PROJECT ABSTRACT Project Title: Coaching the Coaches: Supporting Family Involvement in Virtual Home Visits through Video Feedback Applicant Organization: Arkansas Department of Health Address: 4815 West Markham, MS-16, Little Rock AR 72205 Project Director: Tamara Baker Phone Numbers: P 501-661-2531, F 501-661-2464 E-mail: email@example.com Website Address: healthy.arkansas.gov This application is for Track Two. Annotation: This proposal supports virtual delivery of evidence-based home visitation (EBHV) by generating knowledge on implementation and effectiveness of a video-coaching innovation. Virtual EBHV was rapidly implemented during the COVID-19 pandemic, but it is still mostly unknown how virtual services impact family involvement. We will: 1) combine program and administrative data to study virtual services; and 2) design, pilot, and evaluate a workforce video-coaching innovation to increase family retention. The proposed innovation will promote the success and sustainability of virtual EBHV delivery and reach rural, underserved populations disproportionally affected by COVID-19. Problem: Prior to COVID-19, family involvement with in-person EBHV was greatly variable. Nationally, fewer than half of families (46%) participating in multiyear EBHV were retained for one year. In Arkansas, roughly 15% percent of families left services in the first 90 days, and another 25% left within the first 180 days. After the start of COVID-19, there was a reduction in the number of completed home visits, suggesting possible lessening of family involvement. Further, the effectiveness of virtual delivery of EBHV is still largely unknown. Purpose: There are two goals for the proposed project: 1) to understand and 2) to improve upon the current practices of virtual visits using a new innovation of video coaching to support rapport-building during the intake phase to promote family involvement. Goals and Objectives: Goal 1: Generate knowledge on the
retention, equity, and effectiveness of virtual visits. To achieve this goal, we will 1) determine if the content of home visits differs based on the delivery method and structural and social determinants of health (SSDOH), 2) determine how delivery methods and SSDOH are associated with EBHV duration and intensity, and 3) determine how healthcare utilization outcomes and immunization completion of EBHV participants are associated with home visiting delivery methods and SSDOH. Goal 2: Increase retention rates in virtual services. To achieve this goal, we will 1) design and pilot a video-coaching intervention that strengthens relationship-building during the intake phase of home visitation, 2) engage key stakeholders to collect feedback on adaptations needed to make video coaching feasible for widespread EBVH implementation, and 3) evaluate the effectiveness of video coaching, overall and by participants’ risk-factors. Methodology: Video coaching provides trainees a direct learning experience as services transition to virtual modalities. Coaches review trainees’ performances, work with them to identify specific areas for improvement, and provide guidance for adjustments. This pilot intervention will be implemented in the first 3 months of services, which are the most influential for participants’ engagement. We hypothesize that home visitors who receive coaching (N=36) will demonstrate improved technical skills compared to home visitors who did not receive the intervention (N=48), as assessed by HOVRS scales and length of family involvement in services (Goal 2). Using data from self-reflections on the coaching experience, we will also assess home visitors’ views on the utility of this intervention. To establish the effectiveness of virtual visits, we will compare administrative data to EBHV participants of similar background who received in-person visits (Goal 1).