Personal Encounters: An Innovative Home Visitation Model for High-Risk Families (A8)

A model for building a trustworthy system in which families are identified and appropriate services are delivered through both personal and group experiences and collaborative referrals.

Transcript

1. Personal Encounters: An Innovative Home Visitation Model for High-Risk Families (A8) Aimee Hilado, PhD, Claudia Quigg, MEd, and Christine Leow, PhD Zero To THREE National Training Institute December 9, 2011
2. What is Baby TALK? A model for building a trustworthy system in which families are identified and appropriate services are delivered through both personal and group experiences and collaborative referrals
3. Workshop Agenda  Introduce the Baby TALK model of intervention with high-risk families.  Discuss innovative components of the model that support home-visiting services.  Share current research on the Baby TALK model.  Provide strategies for enhancing program effectiveness in the area of identification and recruitment.
4. Where is Baby TALK?  In 36 states and Canada  Demonstration program in Decatur, Illinois  In new communities as professionals are trained
5. What makes Baby TALK unique?  A commitment to building seamless systems, not taller silos!  A passion for reaching families with whatever they need to be successful with their children
6. Baby TALK’s mission is to positively impact child development and nurture healthy parent-child relationships during the critical early years.
7. The Baby TALK model: 12-words  Build a system.  Screen every family.  Identify the need.  Deliver appropriate services.
8. Critical Concepts 1. “Tell me about your baby.” 2. Going where families are 3. Coming alongside 4. Building relationships 5. Collaboration 6. Systems building 7. Parallel process 8. Facing difficult issues 9. Becoming even better
9. Component 1: Building a trained staff In order to implement the model in your area, professionals must attend training through the Baby TALK Training Institute  What is the Training Institute?  What will I learn?  What support is available after training?
10. Who can implement Baby TALK?  Educators  Librarians  Health care providers  Early intervention providers  Case managers  Home visitors  Family support/social workers
11. Component 2: Strategic placement of Baby TALK staff throughout the community
12. Program Delivery Models: Personal Encounters and Group Encounters All are collaborative & purposeful
13. Earliest Encounters: Opportunities to Meet Newborns  Hospital OB units  Clinical settings such as WIC, Prenatal Clinics, Pediatrician’s office, Health Department  Family Literacy  Home visits  Baby TALK Times  Pre-Kindergarten
14. is not to recruit people for our program… but rather to have a high quality interpersonal experience with a family which concludes with enrollment into BT in our quest to become “ever better” “Making Space for the Heart of our Work” Our goal for Encounters
15. Assessment of the Situation  What is the atmosphere/activity level of the environment? ◦ Are there distractions for the parent or child?  What is the availability of the family? ◦ Assess the emotional availability of the family ◦ Note family dynamics and the emotional temperature
16. Component 3: Creating a “trustworthy system of care” for participants
17. Nurturing the Relationships  System Building  Community Collaboration  Agreements with other agencies
18. Working across agencies to design seamless systems, not silos
19. Make sure collaborative goals benefit everyone
20. Baby TALK Professionals as Gracious Guests  Programming is held at community sites  We remain flexible  We are conscious of the emotional temperature of the environment  We are conscious of the physical environment
21. Transitions in Collaborations What happens when . . . ◦ A key collaborator leaves a position? ◦ When a collaborating agency moves their site where you were providing services?
22. What can you accomplish together if you combine efforts and resources to build a better system?
23. Baby TALK Standards Area V Family and Community Partnerships A. Develop relationships with families to support their goals B. Nurtures healthy working relationships with collaborators C. Goes where families already are in the community D. Promotes the referral process E. Promotes ongoing collaborations across varied social service agencies
24. Component 4: Providing extensive support through personal encounters  Every encounter will include ◦ Preparation ◦ Assessment of situation ◦ Affiliation ◦ Observation ◦ Developmental Behaviors ◦ Exploration of System of Support ◦ Introduction to BT and system of care ◦ Reflection
25. Does the model work? Current research findings
26. BT components under review 1. Early identification – can the model identify families early? 2. Recruitment – does the model serve high- risk families? 3. Retention – what elements of the model support high retention and return rates? 4. Child and family outcomes – are there positive gains for participants?
27. Baby TALK Logic Model PERSONAL ENCOUNTERS: In Prenatal Clinics, Hospitals, High School/Alternate Programs, WIC clinics, etc. PARENT ACTIVITIES: Intensive Home Visitation; Educational support for high school/GED diploma; Education on child development content and positive parenting behaviors; Access to relevant social services CHILD ACTIVITIES: Intensive Home Visitation; Access to early childhood programming i.e. Early Head Start; Early Intervention, Lapsits; Family Fun Times activities PARENT SHORT TERM EFFECTS: Increased knowledge of child development, increased knowledge of effective parenting skills, increased confidence levels, increased academic skills that earn a GED or diploma, lowered parent toxic stress PARENT LONG TERM EFFECTS: Increased positive parent-child interactions, strengthened parenting skills, improved health seeking behavior, increased competence in accessing services, reduced child abuse/neglect, reduced drop-out rates, increased graduation rates CHILD - SHORT TERM EFFECTS: Increased educational experience 0-3 years, lowered toxic stress; CHILD - LONG TERM EFFECTS: Improved social, behavioral, language, and cognitive skills (school readiness), Fewer school-age placements in special education
