Yale Child Study Center, 230 South Frontage Rd, New Haven, CT, 06520, USA.
Yale School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA.
Prev Sci. 2021 Nov;22(8):1108-1119. doi: 10.1007/s11121-021-01223-w. Epub 2021 Mar 17.
Prevention of child maltreatment is a goal of home visiting (HV) for new mothers. How home visitors and their clinical supervisors manage concerns about child maltreatment may impact both the families' and the home visitors' engagement with the program. We sought to understand how HV personnel encounter and respond to concerns of child maltreatment and how these concerns are related to their work with families. We conducted an interpretive descriptive qualitative study of home visitors and supervisors in a statewide HV program, using the Parents as Teachers curriculum, to describe the experience of HV personnel. Two researchers conducted semi-structured interviews March 2016 to October 2017. Interviews were concurrently transcribed, coded, and analyzed, using thematic analysis. After 13 interviews with home visitors and 13 interviews with supervisors, codes and themes were saturated. We identified three themes: Decision to Call Child Protective Services (CPS), Relationships, and Collaborating with CPS. The decision to call CPS was described as difficult, and there was substantial variation in the details of this decision. The relationship between home visitor and family was consistently the most important. Variations were seen in how home visitors and supervisors collaborated with CPS, ranging from strong connections through liaisons to frustrations due to poor communication and perceived variation in how cases were handled. The decision to report a family to CPS is a challenging clinical issue; additional training and connections with CPS may improve consistency across sites for home visitors.
预防儿童虐待是新妈妈家访（HV）的目标。家访者及其临床主管如何处理儿童虐待问题，可能会影响家庭和家访者对该项目的参与度。我们试图了解家访人员如何遇到和应对儿童虐待问题的担忧，以及这些担忧如何与他们与家庭的工作相关。我们对一个全州范围内的 HV 项目中的家访人员和主管人员进行了一项解释性描述性定性研究，该项目使用了父母为老师的课程，以描述家访人员的经验。两名研究人员于 2016 年 3 月至 2017 年 10 月进行了半结构化访谈。访谈同时进行转录、编码和分析，采用主题分析。在对 13 名家访者和 13 名主管人员进行访谈后，代码和主题达到饱和。我们确定了三个主题：决定致电儿童保护服务（CPS）、关系和与 CPS 合作。决定致电 CPS 被描述为困难的，而且这个决定的细节存在很大差异。家访者与家庭之间的关系始终是最重要的。家访者和主管人员与 CPS 的合作方式存在差异，从通过联络人建立的紧密联系到由于沟通不畅和对案件处理方式的不同看法而导致的沮丧。向 CPS 报告家庭的决定是一个具有挑战性的临床问题；为家访者提供额外的培训和与 CPS 的联系可能会提高各站点的一致性。
