5 Home Visitor Group Interview Guide

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INSTRUMENT 5 Home Visitor Group Interview Guide

Public Burden Statement: According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0906-XXXX. This information collection aims to explore how families that experience disparities in outcomes targeted by the MIECHV program experience home visiting services. This study is an initial step in understanding those experiences and will provide a better understanding of how MIECHV-funded home visiting programs currently address disparities and promote equity. Data collection activities include interviews, focus groups, online surveys, program observations, and review of documents and management information systems data. The time required to complete this information collection is estimated to average 1 hour and 30 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, to review and complete the information collection. This information collection is voluntary and confidentiality is followed according to law. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: HRSA Information Collection Clearance Officer, 5600 Fishers Lane, Room 14N39, Rockville, MD or [email protected].

Note to OMB: The Home Visitor Group Interview uses a semi-structured qualitative approach, as recommended by Weiss (1995).¹ This approach allows the HV-AIM project team to pursue the same constructs across participants while developing depth and coherence from groups regarding the meaning of the constructs from their subject position. These group interviews are focused primarily on the co-construction of knowledge². Therefore, the items in the protocol are designed to address the constructs under investigation while providing adequate space for the interviewer and participants to develop meaning through an exchange of ideas. The group interviews are distinct from a “survey interview approach,” which collects categorical data in a fixed-item interview format.

This is a guide, not a script. These are example questions that are similar to the questions we will ask. We will tailor the questions based on findings from the family survey and information learned about the program from the local implementing agency and family nomination form. We will also tailor questions based on participant responses.

Home Visitor Small Group Interview Guide

Introduction and Consent

Thank you for taking the time to talk with us about your experiences as home visitors working with Black families.

First, I’d like to read an informed consent statement, which you all also received by email. It may be helpful to follow along with the statement I read as it includes standard language we are required to state.

You are all invited to participate in a group discussion about your experiences as a home visitor working with Black families. The information collected in this discussion will inform considerations for program improvement efforts related to removing potential barriers to family enrollment and engagement in home visiting services and providing supports for families from historically marginalized communities.

This is not an interview to evaluate your performance. Participation in the group discussion is voluntary. The discussion will take approximately 60 minutes. You may choose not to participate in the discussion or end your participation at any time without affecting your employment. You can decline to answer any questions for any reason. There are no foreseeable risks to your participation in the interview. Although you do not receive any direct benefits from participating in this interview, your stories and input will help to improve home visiting services for families from historically marginalized communities. Your name or other personally identifying information will not appear in any report and your responses to this discussion will remain private to the extent permitted by law. We will not share any of your responses with anyone else at your home visiting program. Your anonymous responses, however, may be included in a report that is shared with our funders and made available to the public.

I’d like to record our discussion so we can be sure to capture your responses accurately. No one besides the HV-AIM project team will listen to the recording. If you want to say anything you do not want recorded, please let me know and I will be glad to pause the recording. Recordings will be transcribed and analyzed, and then destroyed. All the information you share in this discussion will be stored in a password protected electronic database and will only be accessible to the HV-AIM project team.

Do you agree to participate in the group discussion?

• Yes • No

May I record the discussion?

• Yes • No

[If a participant does not want to be recorded, a team member will take notes.]

Great, let’s get started. Today’s discussion will focus on understanding how you have worked with Black families in providing home visiting services.

Introduction

We would like to start by getting to know everyone a bit more. Let’s go around and everyone can introduce themselves and tell us how long you have been a home visitor. And, if you feel comfortable sharing, please tell us one thing you are proud of as a home visitor.  

As we go through introductions, please complete the poll using the link provided in the chat or the instructions on the slide so we can learn about who is joining the discussion. [Will provide poll to respondents to gather demographic and background information, using questions listed below].

1. I identify my race or ethnicity as (please select all that apply):  

1. American Indian or Alaska Native (For example, Navajo Nation, Blackfeet Tribe of the Blackfeet Indian Reservation of Montana, Native Village of Barrow Inupiat Traditional Government, Nome Eskimo Community, Aztec, Maya, etc.)

