Reflective Outcomes and Organizational Transformation Study in Home Visiting (ROOTS-HV) - Home visiting programs rely on a skilled and stable workforce to provide effective services to children and families. However, home visitors frequently experience high levels of occupational stress, burnout, and secondary traumatic stress due to the complex needs of the families they serve, contributing to workforce retention challenges and reduced job satisfaction. Reflective supervision (RS) is widely recommended as a workforce support strategy and is encouraged by many evidence-based home visiting models and the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program. RS is intended to promote professional growth, emotional support,and reflective practice among home visitors. Despite its widespread use, there is limited evidence regarding which specific reflective supervision practices are most strongly associated with positive workforce outcomes. Existing research has identified significant gaps in the measurement and evaluation of RS and a need for studies that examine how supervisory practices influence workforce well-being, engagement, and retention. To address this gap, the proposed ROOTS- HV study will conduct a multisite, longitudinal mixed-methods evaluation of existing reflective supervision practices in Georgia Maternal, Infant, and Early Childhood Home Visiting (MIECHV) and Healthy Start (HS) home visiting programs. Using the Supervisor Practices in Reflective Supervision-Home Visiting (SuPRS-HV) measure, the study will examine how specific supervisory practices are associated with workforce outcomes, including perceived supervisory support, self-efficacy, burnout, job satisfaction, engagement, and intent to remain in the workforce. Findings will generate actionable knowledge for home visiting programs seeking to strengthen supervisory systems and support workforce sustainability. These sites are located in urban and rural areas and utilize. Georgia’s Maternal, Infant, and Early Childhood Home Visiting (MIECHV) and Healthy Start programs serve pregnant individuals, new and expectant parents, infants, young children, and families who may experience social, economic, and other factors that can affect maternal and child health and family well-being. Participants are primarily families who may benefit from coordinated, family centered services that promote healthy pregnancies, positive parenting, child development, and access to community resources. For the ROOTS-HV study program participants can therefore serve not only as recipients of services but also as meaningful partners whose lived experiences and recommendations inform research questions, outcomes, implementation strategies, and the translation of findings into practice. The study aims to: (1) describe how reflective supervision is implemented across participating programs; (2) examine variation in RS practices across programs, supervisors, and settings; (3) assess associations between SuPRS-HV practices and workforce outcomes, including perceived supervisory support, professional confidence, job stress and burnout, work engagement, job satisfaction, and intent to remain in the workforce; (4) examine caregiver-home visitor relationship outcomes and compare caregiver-home visitor perspectives and (5) examine the utility of SuPRS-HV as a continuous quality improvement tool that strenthen workforce supports and program quality. Using repeated SuPRS-HV assessments, home visitor surveys, program and supervisor characteristics, administrative workforce data, and qualitative interviews and focus groups, the project will identify patterns and associations between reflective supervision practices and workforce well-being. Findings will provide actionable evidence to support workforce retention, professional development, and continuous quality improvement within Georgia’s home visiting system.
