Enriching home visits to engage patients

Enriching home visits to engage patients

Home visitors are on the frontlines of battling the effects of poverty on children and their families. They coordinate family support services including health care, transportation, housing, job placement, counseling, and, in some places like Wyandotte County and southeast Kansas, they even bring Early Head Start into the homes of low-income children.

Project Engage, directed by Kathryn Bigelow, assistant research professor, and co-directed by Dale Walker, associate research professor, is training these family support advocates to implement a proven language promoting intervention with parents of children ages 12 to 30 months enrolled in home-based Early Head Start. In addition to the 90-minute weekly home visits, half of the 146 parents will also get five text messages per week that reiterate how they can help develop their children’s language development in the critical first years of life.

Parents can talk to their babies during everyday routines such as bathing or diapering, explained Bigelow. Parents can describe what they are doing as they change a diaper, such as “Here’s your foot!” or imitate and expand on their baby’s vocalizations during a bath. Later, when toddlers begin to gesture and talk, parents can acknowledge, imitate and encourage those attempts, she said.

While this may seem familiar and natural to many parents, many families need explicit guidance in supporting their child’s language development is is particularly true for highly mobile, low-income families led by single parents who may have had parents who used a less positive style of communicating.

Parenting programs designed to improve parenting practices have suffered from a lack of parent engagement and retention, said Bigelow, but the hope is that with the addition of reminders and activity suggestions delivered via cell phone, programs can increase the “dosage” of parenting instruction with minimal expense in both urban and rural communities. In turn, children would start school ready to learn and to read—the ultimate goal of Early Head Start.

The randomized controlled trial will measure parent engagement, parent-child interaction and child language.

The findings from Project Engage will become part of President Obama’s Bridging the Word Gap initiative, directed by Walker with Judith Carta and Charles Greenwood, who along with Bigelow, are researchers at the Kansas City, Kansas-based Juniper Gardens Children’s Project located in the Children’s Campus.