The Impact of the COVID-19 Pandemic on the Delivery of Community Resources in Georgia's Home Visiting Program Restricted; Files Only

Abstract

Background: Home visiting programs are a key early intervention strategy to promote positive health and social outcomes for at-risk expectant mothers and families with young children. The Georgia Home Visiting Program is comprised of 21 program sites implementing evidence-based home visiting models such as Healthy Families Georgia, Nurse-Family Partnership, and Parents as Teachers. The unprecedented novel COVID-19 pandemic forced home visiting programs to transition to a virtual environment as in-person visits were halted to prevent the spread of the virus. 

Purpose: To assess the factors affecting the coordination of community resources by home visitors and the subsequent receipt of these resources by home visiting clients during the pandemic in order to provide recommendations to strengthen this key home visiting service.

Methods: The concurrent mixed methods study collected data from all 21 program sites. Data collection included online surveys and in-depth interviews (IDIs) with home visiting staff (120 surveys, 8 interviews) and clients (317 surveys, 5 interviews). Surveys and IDIs were analyzed separately, and findings were compared and contrasted in a final stage of data interpretation. 

Results: Since the start of the COVID-19 pandemic, home visiting clients reported specific community resource and social support needs, such as housing, employment, food, and mental health care. Home visiting staff were able to assist clients with these needs by expanding their collaboration with local agencies. Clients appreciated the support they received from their home visitors to connect to these agencies and identified this as a key factor in receiving the services they needed. However, community resource linkages were not always successful, due to either a lack of understanding of the available community resources and the discontinuation of community resources due to the pandemic. In some cases, clients faced barriers to resources when services could only be accessed online. 

Discussion: The coordination of community resources is a crucial home visiting service more than ever during a global pandemic with economic repercussions to many home visiting clients and their families. Fortunately, home visitors are able to successfully continue serving clients and addressing their needs with referrals to wrap around services.

Table of Contents

INTRODUCTION………………………………………………………………………………...1

LITERATURE REVIEW………………………………………………………………………….5

METHODS…………………………………………………………………………………….....27

RESULTS………………………………………………………………………………………....36

I.          PARTICIPANT CHARACTERISTICS………………………………………...........37

II.        RESOURCE NEEDS DURING THE PANDEMIC..........................................41

III.      COMMUNITY RESOURCE REFERRALS....................................................52

IV.      ACCESS/RECEIPT OF COMMUNITY RESOURCES.....................................63

V.        RECOMMENDED ACTIONS TO IMPROVE RESOURCE COORDINATION....69

DISCUSSION………………………………………………………………………………….....72

RECOMMENDATIONS………………………………………………………………………...82

CONCLUSION…………………………………………………………………………….….....86

REFERENCES…………………………………………………………………………….……...86

APPENDIX A: HOME VISITING STAFF AND CLIENT SURVEYS…………………….102

HOME VISITING STAFF SURVEY……………………………………………………….….102

HOME VISITING CLIENT SURVEY………………………………………………………...115

APPENDIX B: HOME VISITING STAFF AND CLIENT INTERVIEW GUIDES……...128

HOME VISITING STAFF IN-DEPTH INTERVIEW GUIDE…..……………………...…128

HOME VISITING CLIENT IN-DEPTH INTERVIEW GUIDE……….....……………....133

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	home visiting community resources social services mixed methods social determinants of health
Committee Chair / Thesis Advisor	Clark, Cari Jo, Emory University
Committee Members	Blake, Sarah C., Emory University
Partnering Agencies	Georgia state or local health department

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