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A Qualitative Exploration of Co-location as an Intervention to Strengthen Home Visiting Implementation in Addressing Maternal Child Health

Maternal and Child Health Journal volume 22, pages 883–892 (2018)Cite this article

Abstract

Objectives The aim of this paper is to explore the process and impact of co-locating evidence-based maternal and child service models to inform future implementation efforts. Methods As part of a state-wide evaluation of maternal and child home visiting programs, we conducted semi-structured interviews with administrators and home visitors from home visiting agencies across Pennsylvania. We collected 33 interviews from 4 co-located agencies. We used the Consolidated Framework for Implementation Research (CFIR) to describe the key elements mitigating implementation of multiple home visiting models. Results A primary advantage of co-location described by participants was the ability to increase the agency’s base of eligible clients through the implementation of a model with different program eligibility (e.g. income, child age) than the existing agency offering. Model differences related to curriculum (e.g. content or intensity/meeting frequency) enabled programs to more selectively match clients to models. To recruit eligible clients, new models were able to build upon the existing service networks of the initial program. Co-location provided organizational opportunities for shared trainings, enabling administrative efficiencies and collaborative staff learning. Programs implemented strategies to build synergies with complementary model features, for instance using the additional program option to serve waitlisted clients and to transition services after one model is completed. Conclusions for Practice Considerable benefits are experienced when home visiting models co-locate. This research builds on literature encouraging collaboration among community agencies and provides insight on a specific facilitative approach. This implementation strategy informs policy across the social services spectrum and competitive funding contexts.

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Acknowledgements

We would like to acknowledge the administrators and home visitors who generously shared their time and valuable input with us to make this research possible. We would also like to acknowledge the contributions of research staff at the Mixed Methods Research Lab who helped manage and code the qualitative dataset.

Funding

This research was funded by the Commonwealth of Pennsylvania Department of Human Services.

Author information

Authors and Affiliations

  1. PolicyLab, Children’s Hospital of Philadelphia, 2716 South St, Philadelphia, PA, 19146, USA

    Katherine S. Kellom, Meredith Matone & David M. Rubin

  2. Division of General Pediatrics, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA

    Meredith Matone & David M. Rubin

  3. Department of Pediatrics, University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, USA

    David M. Rubin

  4. Mixed Methods Research Lab, University of Pennsylvania, 51 N. 39th St., Philadelphia, PA, 19104, USA

    Frances K. Barg & Peter F. Cronholm

  5. Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, USA

    Frances K. Barg & Peter F. Cronholm

  6. Center for Public Health Initiatives, University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, USA

    Frances K. Barg & Peter F. Cronholm

  7. Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, USA

    Frances K. Barg

  8. Leonard Davis Institute of Health Economics, University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, USA

    Peter F. Cronholm

  9. The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH, 43210, USA

    Aderinola Adejare

Authors
  1. Katherine S. Kellom
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  2. Meredith Matone
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  3. Aderinola Adejare
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  4. Frances K. Barg
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  5. David M. Rubin
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  6. Peter F. Cronholm
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Contributions

The initial research proposal was developed by DR and MM with input from PC and FB. Data collection and analysis were performed by KK, AA, and PC. All authors contributed to the development and writing of the manuscript and have approved the final version for publication.

Corresponding author

Correspondence to Peter F. Cronholm.

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The authors declare that they have no conflict of interests.

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Kellom, K.S., Matone, M., Adejare, A. et al. A Qualitative Exploration of Co-location as an Intervention to Strengthen Home Visiting Implementation in Addressing Maternal Child Health. Matern Child Health J 22, 883–892 (2018). https://doi.org/10.1007/s10995-018-2463-8

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  • DOI: https://doi.org/10.1007/s10995-018-2463-8

Keywords

  • Home visiting
  • Qualitative methods
  • CFIR
  • Implementation strategies
  • Early childhood system