Challenges, Benefits Found in Providing Home Visiting Services for Pregnant and Parenting Foster Youth

In 2015, the Illinois Home Visiting Task Force established a subcommittee to design and implement a pilot project to connect pregnant or parenting youth in foster care with home visiting services. A major goal of that pilot project was to promote collaboration between the home visiting and the child welfare systems. Results from an implementation study of the pilot project point to both the ongoing challenges and benefits associated with providing home visiting services to pregnant or parenting youth in foster care.

What We Did

Ten Healthy Families Illinois (HFI) programs participated in the pilot project. The Illinois Department of Children and Family Services contracted with Chapin Hall to conduct an implementation study. We used a mixed-method design to examine the home visiting services that youth enrolled in the pilot project received, assess fidelity to the HFI model, and identify barriers to implementation. We also measured parent-, child- and system-level outcomes. The implementation study used three types of data:

  • Program data: Home visitors and doulas entered data about each completed and missed home visit into a web-based data collection
  • Interview Data: Semi-structured interviews were conducted with home visitors, doulas, home visiting supervisors, and pilot
  • Administrative Data: DCFS administrative data were used to examine the demographic characteristics and placement histories of pilot participants and to track child welfare services involvement among their children.

What We Found

Home visiting services can successfully be delivered to pregnant and parenting youth in care.  Over 29 months, home visitors and doulas completed 972 visits with 43 pilot project participants who were pregnant or parenting. Both participants and service providers reported that participants benefitted from the services they received in a variety of ways ranging from increased knowledge of child development, enhanced parenting skills and improved co-parenting relationships.

At the same time, engaging pregnant and parenting youth in care in home visiting services can be difficult. It often took additional time for home visitors and doulas to build rapport and trust with participants.  Factors such as unstable living arrangements and mental health crises made delivering home visiting services to participants particularly challenging.  Faced with these challenges, home visitors and doulas sometimes deviated from their usual way of delivering services to accommodate participants’ needs and circumstances.

What It Means

As a result of the Family First Prevention Services Act, states can claim federal reimbursement for providing families whose children are at risk for foster care placement with evidence-based home visiting services. This has the potential to significantly increase access to evidence-based home visiting services among child welfare system-involved families across the country. The lessons we learned from the pilot project can help child welfare systems and home visiting programs prepare for the challenges they are likely to face engaging and delivering home visiting services to eligible families.

Recommended Citation
Dworsky, A., Gitlow, E., & Ethier, K. (2018). Home visiting for pregnant and parenting youth in care: Final report. Chicago, IL: Chapin Hall at the University of Chicago.

Watch presentation from Home Visiting Summit 2021

Download the Pilot Evaluation Report
Download the Pilot Evaluation Brief