Objectives This study was conducted to look inside home visits to examine active intervention ingredients used and their relations with ratings of home visit quality. In particular, triadic interactions that engage the home visitor, parent, and child together and provide a context for home visitors to facilitate parent-child interactions by observing, modeling and coaching behaviors that promote optimal child development were examined. Methods Observations were conducted to describe intervention activities (with the HVOF-R) and rate quality of home visit practices and engagement (with the HOVRS A+). Results Analyses revealed the majority of home visit time (71%) was spent in home visitor-parent interactions with only a small proportion of home visit time (17%) spent in triadic interactions and an even smaller proportion of time (2%) during which home visitors actively coached parent-child interactions. Amount of time spent in triadic interactions was related positively to quality ratings of home visit practices and engagement. Moreover, time spent coaching parent-child interactions uniquely predicted home visit quality after accounting for visit length and home visitor time spent observing and modeling. Conclusions for Practice Increasing the percentage of home visitors engage the parent and child in triadic interaction should be a focus for home visiting programs. Home visitors will likely need professional development and supervisory support to enhance their skills in coaching parent-child interactions during triadic interactions.
Examination of and support for specific practices that promote high‐quality home visiting are essential as family support programs continue to expand across the country. The current study used direct observation of 91 home visits across 41 home visitors to examine relations among interaction partners, content of the interactions, the home‐visitors’ activities, and quality of home‐visitors’ practices and family‐members’ engagement within programs funded by the Maternal, Infant, and Early Childhood Home Visiting program. More time spent in triadic interactions focused on child‐related content, as measured by the Home Visit Rating Scale‐Revised, was related to higher quality of family engagement in home visits, as measured with the Home Visit Observation Rating Scales. Time spent in adult‐focused interactions and administrative tasks, however, was related to lower quality of home‐visiting practices and family engagement. Implications for research and practice are discussed.
Research-based professional development opportunities for early childhood home visitors are valuable to the Early Head Start-Home-Based Option (EHS-HBO) and to the home visiting field broadly to strengthen effective practice. We explored EHS-HBO home visitors' (N = 5) perspectives on effective practice through a professional development activity that included viewing videos of their own practice, analyzing the video and assessment data of their practice and parent-child interactions, and reflection. A convergent mixed methods multiple-case study was used. A variety of skills were noted within each case as indicators of effective practice, suggesting that a plethora of complex skills are needed to work with families. Across-case analytic strategies were used to compare subthemes, codes, and substantial statements across cases to generate themes. Two major themes emerged from our data analysis across cases: practicing self-reflective consciousness and building foundations for parent-child interactions. The findings have implications for professional development activities.
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