Participation Patterns in Home-Based Family Support Programs: Ethnic Variations*

FEATURE ARTICLE Participation Patterns in Home-Based Family Support Programs: Ethnic Variations* This study investigated the relationship between ethnicity and retention among families participating in a national network of homebased family support programs. Using archival data collected on 224 African American, 227 European American, and 219 Latino American mothers of newborns and 153 home visitors, multivariate analyses indicate greater participation by African American and Latino parents as compared with European American parents. Retention predictors van, by ethnicity. Strategies to form a supportive parent-provider alliance are discussed. Key Words: attrition, ethnicity, family support programs, home visitation, retention. Family support programs seek to diffuse the stressors associated with child rearing for at-risk populations and to foster positive parenting behaviors. Typically offered as a voluntary service, goals for family support programs may include increasing parental knowledge of child development (Arcus, 1995); improving parental caregiving skills (McCurdy, 1995); or providing social support to the family (Thompson, 1995). The specific service goals and target (e.g., parent, parentchild dyad, family) often determine the service delivery strategy. For example, an expanding number of family support programs now deliver home-based services in an effort to foster higher participation rates by delivering services in a familiar setting, to achieve greater impacts with parent and child, and to better identify the types of supports that could most benefit the family (Gomby, Culross, & Behrman, 1999). Due to the voluntary nature of these programs, success of an intervention hinges, in part, on parental decisions regarding service necessity and program effectiveness in engaging parents. Home-based service delivery has been advocated as a potential method to enhance engagement in family support programs; however, the wide variation in retention rates across voluntary home visitation programs (see Duggan et al., 2000; McCurdy & Daro, 2001) suggests that many "model" home visitation programs struggle to deliver supportive services to the target population. Increasing engagement in these programs is a critical first step toward impacting outcomes related to parenting and child functioning. Despite the relevance of service involvement for understanding program effectiveness, little is known about the factors that encourage or discourage parental involvement in voluntary home visitation programs (Duggan et al., 2000; Littell, Alexander & Reynolds, 2001; Spiker & Wagner, 2001). Attrition research in other arenas, such as psychotherapy, indicates that the formation of a therapeutic alliance between provider and client is critical for retaining clients and enhancing outcomes (Horvath & Symonds, 1991). Studies also note relatively high attrition rates by minority clients from therapy as compared with European Americans (e.g., Wierzbicki & Pekarik, 1993), suggesting that factors promoting this alliance may vary across ethnic groups. In light of these findings, some studies have attempted to identify the factors that enhance minority retention in therapy, with emphasis on an ethnic "match" between provider and client as a potential ingredient for establishing the therapeutic alliance (Atkinson & Lowe, 1995). Although this issue has not been examined in home visitation programs, researchers in this field now propose that establishing a therapeutic (Korfmacher, 1998) or trusting alliance (Duggan et al., 1999) is central to engaging parents in home visitation programs. Building from this work, the current study sought to further our understanding of engagement in home-based family support programs by investigating two issues: (a) whether participation patterns in home visiting programs vary by ethnicity, and (b) whether the factors that promote a "supportive" provider-parent alliance vary by ethnicity. …