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Parents as Teachers Launches Home-Visiting Program With Technology Twist

Parents as Teachers, a 32-year-old program that supports vulnerable families through regular face-to-face interactions with trained counselors, is launching a new pilot program in Los Angeles that will drop the "home" part of home visiting. 

Sixty-five families are getting tablets that will allow them to have twice-monthly chats with parent-educators through a Web-based conference system. The pilot program is a partnership parents_as_teachers_web_pilot.jpgbetween Parents as Teachers and the University of Southern California's school of social work, whose graduate students will be working with the families. LA Best Babies Network, an organization that supports pregnant women, newborns, and families, recruited the participants, and the virtual visits are expected to begin in April. 

In addition to the regular conferences with parent-educators, families will have a chance to interact online every month with other families participating in the pilot program. Group meetings are a part of the Parents as Teachers model and are traditionally held in schools, libraries, or other community meeting spaces. And the educational toys and books that families would normally get when they meet face-to-face with counselors will be provided in an introductory kit. 

The technological backbone of the project is USC's Telehealth Clinic, which has been delivering secure mental-health counseling online since 2013 and is like "Skype on steroids," said Dorian Traube, an associate professor at the USC school of social work. The system allows group participation and permits leaders to do things like "share" handouts. 

Traube is also the lead investigator of a research project associated with the pilot program, which is intended to yield information on how to best adapt home visiting to Web-based models. "One of the things we're really focusing on is trying to figure out the elements to engage families," she said.

What Is Home Visiting?

Home-visiting programs have long been a tool for agencies that focus on family health and well-being. The 2009 Affordable Care Act gave a boost to home visiting by creating the Maternal, Infant and Early Childhood Home Visiting Program. MIECHV provides money to states to implement evidence-based home-visiting programs. Parents as Teachers is one of 17 models shown to improve parenting skills and improve child outcomes.

Though the models have similar goals, they can vary in structure and focus. The Nurse-Family Partnership, for example, sends registered nurses into the homes of first-time expectant mothers who are no later than their second trimester of pregnancy and focuses on maternal health and child development until age 2. Another model, Home Instruction for Parents of Preschool Youngsters works with families who have children between 3 and 5 years old. It focuses more on early learning.

Parents as Teachers operates in all 50 states and works with a family from a child's conception until the start of kindergarten. Its four goals are to increase parents' knowledge of child development and improve parenting practices, provide early detection of developmental delays and health issues, prevent child abuse and neglect, and increase children's school readiness. 

So why try out a Web-based model? Traube explained that many families that need help are reluctant to have someone visit them at home. The teleconferencing program would also work for families who live in remote areas, or in areas that are difficult for parent-educators to get to because of safety concerns. 

The online platform would also allow counselors to have higher caseloads, because they don't have to account for travel time. Even though Los Angeles is densely populated, routine traffic jams make travel a challenge, Traube said.  And finally, the online interface will allow more scheduling flexibility. 

Learning Through Online Home Visiting

The Web-based program extends not only to the families, but to the parent-educators themselves. Rather than meeting face-to-face meetings to learn the new technology, those educators will also be trained through the same platform that families are expected to use. 

"We want the practitioners to experience the philosophy in training," said Donna Hunt O'Brien, the director of training, curriculum, and program innovations at Parents as Teachers National Center in St. Louis.

There are a lot of questions about how home visiting will fit into the virtual world. For example, part of Parents as Teachers' educational model includes playdates, where parent-counselors observe children with their parents and offer ideas for positive interactions. Figuring out how to do those observations virtually—without having the young children being completely distracted by the tablet—will be an interesting challenge, she said 

"What we think we'll see is what we've seen before with videotaping. First the child wants to look at themselves. Then it just becomes a part of what's happening.," O'Brien said. 

The pilot will also help Parents as Teachers learn the characteristics of families and of parent-educators who operate well in the virtual environment.

"Different generations of parents will respond differently. But I don't think we should make an assumption that the platform changes the relationship," she said. "We need to study if something gets in the way." 

Photo illustration: Sixty-five Los Angeles families will receive face-to-face counseling via Web-based conference sessions, part of a partnership between Parents as Teachers and the University of Southern California's school of social work.—Courtesy Parents as Teachers National Center.

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