Home visitor perspectives on implementing a precision approach to home visiting in communities serving Native American families.
Home visitor perspectives on implementing a precision approach to home visiting in communities serving Native American families.
复制标题
家访者对在服务美国原住民家庭的社区中实施精准家访方法的看法。
DOI：
10.1002/imhj.22012
复制
发表时间：
2022
影响因子：
2.4
通讯作者：
Haroz,EmilyE
中科院分区：
文献类型：
--
作者：
Russette,HelenC;Grubin,Fiona;Ingalls,Allison;Martin,Lisa;Leonard,Amanda;Kushman,Elizabeth;Cisler,Aimee;Leffler,Elizabeth;Herman,Angelina;Haroz,EmilyE
家庭精神（FS）是联邦政府认可的循证家访计划，作为准家庭和有幼儿家庭的关键预防策略。与其他家访计划一样，它在实施过程中分享了客户在保留和参与方面的挑战。我们评估了（1）对金融服务实施精确方法的可行性和可接受性;（2）金融服务交付方法的差异。家庭访客，主要服务于美洲原住民家庭，提供了一个标准的（N= 6）或精确的方法（N= 6），FS在四个研究中心，每个参加了多达四个虚拟焦点小组讨论（FGD）（N= 16）。在课程方法、关系和背景层面上确定了实施的促进因素和障碍。促进因素：相关和文化敏感的课程、课程结构、客户-家庭访客关系、客户购买、家庭访客自主权、领导力支持、灵活的资金和培训。障碍：不相关的课程，物质使用内容，缺失的主题，经历危机的家庭，客户和家庭访客的可用性，客户反馈，不支持的领导，资金不足以及组织政策和做法。精确方法提供（1）支持内容与客户相关性的课程定制;（2）支持课程交付灵活性的目标时间框架。这种模式结构可以提高客户的参与度和保留率。
Family Spirit (FS) is a federally endorsed evidence‐based home visiting programs serving as a key prevention strategy for expectant families and families with young children. Like other home‐visiting programs, it shares client challenges in retention and engagement during implementation. We assessed (1) the feasibility and acceptability of implementing a precision approach to FS; and (2) differences in approaches to FS delivery. Home visitors, serving primarily Native American families, that delivered a standard (N= 6) or a precision approach (N= 6) to FS across four study sites each participated in up to four virtual focus group discussions (FGDs) (N= 16). Facilitators and barriers to implementation were identified across the curriculum approach, relational and contextual levels.Facilitators: Relevant and culturally sensitive lessons, lesson structure, client–home visitor relationship, client buy‐in, home visitor autonomy, leadership support, flexible funding, and training.Barriers: Irrelevant lessons, substance use content, missing topics, families experiencing crises, client and home visitor availability, client feedback, nonsupportive leadership, inadequate funding, and organizational policies and practices. The precision approach offers (1) tailoring of lessons that supports relevance of content to clients; and (2) a target timeframe that supports flexibility in lesson delivery. This model structure may improve client participation and retention.