Service Coordination in Early Childhood Home Visiting: a Multiple-Case Study

作     者：Correll, Leeya West, Allison Duggan, Anne K. Gruss, Kelsey Minkovitz, Cynthia S. 

作者机构：Johns Hopkins Bloomberg Sch Publ Hlth Dept Populat Family & Reprod Hlth Baltimore MD 21205 USA 

出 版 物：《PREVENTION SCIENCE》 (预防科学)

年 卷 期：2023年第24卷第6期

页      面：1225-1238页

核心收录：

学科分类：12[管理学] 1204[管理学-公共管理] 120402[管理学-社会医学与卫生事业管理(可授管理学、医学学位)] 1004[医学-公共卫生与预防医学(可授医学、理学学位)] 10[医学] 

基　　金：Robert Wood Johnson Foundation Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) [UD5MC24070, UD5MC30792] NIMH T32 training grant [T32MH122357] 

主　　题：Home visiting Service coordination Early childhood Multiple-case study Qualitative 

摘      要：Early childhood home visiting is a preventive service delivery strategy that aims to promote child and parent health, positive parenting, child development and school readiness, and family economic self-sufficiency. To meet families needs, programs provide a combination of direct services, and referrals and linkages to community-based services. Service coordination is therefore a critical component of home visiting s role within the early childhood system of care. This multiple-case study describes facilitators and barriers to service coordination, as identified by home visiting program staff and families. We interviewed program managers, supervisors, home visitors, and families from four local home visiting programs in the eastern USA with diverse contextual characteristics that showed evidence of having strong coordination. Using multiple-case study methodology, we analyzed the data to understand key facilitators and barriers to service coordination for each case and identify and describe common themes across cases. Facilitators included interagency relationships and collaboration;a culture of teamwork;dedicated, well-connected staff;supervision;trusting relationships with families;and warm handoffs. Barriers to service coordination were limited availability and accessibility of local resources, perceived stigma among other service providers, and families ambivalence toward some services. Home visiting staff and families emphasized that relationships at multiple levels are fundamental to service coordination, barriers are complex, and coordination is time- and labor-intensive. Coalitions that bring together diverse stakeholder groups at the state and local levels can provide meaningful coordination support to the early childhood services.