28. Current Study Context: Early Identification & Recruitment  What did we study?  Who was involved?  Relevant comparison groups included ◦ Illinois Early Childhood Asset Map (IECAM) ◦ U.S. Census Bureau ◦ Head Start Family and Child Experience Survey (FACES 2003)
29. Major Findings  The model’s approach to identifying at- risk families (personal encounters) allows early childhood professional to identify high-risk participants early and implement supportive or intervention services as soon as possible.
30. Maternal Education 19.1% 36.2% 28.5% 16.3% 33.1% 37.3% 25.8% 3.7% 0.0% 20.0% 40.0% 60.0% 80.0% 100.0% Baby TALK (n=5,370) Head Start (n=2,289)
31. Maternal Employment  Remaining percentages reported “other;” or “self- employed or student” 50.8% 42.2% 52.8% 47.3% 0.0% 20.0% 40.0% 60.0% 80.0% 100.0% Employed Unemployed Baby TALK (n=4,903) Head Start (n=2,165)
32. Marital Status  Remaining percentages reported divorced, separated, or widowed 42.4% 53.1% 4.5% 59.9% 22.8% 17.2% 40.6% 40.9% 18.5% 0.0% 20.0% 40.0% 60.0% 80.0% 100.0% Married Single *Other Baby TALK (n=5,100) Macon County (n=82,167) Head Start (n=2,297)
33. Income Levels 34.1% 13.9% 10.7% 9.6% 7.6% 24.1% 35.8% 34.7% 17.2% 6.6% 3.2% 2.6% 0.0% 20.0% 40.0% 60.0% 80.0% 100.0% Baby TALK (n=2,960) Head Start (n=2,315)
34. Characteristics of of Young Mothers Mothers under the age of 20 (n=234)  72% of young mothers had less than a high school diploma.  51.9% of young moms lived with extended family while 17.6% lived in single-parent homes. Only 9.9% lived in a two-parent household  82.7% of young mothers made less than $10,000 annually  44.2% of young moms reported being unemployed at the time of identification. Only 12.1% said they were employed and the remaining percentages reported student status.  56.7% of young moms identified as Black, 34.8% identified as White, 2.3% identified as Hispanic and 3.2% reported Other
35. Early Identification The top three Decatur locations were: 1. Hospital settings ◦ 56% of mothers (2,419 mothers) were identified at Decatur Memorial Hospital and St. Mary’s hospital combined 2. A public health facility for low-income mothers ◦ 22% (937 mothers) were located at the Women, Infant, and Children (WIC) social service office. 3. A community health clinic ◦ An additional 10% (424 mothers) were identified at the Community Health Improvement Center (CHIC) Decatur office.
36. Early Identification of Young Mothers Young mothers under the age of 20 years were first encountered in the following top five Decatur locations: 1. Hospital settings (29% - 168 moms) 2. A local WIC social service office (30% - 170 moms) 3. A community health clinic (13% - 76 moms) 4. High school and alternative high school programs (11% - 65 moms) 5. Local public libraries (7% - 40 moms)
37. Understanding the BT model and retention rates  BT Home-visiting study: Context ◦ How do we define a successful home-visit? ◦ What are the elements of BT’s home-visiting model that keeps families engaged? ◦ The BT model’s ability to address challenges with high-risk participants?  Findings
38. Reflections from a study participant  Parents said it was important to have a connection early in their pregnancy.  Parents wanted home-visitors who were educators and supportive, but didn’t belittle them. Quotes from parents: “[The home-visitor] came over and they was more, they was active with me and my baby. That’s what I liked most. They wasn’t just ignoring her and just talking to me. They were interacting with me and the baby… It was good. They just taught me a lot of things that I didn’t know and more things that can help me. More things that can help me relate with her better.”
39. Quotes about home-visitors  “[The home-visitor] really got a good way with kids. A very soft kind-hearted way…I would trust her with my kid and nobody gets my kid.”  “We don’t have much but what we do have is a lot of love and a lot of ability to find help. You know I, I wasn’t given that as a kid. I wasn’t raised by my parents so it’s nice to have the help now.”
40. Reflections from a BT home-visitor  Home-visitors defined success as parents who allowed them into the home, and parents who were open to materials and support.  Home-visitors felt the BT model helped them make stronger connections with participants.
41. Quotes from home-visitors on the challenges facing families.  “It’s like you want to focus on child development but how can you really expect the family to focus on child development when they might not have food or a place to live or a safe place to sleep at night. And do a little extra support and advocate for them. I mean the good thing is we do have a lot of relationships with so many places in town that we can get extra services and help for these families.”  Speaking of common ground between parents and Baby TALK, one home-visitor said: “They [parents] love their child and then when they realize we love them too, and that we want to help, then it’s starts opening up a little bit.”
42. Pulling it together  What do these findings suggest for best practices in early childhood interventions?  What are the policy implications for these preliminary findings?
43. Next steps: BT Research Agenda  Examine national trends in BT programs across the country  Examine child and family outcomes ◦ Toxic stress levels (parent-child) ◦ Social-emotional/Cognitive readiness for children ◦ Health and safety compliance ◦ Parent self-efficacy and self-sufficiency ◦ Positive parenting skills
44. Next steps for practitioners and researchers  Integrate the BT model in your programs and communities ◦ Training is available ◦ Strategies of the BT model can be incorporated without being cost prohibitive  Get involved in the research initiatives and keep informed on our upcoming findings. Go to www.babytalk.org, Tab -> The Research Institute
45. Website: www.babytalk.org Claudia Quigg, M.Ed. Baby TALK Inc., Founding Executive Director cquigg@babytalk.org Aimee Hilado, Ph.D. Loyola University Chicago ahilado@luc.edu Christine Leow, Ph.D. Branch Associates, Inc. cleow@branchassoc.com