Home Visitor Individual Interview 12 Month

OMB Control No: _____

Expiration Date: ______

Length of time for instrument: 1.50 hours

ATTACHMENT 25: MIHOPE HOME VISITOR INDIVIDUAL INTERVIEW_12 MONTH

5/29/2012

HOME VISITOR INDIVIDUAL INTERVIEW - 12 MONTH

PROTOCOL

Thank you for agreeing to participate in this interview. Your participation is important to the Maternal Infant Home Visiting Program Evaluation (MIHOPE) study. I’m _____________ and I work for _______________, an independent research firm/university.

We are conducting a study for the Department of Health and Human Services to learn about home visiting programs funded by the Maternal, Infant, and Early Childhood Home Visiting program. We want to talk to home visitors to learn about your experiences providing services and working with families, as well as the support and training you receive to carry out your role. Our reports will describe the experiences and viewpoints expressed, but comments will not be attributed to specific individuals or programs. No individuals will be quoted by name.

I would like to tape-record our interview. I am taping our interview so I can listen to it later when I write up my notes. No one besides our research team will listen to the tape. If you want to say anything that you don’t want to be taped, please let me know and I will be glad to pause the recorder. Do you have objections to being part of this discussion or to be tape-recorded?

The interview will take about 75 minutes.

Once again, thank you for participating. Do you have any questions before we get started?

A. OUTCOME PRIORITIES

1. From your perspective, which outcomes are the most important ones that you work on with families? Which are least important?

2. Are there any outcomes where you put a different priority on an outcome than your program does?

IF YES, ASK:

3. How does this influence the activities you carry out to achieve an outcome? For example, do you ever devote more time and attention to activities than your program expects, because you put a different priority on it?

4. How does your supervisor respond to this?

B. THEORY OF CHANGE

Let’s talk about your program’s theory of change, that is, its philosophy for how services will improve those intended outcomes.

1. Does your program site specify any theories of behavior to explain how home visitors’ actions will lead to improved outcomes for parents and children? Do you know what theories, if any, your program is based on?

FOR EACH THEORY, ASK:

1. What does this theory mean to you? How does it influence the activites you carry out and how you interact with families?

C. WORKING WITH FAMILIES

ENJOYMENT WORKING WITH DIFFERENT TYPES OF FAMILIES

1. Please describe the families you work with and how they vary in terms of strengths and needs.

2. Families are different in many way. What types of families do you most and least enjoy working with? I’m especially interested in what it is that distinguishes these two types of families.

3. How would you compare the activities you carry out with the families you enjoy working with most and least?

BUILDING RELATIONSHIPS WITH FAMILIES

4. Let’s focus on family engagement. What strategies do you use to build relationships with families? What strategies do you use when it is challenging to build a relationship?

5. With what types of families do you feel you build the strongest relationships?

6. Some of the families in your caseload are in the MIHOPE study. [NAME THEM.] With which families do you feel you have an especially strong relationship?

7. What strategies did you use with these families to establish a strong relationship with them?

APPROACHES TO WORKING WITH WELL VS. POORLY ENGAGED FAMILIES

8. Families can differ in how open they are to home visiting. Some families are very eager for home visiting services, are willing to share information on sensitive issues, and are receptive to to education and support to address these issues. Other families are more guarded, are reluctant to discuss sensitive issues, and seem disinterested in education and support to address these issues. Do you have experience with both types of families?

IF YES, ASK:

1. Let’s consider two mothers who are both in a violent relationship, but in one case the mother is open to discussing this and in the other she is not. How would you compare the activities you carry out with each mother?

2. How effective do you feel you would be working with each mother?

3. How much would you look forward to visits with each mother?

EMOTIONAL EXHAUSTION

9. Home visiting is a very challenging job. It can be emotionally exhausting. Do you ever feel this way? What types of situations give rise to this?

D. APPROACHES TO CARRYING OUT INTENDED SERVICES

Each interview will focus on issues felt to be most relevant for the participant, based on responses to the web-based surveys and logs. Candidate topics and questions include:

COMFORT CARRYING OUT ROLE IN GENERAL

1. Home visiting involves carrying out many different activities with families. Think about the different activities you are expected to carry out with families. What activities do you feel most comfortable and competent carrying out?

2. What activities do you feel least comfortable and competent carrying out?

3. Is your lack of comfort with some activities common across all families, or does your comfort vary by family? IF VARIES BY FAMILY, ASK: For what types of family are you least comfortable carrying out these activities?

4. How would you rate the support your supervisor provides you to deal with this lack of comfort? What are the strengths and weaknesses of her reponse to this?

CHOOSING TOPICS FOR VISITS

5. In preparing for visits, how do you make decisions about the topics to be covered?

6. When you make a visit, how often are you able to carry out the activities you had planned on the topics you had planned?

7. Is your difficulty carrying out planned activities common across all families, or greater for some families? Why is it especially hard to carry out planned activities with some families?

8. How would you rate the support your supervisor provides you to deal with this situation? What are the strengths and weaknesses of her response?

