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Early Impacts of COVID-19  

From the June 2020 HFA Network Health Survey

The COVID-19 pandemic brought sudden and dramatic changes to home visiting, including financial and technology challenges for families and program sites.  Healthy Families America (HFA) conducted a network health survey during the latter half of May 2020 to assess early impacts and inform resources needed from the national office.

Over half of HFA sites responded (n=361, 61%) from 40 of 45 states and territories currently implementing HFA.  Additionally, 22 state-level home visiting leaders responded.  Sites that responded are a representative cross-section of the HFA network and reflect the diversity of the HFA network with regard to size, race/ethnicity, and state infrastructure (independent sites vs multi-site system sites).

Overall, sites indicated that they were adjusting to the “new normal” with an average rating of 73 out of 100 (from 0 = extremely stressful/many unresolved challenges to 100 = adjusting very well).  State leaders’ responses were consistent with site ratings.  At the same time, sites and the families they serve face many challenges now and in the future.  The survey results highlight multiple concerns, and also identify the building blocks for recovery and improvement.

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What we learned

Already vulnerable before COVID-19, families show greater financial, emotional, and physical health needs.

Site leaders estimated the percent of families for each item below:[1]

  • One-third of families (34%) were not able to meet basic needs, with numbers expected to increase somewhat over the next few months.
  • Nearly half of families (47%) had experienced a recent loss of household income.
  • About one-third of families (32%) show increased risk for child abuse or neglect.
  • Nearly half of families (42%) have experienced increased depression, intimate partner violence, and/or substance use.
  • Over one-third (37%) of families are at greater risk of exposure to COVID-19 due to their work or living situation.

[1] The chart shows two estimates: the top reflects the mid-point of the range estimated by site leaders; the lower, darker shaded area represents the more conservative lower end of the range estimated by site leaders.

Most staff and many families have access to technology needed for virtual home visiting, but there is work to do.

Almost 9 out of 10 site leaders reported that direct service staff have some or all of the technology resources needed to work from home, including 87% with a work-issued tablet or computer, and two-thirds issued a smart phone, webcam, and minutes.  Most staff have experience with online training or meetings (78%), and most are relatively comfortable with learning through online training (60%). Responses from state leaders generally agreed with these results.

Many families also have essential technology.  About two-thirds of families (62%) have a smartphone, and just over half (54%) have sufficient minutes they can use for home visits.  Also, just over half of families (57%) seem to be relatively comfortable with virtual visits.

The biggest technology gap for both staff and families is fast and reliable home internet (34% of direct service staff, 48% of families).  This is a critical issue for reaching families with virtual home visiting, especially when both staff and families are sheltering at home.

Most HFA sites successfully shifted to virtual home visiting while “sheltering at home”.

In the two weeks prior to the survey, over half of sites (61%) provided video visits (such as Zoom or another meeting platform) to at least half of the families who were due for a visit.  While video visits offer much greater capacity for supporting families, phone visits are another option.  The vast majority of sites (89%) were able to visit most families via video or phone visits, and of the remaining sites, video and/or phone visits were completed with at least one-quarter of families.  Across the HFA network, site leaders estimate 13% of families due for a visit did not receive one, whether owing to family reluctance or because of limited access to technology.

Financial stability is uncertain, with significant potential for future cuts.

At the time of the survey (about two months into the pandemic), funding impact was mostly uncertain.  About 10% of sites estimated cuts averaging 12% funding cuts in the next year or two.  Over half of sites (57%) and state leaders (50%) were unsure or did not respond to the questions on cuts.  Most sites and state leaders thought site closure or disaffiliation was unlikely (60% and 77%, respectively, with nearly all others indicating “unsure” or no response to the item).

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HFA and COVID-19

Get guidance on virtual visiting, advocacy, and get connected to resources.

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Stories from the field

Read stories from HFA folks across the country who adjusted to a new way of serving families.

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Advocating for Home Visiting

Learn more and download resources around our campaign, “Home Visiting Is Essential”

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We promote child well-being and prevent the abuse and neglect of our nation’s children by delivering home visiting services that empower families and communities.

Healthy Families America is the signature home visiting program of Prevent Child Abuse America.

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