Shifting from in-person to virtual home visiting in Los Angeles County: Impact on programmatic outcomes

Abstract

Purpose This paper describes the effect that the COVID-19 pandemic, and subsequent shift from in-person to virtual (video-based) home visiting, had on the Los Angeles County Welcome Baby Home Visiting Program. Description The Welcome Baby (WB) Program is a voluntary, universal home visiting program for expectant women and women with infants in Los Angeles County implemented in 14 hospitals in Los Angeles County. Oversight of the program is managed by LA Best Babies Network (LABBN) and funded by First 5 LA. The COVID-19 pandemic forced Welcome Baby Home visitors to shift from in-person home visits to virtual visits, which had an impact on programmatic outcomes. Assessment LABBN manages a database utilized by WB sites. In assessing data trends before and during the pandemic, shifting to virtual visits resulted in an increase in both missed visits and completed visits, and a decrease in overall visit length. Completion of required assessments and overall client program completion were not affected by the COVID-19 pandemic. Conclusion The Welcome Baby sites across Los Angeles County were able to successfully migrate in-person visits to a virtual platform, proving that virtual visits are possible and do provide some programmatic benefits. However, the long-term efficacy of virtual visits remains to be seen, and further research is warranted.

Using Community Health Workers to Improve Health Outcomes in a Sample of Hispanic Women and Their Infants: Findings from a Randomized Controlled Trial

“…Anecdotally, study staff reported it was easier organizing visits virtually than in-person visits and participants liked the delivery mode. Similar to other home visiting programs impacted during COVID-19 (e.g., Bock et al, 2021), the opportunity suggests that virtual visits are feasible for delivery of MIHOW and should be considered in future efforts. In addition, when the group meetings for women assigned to the MIHOW group converted to a virtual format, attendance more than doubled.…”

“…Total scores range between 0 and 30. Scores > 10 may indicate minor depressive symptomatology with scores > 13 indicating a likely depressive illness (Cox et al, 1987; Lara-Cinisomo et al, 2017). Cronbach's alphas of the scores in the current study ranged from 0.78 to 0.87.…”

“…Midway through the last year (year 3) of the study, the COVID-19 pandemic provided challenges and opportunities. With extremely limited information available on conducting home visits virtually (Bock et al, 2021), the team quickly converted in-person MIHOW and data collection visits to a virtual format. At the time of conversion, study enrollment was complete and most participants had received several study contacts.…”

Effects of COVID-19 on home visiting services for vulnerable families: A cross-state analysis of enrollment, engagement, and attrition patterns.

“…For instance, some programs administered by public health agencies reassigned home visiting staff to COVID-related duties. Programs may have enhanced client engagement and retention by shifting from in-home to telehealth modalities (Bock et al, 2021; Williams et al, 2021), though these transitions often come with technological and logistical challenges (Marshall et al, 2020; Traube et al, 2020). Perhaps the most plausible reason for the decrease in early program dropout is the decrease in enrollments during COVID.…”

Transitioning to virtual interaction during the COVID‐19 pandemic: Impact on the Family Connects postpartum home visiting program activity

“…Families with vulnerabilities have also been disproportionately affected by the burden of the COVID‐19 pandemic which might have affected program participation (Kirby, 2020 ; Raifman & Raifman, 2020 ). On the contrary, program completion rates and adherence to requirement protocol assessments remained at high levels during the transition to virtual delivery during the pandemic for the Welcome Baby universal home‐visiting program for expectant mothers and women with infants in the Los Angeles County (Bock et al., 2021 ). However, the Welcome Baby recipients are considered low‐risk which might have contributed to high program participation both pre‐ and post‐pandemic onset (Bock et al., 2021 ).…”