2. Asian (For example, Chinese, Asian Indian, Filipino, Vietnamese, Korean, Japanese, etc.)

3. Black or African American (For example, African American, Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc.)

4. Hispanic or Latino (For example, Mexican, Puerto Rican, Salvadoran, Cuban, Dominican, Guatemalan, etc.)

5. Middle Eastern or North African (For example, Lebanese, Iranian, Egyptian, Syrian, Iraqi, Israeli, etc.)

6. Native Hawaiian or Pacific Islander (For example, Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, Marshallese, etc.)

7. White (for example, English, German, Irish, Italian, Polish, Scottish, etc.)

8. Prefer not to answer

2. Are you: Mark all that apply.

1. Female  

2. Male  

3. Transgender, non-binary or another gender  

4. I prefer not to answer  

3. I am: 

1. 18-21 years old 

3. 22-29 years old 

4. 30-44 years old 

5. 45 years old or older 

3. I have worked as a home visitor for:

1. Less than 6 months

2. 6 months-1 year

3. 2 years-3 years

4. 4 years-5 years

5. More than 5 years

Now, we would like to talk a little about your experiences and thoughts on working with and supporting Black caregivers through home visiting. 

Reflective Organization

1. How does your home visiting program engage in reflective practices? Reflective practices in home visiting typically involve “stepping back” to consider the meaning of what is happening in interactions and relationships, and to examine professional and personal responses to inform plans and decision making about next steps. This might include internal reflective dialogue, reflection with colleagues, or reflection in the context of group or individual supervision.

1. Please describe the range of reflective practices within your home visiting program.

2. Please tell me about a time when you discussed a parent or caregiver’s experience with racism within your programs reflective practice.

   1. How did reflecting on this experience change your perspective on race?

3. What types of resources are available in your home visiting program to support you in reflecting on this type of event or family experiences with racism?

4. Tell me about the reflective supervision practice that would help you address this issue.

Race Talk

1. Can you tell me about a time when your colleagues were talking about a Black family enrolled in your program and an experience of racism came up?

   1. What was the experience?

   2. How did you address it?

   3. [If the participant says that they have not been a part of such an exchange]

      1. What are your thoughts on why this type of conversation has not come up in your work?

Implicit Bias

1. Research shows that some Black parents and families experience worse outcomes than White parents and families in areas such as education, health, and economics.

   1. What do you think about this?

   2. What do you believe contributes to some Black parents and families experiencing worse outcomes?

2. Are any of you familiar with the term implicit bias?

   1. [If no, provide a definition before moving on]

      1. Definition: Implicit bias is a form of bias that occurs automatically and unintentionally, that nevertheless affects judgments, decisions, and behaviors.

   2. Some in the home visiting field have suggested that addressing implicit bias about race could improve services to Black families. What are your thoughts on that suggestion?

   3. Have you attempted to address implicit bias? If so, how? What were the challenges? Did it support your work with Black families?

3. How do you support Black families when they share an experience of racism?

   1. What enabled you to provide a supportive response?

   2. What challenges or barriers did you experience to provide a supportive response?

4. What would help you feel confident and comfortable in supporting Black families when they share experiences of racism?

5. Can you each describe strategies you use to center and promote race equity in your work with Black families?

6. What challenges or barriers do you face in centering and promoting race equity in your work with Black families?

Equity Budgeting

1. Can you each tell me about how your program has provided formal trainings or workshops that prepared you to have conversations focused on race like the ones we just discussed?

   1. How does your program ensure you have adequate time to attend training or workshops?

   2. How does your program provide time for follow-up and coaching to support and apply information learned in trainings or workshops?

   3. How do you include what you learning from trainings and workshops into your actual practices, if at all?

Recommendations

1. In what ways does your program work to ensure that home visiting services are accessible to Black families?

   1. Can you describe successful strategies for recruiting and enrolling Black caregivers?

   2. Can you describe any challenges or barriers experienced in recruiting and enrolling Black caregivers?

2. What advice would you have for home visiting programs that are trying to make their home visiting services accessible to Black caregivers?

3. What advice would you have for other home visitors that are working to be responsive to the experiences of Black caregivers?

Reflections

1. Having participated in this discussion, what is your comfort level with discussing racism and racial equity? Do you feel supported or knowledgeable about speaking on this topic?

2. Do you think these are top concerns or priorities of your program? If so, how? If not, why is that?

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