Family Functioning and Involvement in Home Visiting: Examining Program Characteristics as Moderators to Support Retention in Services




Lorraine M. McKelvey and Shalese Fitzgerald

Brief Type

Journal Publication


  • Healthy Families America (HFA)
  • Parents as Teachers (PAT)


Developing strategies to improve retention in home visiting programs is critical to their success. The purpose of the study is to examine how the content provided during home visits moderates the association between family risks (economic, household functioning, and conflict) and retention in services. Parents (n = 1,322) voluntarily enrolled in Healthy Families America (n = 618) and Parents as Teachers (n = 704). Family characteristics were collected using the Family Map Inventories. Multilevel analyses showed a moderating impact of the time home visitors spent supporting parent–child interaction for all family risks examined. Moderating effects demonstrated a stronger positive association between focusing on the parent–child relationship and retention at 6 and 12 months for parents demonstrating greater needs. There were no moderating effects of child development content or case management activities with retention at 6 and 12 months. Together, families were more likely to stay in services when home visitors focused on parent–child interaction and child development, but less likely retained with more case management. Parents with greater risks were more likely to remain in services with more time focused on supporting parent– child interactions. Findings suggest the need to support our home visiting workforce in their work to promote healthy parent–child relationships. (author abstract)

Data Collection Methods

  • Standardized assessment tools
  • State administrative record reviews



For More Information

McKelvey, L. M., & Fitzgerald, S. (2020). Family functioning and involvement in home visiting: Examining program characteristics as moderators to support retention in services. Infant mental health journal41(2), 220-231. doi: https://doi.org/10.1002/imhj.21842
Author Contact Information:
Lorraine M. McKelvey


  • Participant Characteristics
  • Participant Recruitment, Retention, Engagement, and Dosage