Center for Child and Family Policy, Duke University, Durham, North Carolina, USA.
Department of Pediatrics, Duke University, Durham, North Carolina, USA.
Infant Ment Health J. 2022 Jan;43(1):159-172. doi: 10.1002/imhj.21953. Epub 2022 Jan 8.
In this paper, we analyze program activity for Family Connects (FC), an evidence-based postpartum home-visiting intervention, during the COVID-19 pandemic. When the pandemic began, FC transitioned to a virtual protocol which maintains key psychosocial components of the in-person protocol and adjusts health assessments to address the lack of in-person contact. Program performance is contrasted for periods before the pandemic onset (April 2019-March 2020) and after the onset (April 2020-March 2021), involving 10,280 scheduled visits and 6696 visited families (46% non-Hispanic white; 20% non-Hispanic Black; 23% Hispanic; and 10% other race). Post-pandemic onset, FC program participation rates were at 89.8% of pre-pandemic levels. Home visitors observed post-onset increases in families' concerns about home safety but declines in families' needs related to infant care. Community connections were facilitated for 42.9% of visited families post-pandemic onset compared to 51.1% pre-pandemic onset. We conclude that post-pandemic onset virtual delivery rates of FC declined but are high enough to merit continued implementation during a period when some families will decline in-person visits. When in-person visits are deemed safe per public health guidelines, the findings suggest a hybrid approach that could maximize program outreach by prioritizing in-person contact and offering virtual delivery as a second choice.
在本文中,我们分析了家庭联系(FC)项目的活动情况,该项目是一种基于证据的产后家访干预措施,在 COVID-19 大流行期间实施。大流行开始时,FC 过渡到虚拟方案,保留了面对面方案的关键心理社会组成部分,并调整了健康评估,以解决缺乏面对面接触的问题。方案实施情况在大流行前(2019 年 4 月至 2020 年 3 月)和大流行后(2020 年 4 月至 2021 年 3 月)进行了对比,涉及 10280 次预约和 6696 次家访(46%为非西班牙裔白人;20%为非西班牙裔黑人;23%为西班牙裔;10%为其他种族)。大流行后,FC 项目参与率达到了大流行前水平的 89.8%。家访人员观察到,家庭对家庭安全的担忧在大流行后有所增加,但与婴儿护理相关的家庭需求有所下降。与大流行前相比,在大流行后,有 42.9%的家访家庭建立了社区联系。我们的结论是,FC 的大流行后虚拟交付率有所下降,但仍足够高,值得在一些家庭拒绝面对面访问的时期继续实施。当根据公共卫生指南认为面对面访问是安全的时候,调查结果表明,采用混合方法可以通过优先考虑面对面接触,并将虚拟交付作为第二选择,最大限度地扩大项目的覆盖面。