Changes in the Utilization of Home Visiting Services During COVID-19: Analysis of the National Parents as Teachers Program

This study utilizes Andersen’s Behavior Model of Health Services Use to examine changes in the utilization of home visiting (HV) services after the onset of the pandemic and subsequent shift to virtual HV service delivery. HV programs are a vital public safety net program for low-income young children and families in the US, many of whom continue to face considerable challenges in recovering from the pandemic. Linear and logistic regressions were utilized to examine whether there were differences in predisposing factors, enabling resources, and need for families enrolling in the national Parents as Teachers HV program before and after the onset of the pandemic. In terms of predisposing factors, there were no significant differences in terms of parent/guardian race, ethnicity, language, or employment. However, families differed in terms of risk factors—for example, families enrolling after the onset of the pandemic were more likely to have a history of child abuse and neglect. Similarly, in terms of enabling resources, referrals from child protective services increased from 6.4% to 10.6% after the onset of the pandemic. In terms of need, while the average number of resource connections dropped during the pandemic, referrals for basic needs increased significantly from 29.2% to 43.3%, with 54% of families initiating services. Results show differences in some predisposing factors, enabling resources, and need. Findings suggest that HV programs should focus attention on families’ immediate concerns and move to a crisis intervention model as families continue to recover from the impacts of the pandemic.