Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee.
Department of Family and Preventive Medicine, College of Medicine, University of Arkansas for Medical Sciences.
Fam Syst Health. 2022 Jun;40(2):262-267. doi: 10.1037/fsh0000667. Epub 2021 Dec 20.
COVID-19 has resulted in massive health and economic consequences, with effects felt most acutely by populations that were disadvantaged prior to the pandemic. For families with young children, the effects have been compounded by service interruptions, though there is a lack of empirical evidence that demonstrates how COVID-19 has affected home visiting programs. This cross-state study is the first to examine the effects of the pandemic on home visiting enrollment, engagement, and retention patterns.
Program implementation records gathered from 2017-2020 in Arkansas and Wisconsin were analyzed. Both states operate a large network of home visiting programs that serve predominantly low-income families and that are supported by the federal Maternal, Infant, and Early Childhood Home Visiting program. Trends prior to COVID were compared to post-COVID trends (March 12 to December 31, 2020) in program enrollments, service capacity, visitation frequency, service modalities, attrition rates, and service duration.
Compared to average pre-pandemic enrollments from 2017-2019, post-COVID enrollments decreased by 33-36%. Total visits fell by 15-24%; the percentage of completed visits relative to expected visits declined more modestly. However, the average duration of services increased post-COVID while rates of early program dropout decreased.
The findings suggest that enrollment and engagement in home visiting decreased during the COVID-19 pandemic, which is unfortunate given the large number of vulnerable families served nationwide. Further research is needed to examine how COVID affected both consumer and program behaviors. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
COVID-19 疫情对健康和经济造成了巨大影响，受疫情影响最严重的是那些在疫情前处于不利地位的人群。对于有年幼子女的家庭来说，服务中断使情况更加复杂，尽管缺乏实证证据表明 COVID-19 如何影响家庭探访项目。这项跨州研究首次考察了疫情对家庭探访项目的参与、参与度和保留率的影响。
对阿肯色州和威斯康星州 2017 年至 2020 年收集的项目实施记录进行了分析。这两个州都运营着一个庞大的家庭探访项目网络，主要为低收入家庭提供服务，并得到联邦孕产妇、婴儿和儿童早期家庭探访项目的支持。将疫情前的趋势与 2020 年 3 月 12 日至 12 月 31 日（疫情后）的项目注册、服务能力、探访频率、服务模式、流失率和服务持续时间进行了比较。
与 2017 年至 2019 年的平均疫情前注册人数相比，疫情后注册人数下降了 33%-36%。总探访次数下降了 15%-24%；相对于预期探访次数，完成探访的比例下降幅度较小。然而，疫情后服务的平均持续时间增加，而早期项目辍学率下降。
这些发现表明，在 COVID-19 大流行期间，家庭探访项目的参与和参与度下降，考虑到全国范围内服务的弱势家庭数量众多，这令人遗憾。需要进一步研究来考察 COVID 如何影响消费者和项目行为。
