Chapin Hall

Even with Shortened Training, Home Visitors can Improve Skills

A previous study showed positive impacts on home visitors’ ability to engage parents in home visits after an 18-month training in the Facilitating Attuned Interactions (FAN) approach, developed by Erikson Institute’s Fussy Baby Networks. However, the length and intensity of the training was difficult for staff to manage with their other responsibilities. This study was developed to see whether training in the FAN approach could be delivered effectively in a shorter time period (12, 9, or 6 months). Results indicated that a shorter training in the FAN approach had similar effects on program staff as the original 18-month training. The condensed FAN training helped staff understand and regulate their own feelings, see parents’ perspectives, and better able to support parents in solving their own problems.

What We Did

We conducted a quasi-experimental, mixed-methods evaluation to understand the effects of the training on program staff and parents in the program. Training in the FAN approach was delivered to home visitors and supervisors at 17 home visiting programs using the Parents as Teachers and/or Healthy Families America model in Illinois over a period of time ranging from 6 months to 12 months. We assessed the impact of the training on the staff’s practice through interviews, measures of burnout and reflective capacity, and surveys with home visitors, supervisors, and mental health consultants.

What We Found

Results indicate that a condensed training in the FAN approach changed home visitors’ ability to focus on parenting and collaborate with families and built their reflective capacity. Training also enhanced supervisors’ ability to support home visitors. Although the study indicated that staff could learn the FAN approach in a shorter period of time than the original 18-month period, the 9- or 12-month training period was somewhat more effective than the shorter, 6-month period.

Use of the approach changed the structure and dynamics of the home visit. After the training, home visitors were more attentive to parents’ cues, better able to focus on parenting, and better able to explore the concerns of parents. In addition, there was a significant increase in home visitors’ reflective capacity and a decrease in emotional exhaustion and depersonalization, two aspects of burnout.

Furthermore, supervisors—who were instrumental in helping home visitors learn the FAN approach—became more reflective themselves, more attentive to home visitors’ needs and concerns, and better able to support their staff.

These findings were evident in two different home visiting program models, Healthy Families America programs and Parents as Teachers. Although the FAN approach may fit more easily with programs that emphasize reflective capacity in staff and encourage parent-led vs. curriculum-focused visits, the approach can be adapted to different program models and organizational contexts.

What It Means

Home visiting programs face a number of challenges in engaging and serving families in high-risk communities while also developing and retaining skilled home visiting staff. Training in the FAN approach was designed to address these needs. Results from this study indicated that a 9- or 12-month training in the approach changed home visitors’ ability to focus on parenting and parent engagement and builds their reflective capacity.

Supervisors were particularly important in supporting the approach. This suggests that prior to investing in training, efforts should be made to assess supervisors’ understanding of the approach and commitment to implementing it in their program, as well as home visitors’ time for training and readiness for change.

The evaluation of the condensed training did not assess family or child outcomes. However, home visitors, supervisors, and mental health consultants all suggested that implementing the FAN approach improved relationships with families. Further study is needed to learn whether these changes in relationships and home visit dynamics improve family participation in home visiting and, in turn, strengthen the parenting context for child development.