The Journal of Family Psychology recently published a study by researchers at MDRC that examined the impact of the Child First home visiting program during the pandemic. Child First targets families with children from birth through age 6 who are experiencing challenges with caregivers’ mental health or children’s behaviors. The program, which currently serves thousands of families a year across five states, provides a home-based therapeutic intervention embedded in a coordinated system of care. The COVID-19 pandemic presented unique challenges to Child First, forcing programs to pivot and provide telehealth services while addressing new pandemic-related issues facing families.

The recently published paper reports on a randomized controlled trial of Child First conducted between June 2019 and March 2020 in 10 sites in two states. Although study enrollment ended prematurely because of the pandemic, the researchers were still able to collect one-year follow-up surveys from families. This presented a unique opportunity to examine the impacts of an evidence-based home visiting program that served a large proportion of families using telehealth during the COVID-19 crisis.

Findings revealed that Child First improved employment, residential stability, and substance use outcomes for caregivers and families a year after enrollment. Families assigned to Child First received more virtual services during the pandemic compared to those in the control group. This suggests that Child First was adaptable and able to address the immediate needs of families as their lives were upended due to the pandemic.

However, the study did not find any impacts of the program on children’s behaviors, caregivers’ psychological well-being and parenting stress, or families’ involvement with the child welfare system. Another full-scale study is underway to estimate the impacts of the Child First program being implemented now, which is largely back to providing in-home services.

“These results are important because they provide preliminary evidence on the effectiveness of Child First when administered via telehealth during a time of social and economic upheaval,” said lead author Samantha Xia from MDRC. “The study also provides evidence on the benefits and limitations to telehealth in the home visiting field. It suggests, for example, that telehealth can potentially be used to provide care coordination for families but may not be as effective as in-person services when providing psychotherapy. Some programs may continue to provide telehealth services for hard-to-reach families and will need to understand how best to do so.”