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The challenge of relationships and fidelity: Home visitors' perspectives

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  • Barak, Adi
  • Spielberger, Julie
  • Gitlow, Elissa

Abstract

This qualitative study examines home visitors' perspectives on their practical attempts to establish and maintain relationships with clients while also maintaining fidelity to their evidence-based program model. Drawing from a sample of 85 home visitors from three types of evidence-based home visitation programs in Illinois, our results demonstrate that home visitors often feel compelled to adjust the program curriculum to clients' perceived needs. Home visitors also feel that in order to establish and maintain relationships with clients they need to be flexible in working days and working hours, accept alternative meeting places, use cell phones and text messaging, and address crisis situations before presenting the curriculum. Although they acknowledged paperwork as being important to support fidelity, they also perceived it as harming the natural course of relationships or devaluing the importance of relationships in successful programs. State budget cuts, which led to local program instability, also emerged as a barrier to relationships. The cuts discouraged home visitors from using flexible practices within the context of model fidelity. This paper offers a framework for understanding the tensions between relationships and fidelity and discusses implications for policy.

Suggested Citation

  • Barak, Adi & Spielberger, Julie & Gitlow, Elissa, 2014. "The challenge of relationships and fidelity: Home visitors' perspectives," Children and Youth Services Review, Elsevier, vol. 42(C), pages 50-58.
    • Handle: RePEc:eee:cysrev:v:42:y:2014:i:c:p:50-58
    DOI: 10.1016/j.childyouth.2014.03.023
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    References listed on IDEAS

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    1. Kaye, Sarah & Osteen, Philip J., 2011. "Developing and validating measures for child welfare agencies to self-monitor fidelity to a child safety intervention," Children and Youth Services Review, Elsevier, vol. 33(11), pages 2146-2151.
    2. repec:mpr:mprres:6901 is not listed on IDEAS
    3. Krysik, Judy & LeCroy, Craig Winston & Ashford, Jose B., 2008. "Participants' perceptions of healthy families: A home visitation program to prevent child abuse and neglect," Children and Youth Services Review, Elsevier, vol. 30(1), pages 45-61, January.
    4. Levine, D. & McCright, J. & Dobkin, L. & Woodruff, A.J. & Klausner, J.D., 2008. "SEXINFO: A sexual health text messaging service for San Francisco youth," American Journal of Public Health, American Public Health Association, vol. 98(3), pages 393-395.
    5. Riley, Shireen & Brady, Anne E. & Goldberg, Jessica & Jacobs, Francine & Easterbrooks, M. Ann, 2008. "Once the door closes: Understanding the parent-provider relationship," Children and Youth Services Review, Elsevier, vol. 30(5), pages 597-612, May.
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    Cited by:

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    2. Shanti, Caroline, 2020. "The early head start (EHS) home visitor perspective: What does it take to engage parents?," Children and Youth Services Review, Elsevier, vol. 116(C).
    3. Suzanne D. Thomas & Sandra C. Mobley & Jodi L. Hudgins & Donald E. Sutherland & Sandra B. Inglett & Brittany L. Ange, 2018. "Conditions and Dynamics That Impact Maternal Health Literacy among High Risk Prenatal-Interconceptional Women," IJERPH, MDPI, vol. 15(7), pages 1-16, July.
    4. Goldberg, Jessica & Bumgarner, Erin & Jacobs, Francine, 2016. "Measuring program- and individual-level fidelity in a home visiting program for adolescent parents," Evaluation and Program Planning, Elsevier, vol. 55(C), pages 163-173.
    5. Ramey, Heather L. & Rose-Krasnor, Linda, 2015. "The new mentality: Youth–adult partnerships in community mental health promotion," Children and Youth Services Review, Elsevier, vol. 50(C), pages 28-37.

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