Evaluating the Home Visiting Community Health Worker Program: A Pre-Post Study

Researcher(s)

  • Alyssa Brown, Health Behavior Science, University of Delaware

Faculty Mentor(s)

  • Kathleen McCallops, Center for Community Health and Empowerment, ChristianaCare
  • Eli Turkel, Center for Community Health and Empowerment, ChristianaCare

Abstract

Title: Evaluating the Home Visiting Community Health Worker Program: A Pre-Post Study

Background: Home visiting programs are administered to connect households expecting a child, or with young children, toservices that improve health and wellness outcomes. ChristianaCare’s Home Visiting Community Health Worker (HVCHW) program functions as a key facilitator to these outcomes by educating families on the benefits of home visiting. This study aims to evaluate outcomes from the HVCHW program, primarily referral and enrollment rates to home visiting and healthcare utilization among patients.

Methods: Patient data (n=47) were gathered from referral data housed in REDCap which included patient demographic data, social care and baby essential needs, and connections to home visiting. Data from Unite Delaware and electronic health records were queried to assess social care referrals and healthcare utilization. Descriptive statistics were run in R to examine process evaluation outcomes and to evaluate 2 month pre–postchanges in healthcare utilization.

Results: Patients ranged in age from 15 to 42, with 72% of the sample identifying as Black/African American, 66% as Non-Hispanic or Non-Latino, and 85% preferring to speak English. Only 17% of patients enrolled in home visiting, with 24% already enrolled and 59% declining referral. Inpatient and emergency department utilization remained unchanged for most patients, likely due to the study’s brief period (i.e., 2 months pre- and post).

Conclusions: The decline in home visiting enrollment may reflect limitations such as limited family engagement, irrelevant program content, or difficulty connecting with CHWs. To adequately assess pre- and post-referral patient outcomes, more comprehensive data needs to be collected. This would increase the efficacy of future evaluations and program improvements.