Author Affiliations: Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco (Drs Franck and Mehra); and Department of Family and Community Medicine, University of California, San Francisco (Drs Remy and Rienks).
J Public Health Manag Pract. 2024;30(3):403-410. doi: 10.1097/PHH.0000000000001910. Epub 2024 Apr 10.
Prior to the COVID-19 pandemic, home visiting services for low-income children and families were provided almost entirely in person. Little is known about clients' experience of home visiting provided virtually by video or phone instead of, or in addition to, in-person home visiting.
To explore the views of clients in the California Work Opportunity and Responsibility to Kids (CalWORKs) Home Visiting Program (HVP) across California during the first 2 years of the pandemic.
Forty counties in California.
CalWORKs HVP clients, currently enrolled or who left the program in the 6 months prior to each survey.
Clients' ratings of participation in and experiences with the CalWORKs HVP services, as well as unmet needs.
We collected 1617 surveys from clients across 3 survey rounds. Pandemic-related restrictions resulted in decreased frequency of home visits and a shift from in person to primarily virtual visits. As in-person home visit frequency decreased, there were significant declines in clients' level of agreement that they learned child development skills (P = .04), received parenting services (P = .015) or activities (P < .001), or received infant and child nutrition services (P = .003). There were no declines in level of agreement that the CalWORKs HVP improved the quality of life of clients and their children.
Clients consistently rated the CalWORKs HVP as positively contributing to their and their children's well-being, regardless of the shift from in person to virtual visits. Clients' participation in some program components decreased over the evaluation. However, it is unknown if clients received fewer referrals, were hesitant to pursue the referrals, or if fewer services were available. Continued research is needed to evaluate the merits and disadvantages of virtual visits as in-person home visits resume postpandemic.
在 COVID-19 大流行之前，为低收入儿童和家庭提供的家访服务几乎完全是面对面进行的。对于通过视频或电话而不是面对面的家访，或者作为家访的补充来提供虚拟家访服务，客户的体验知之甚少。
在大流行的头 2 年，探索加利福尼亚州“工作机会和儿童责任”（CalWORKs）家访计划（HVP）中的客户对加利福尼亚州 40 个县的看法。
CalWORKs HVP 客户，目前在调查前的 6 个月内注册或离开该计划的客户。
客户对 CalWORKs HVP 服务的参与度和体验的评价，以及未满足的需求。
我们在 3 轮调查中从客户那里收集了 1617 份调查。大流行相关的限制导致家访频率降低，并从面对面转为主要虚拟访问。随着面对面家访频率的降低，客户对他们学习儿童发展技能（P =.04）、接受育儿服务（P =.015）或活动（P <.001）或接受婴儿和儿童营养服务（P =.003）的同意程度显著下降。客户对 CalWORKs HVP 提高客户及其子女生活质量的评价并没有下降。
无论从面对面访问转为虚拟访问，客户始终对 CalWORKs HVP 给予积极评价，认为其对自己和孩子的幸福有贡献。在评估过程中，客户对一些计划组成部分的参与度有所下降。然而，目前尚不清楚客户是否获得了较少的转介，对寻求转介犹豫不决，或者是否提供了较少的服务。随着大流行后恢复面对面家访，需要继续进行研究以评估虚拟访问的优缺点。
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