment in voluntary support services.

Tested this theory against a retrospective sample to confirm factors associated with duration and dosage.

Tested the theory against a prospective sample to confirm factors associated with intent, actual enrollment and retention.

Applied statistical methods (HLM) to detect unique impacts of individual, provider, program and community characteristics on enrollment and retention decisions.

Daro McCurdy Research Approach
daro mccurdy assumptions
Intent is a function of readiness to change, attitude toward seeking help, and prior service experience.

Intent is the strongest predictor of enrollment.

Retention is influenced by many factors and multiple levels:

Participant objective experiences

Participant subjective experiences

Provider characteristics

Program characteristics

Community characteristics

Daro McCurdy Assumptions
the enrollment decision process
The Enrollment Decision Process





I want it.

I’ll try it.

I’ll stick with it.

model predictors
Participant Factors

Demographic characteristics; initial concerns; service attitudes and prior experiences; community context.

Provider Factors

Demographics; job credentials; service delivery style; work environment.

Program/Agency Factors

Connection to community; staff-participant matching.

Model Predictors
integrated theory of parent engagement
Integrated Theory of Parent Engagement

Individual Factors

Service attitudes

Cost-benefit perceptions

Readiness to change

Subjective norms

Past experiences

Individual Factors

Objective experiences

Subjective experiences

Individual Factors

Subjective Norms





Program Factors




Provider Factors



Program Factors

Duration between

acceptance and first contact

Neighborhood Factors

Informal social control

Social cohesion

Concrete resources

Program Factors


Provider Factors

Cultural humility

Service delivery style

Neighborhood Factors

Social Disorganization

Social Capital

what draws parents to these programs
Few new parents actively reject services (< 5%) and 8% of those initially interested do not enroll.

Maternal perception of infant risk – those worried about their baby or who had given birth to a low weight baby are more likely to seek out services.

In some cases, interest in services is higher during pregnancy than at birth.

Parents can articulate possible program benefits.

Parents see a need to focus on parental capacity – they are open to learning.

What draws parents to these programs?
what factors contribute to retention
Participant level

Perception that program changed them.

Involvement with other service programs.

Residing in high risk communities.

Provider level

Cultural awareness/humility

Job experience

More personal service delivery style which balancing responsiveness with mission.

What factors contribute to retention?
what factors account for more visits
Participant factors predicting more visits

Several studies suggest Hispanics are most open to program.

Infant risk – higher the risk the more visits accepted.

Support for program among informal network.

Strong relationship with home visitor.

Residing in a high risk community.

Not working and/or not in school.

Provider Factors

Prior work experience/not simply educational qualifications

Relationship with family

What factors account for more visits?
general findings
Enrollment and retention decisions are influenced by multiple factors occurring at multiple levels.

New parents enroll to help their infant but remain to help themselves.

High risk families living in distressed communities can be successfully enrolled and retained.

Service delivery style and work experience are strong predictors of retention and dosage success.

Service duration and dosage, while correlated, represent different aspects of “engagement”.

General Findings

Strategies to

Improve Enrollment

targets of opportunity
Re-frame the outreach message

Present the program as serving child and parent.

Stress “good care” is more than meeting an infant’s physical needs.

Broaden the benefits to parents

Establish linkages to other providers as child develops and parent matures.

Embed program in trusted community organizations

“Normalize” the service as something of benefit to all parents.

Targets of Opportunity
targets of opportunity1
Take culture seriously

Train staff on cultural sensitivity and humility.

Evaluate race-matching participants and providers.

Ensure outreach message demonstrates respects for diversity.

Focus on the “fit”

Hire for openness and empathy; train and supervisor to insure competence and quality.

Seek a balance between respect for participant and delivering the program message.

Targets of Opportunity