BALANCING FAMILY AND PROGRAM OBJECTIVES

9. Sometimes family and program objectives are quite different. Have you experienced this situation?

IF YES, ASK:

1. How do you reconcile families’ interests/concerns and program objectives? How challenging is this?

2. Is it hard to balance family and program objectives where these differ for all families, or are there certain families where it is especially hard to balance family and program objectives? How would you describe these families?

3. How would you rate the support your supervisor provides you to deal with this situation? What are the strengths of this support? The weaknesses?

IDENTIFYING BEHAVIORAL RISKS FOR POOR PARENTING

10. Does your program expect you to screen or raise the subject of behavioral risks for poor parenting to identify poor parental mental health, substance use and partner violence?

IF YES, ASK:

1. How well has your training has prepared you, and how well do your supervisor and program experts support you in identifying families with these issues?

2. How comfortable are you in carrying out these activities?

3. Are there families for whom it is especially hard to carry out what is expected of you? Which familes are these, among your MIHOPE families?

4. How much does it concern you that a family might leave the program or mistrust you if you ask about these risks?

5. Do you ever choose not to screen rather than risk losing a family?

ADDRESSING BEHAVIORAL RISKS FOR POOR PARENTING

11. What are your program’s expectations regarding your response to parental depression, anxiety, high stress, substance use or partner violence?

12. How well has your training prepared you, and how well do your supervisor and program experts support you in addressing these issues?

13. How comfortable are you in carrying out these activities?

14. Are there families for whom it is especially hard to carry out what is expected of you? Which families are these, among your MIHOPE families?

15. How much does it concern you that a family might leave the program or mistrust you if you ask about these risks?

16. Do you ever choose not to address these risks rather than risk losing a family?

REINFORCEMENT OF PARENTING BEHAVIORS

17. What are your program’s expectations regarding your feedback to parents on their parenting behavior? Are you expected both to reinforce positive parenting behaviors and also to give constructive feedback on ways to improve their parenting, or just to reinforce positive behaviors?

IF BOTH, ASK:

1. How easy or difficult is it for you to provide constructive feedback on ways to improve parenting? If it is difficult, what makes it hard for you to do this?

2. Are there certain families for whom it is especially hard for you to do this? How easy or hard is it to do this for each of your MIHOPE families?

CONSTRUCTIVE FEEDBACK TO PROMOTE POSITIVE PARENTING

18. What are your program’s expectations regarding your actions to promote positive parenting? Are you expected only to reinforce positive behaviors, or to use observed ineffective, harsh and neglectful behaviors as an opportunity to discuss parenting beliefs and attitudes and to suggest and demonstrate alternative parenting behaviors?

IF CONSTRUCTIVE AS WELL AS POSITIVE FEEDBACK, ASK:

1. How well has your training prepared you, and how well do your supervisor and program experts support you in providing constructive feedback?

2. How comfortable are you in providing constructive feedback?

3. Are there families for whom it is especially hard to do this? Which families are these, among your MIHOPE families?

4. How much does it concern you that a family might leave the program or mistrust you if you provide constructive feedback on parenting behaviors?

5. Do you ever choose not to provide constructive feedback rather than risk losing a family?

BUILDING MATERNAL REFLECTIVE CAPACITY

18. Does your program expect you to help mothers build their capacity to observe their own parenting behavior and to reflect on the reasons for their behavior and to adopt more positive behaviors even if this is not comfortable for them?

IF YES, ASK:

1. How well has your training prepared you, and how well do your supervisor and program experts support you in building maternal reflective capacity?

2. How comfortable are you in doing this?

3. Are there mothers for whom it is especially hard to do this? Which mothers are these, among your MIHOPE families?

4. How much does it concern you that a mother might become upset, might leave the program, or might not trust you, if you act to build her reflective capacity?

5. Do you ever choose not to carry out these activities rather than risk upsetting a mother, losing a family or losing a mother’s trust?

E. PROFESSIONAL DEVELOPMENT

1. What competencies – what knowledge and skills – are you expected to have to carry out your role?

2. What feedback has your supervisor given you on your knowledge and skills?

3. How useful has that feedback been in helping you to build your knowledge and skills?

4. How could your program improve the way it assesses and gives you feedback on how well you carry out your role?

5. What does reflective supervision mean to you? Does your supervisor use this approach? How do you feel about it?

6. What kinds of concerns do you talk about with your supervisor? How well is she able to address your concerns? Can you give me an example?

7. Have you had concerns for which your supervisor was not able to provide the expertise or supports you needed? Can you give me an example?

8. Are there issues that trouble you about your job but that you don’t feel comfortable discussing with your supervisor?

IF YES, ASK:

1. Are you willing to share these with me?

2. What are the reasons you have not raised these issues with your supervisor?

1. How well does your program help you prevent and deal with emotional exhaustion from working with challenging families, and what might it do better in this regard?

F. WRAP UP

Thank you for taking the time to talk with me today. Is there anything else you would like to add before we end the interview?