Table of Contents | Previous | Next |
Chapter IV: Program Participation
After recruitment, the second most important step in making any program work is ensuring adequate participation. Prior experience indicates it is not unusual for low-income individuals to have difficulty participating in social service or employment programs in a consistent and sustained manner, because of a variety of destabilizing and disruptive factors in their lives. For a program like BSF, this challenge is even greater, because it requires the attendance of couples rather than individuals. One of the chief assumptions of the BSF intervention is that when couples learn and practice skills together, they are more likely to use and internalize those skills. Another expectation is that application of the information and skills will lead to stronger relationships and help prepare couples to enter and sustain a healthy marriage. These assumptions mean that not one, but two individuals must attend the program—and they must attend together. Participation of couples represents both a program strength and an implementation challenge.
Like recruitment, adequate levels of participation are crucial for both programmatic and research purposes. From the program standpoint, steady and predictable participation by couples within groups is essential to ensure efficient use of program staff and resources. From the evaluation perspective, participation is important because it affects the “dosage” of the intervention. We are on less sure ground here, however. Because there have been no program evaluations of interventions involving large numbers of low-income unmarried couples, the level of program intensity needed to result in effects is not known.
The BSF program model was designed to offer participants a long-term comprehensive experience. Most other marriage education programs are shorter than BSF. In developing the BSF model, we concluded that more extensive services might respond better to the needs of low-income unmarried couples experiencing the birth of a new child. Longer program duration would provide for more opportunities to attend, and more time for unmarried couples to learn and use the skills taught, sort out their relationships, and consider marriage in the context of a supportive program.
The BSF pilot experience offered an opportunity to determine the extent to which couples actually would participate in services once they had consented to be part of the program. Would they lose interest while waiting for a group to form and start? Would they attend with their partners? Would men find the group sessions appealing enough to return? Would late-term pregnancy or the presence of newborns impede parents’ ability to leave home to participate? Would couples become bored with the program after a short time and stop coming? What kinds of program strategies would be useful in encouraging participation? The early experiences of the BSF pilot sites shed some light on these questions.
Couples were not required to participate in the group sessions to receive services through the family coordinator or other family support services; indeed, meeting with the coordinator for some period of time could be useful in encouraging participation at the group sessions. However sufficient data were not yet available regarding couples’ level of contact with family coordinators or participation in family support services at the time of this early analysis to determine a link between family coordinator support and group participation. This chapter instead focuses on participation in the core BSF component: it examines the strategies and approaches that pilot sites took to encourage couples’ initial participation, ongoing attendance, and completion of the marriage/relationship skills education groups. We present information on very early levels of participation achieved at pilot sites, and draw some preliminary lessons about strategies for encouraging participation.
A. HOW BSF SITES ENGAGED THE PARTICIPATION OF COUPLES
The pilot sites took a variety of approaches to engaging enrolled couples in the group activities and encouraging their ongoing attendance and program completion (Table IV.1). These strategies can be described with respect to four dimensions: programmatic supports for facilitating attendance at groups, activities that emphasize the social rewards of participating or that rely on social modeling, individual attention and emotional support by program staff, and tangible incentives, such as baby items, for attending some number of sessions.
Program Supports for Group Attendance. Without exception, BSF pilot sites found it necessary to provide three supports to encourage participation. First, families typically needed child care during the sessions because, even if they were recruited during the prenatal period, many couples had other young children. Some sites were able to provide child care on site, with rooms furnished specifically for this purpose. Others provided vouchers to reimburse participants for child care costs. Having on-site care was particularly useful for the sites that recruited families during the postnatal period, because it meant that parents could bring their newborns with them and check on them and attend to their needs during breaks. Second, transportation to and from group sessions frequently was needed by program participants. Sites provided assistance with transportation in various ways, depending on the resources available in the community (such as reliable bus service or subway systems), the site’s resources, and participants’ needs. Some sites tried multiple methods before finding an approach that worked best for them. Some provided free bus tokens, gas cards, or taxicabs. Others had vans that they could use to pick up and drop off participants. And some sites determined it was only necessary to offer aid with transportation on an “as needed” basis.
| ATL | BALT | B-R | FL | IN | OK | TX | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GSU | LAA | Orange | Broward | Marion | Allen | Lake | San Angelo | Houston | |||||
| Program Supports for Group Attendance | Child care during group |  |
|
|
|
|
|
|
|
|
|
|
|
| Transportation assistance | |
|
|
|
|
|
|
|
|
|
|
|
|
| Meals or refreshments | |
|
|
|
|
|
|
|
|
|
|
||
| Social Rewards Modeling | Introductory sessions | |
|
|
|
|
|
||||||
| Periodic social gatherings/outings | |
|
|
|
|
|
|
|
|||||
| Celebrations | |
|
|
||||||||||
| Married-couple facilitator teams | |
||||||||||||
| Participant testimonials | |
|
|||||||||||
| Individual Attention/Emotional Support | Calls or visits by group facilities | |
|
|
|
|
|
|
|
||||
| Follow-up on absences | |
|
|
|
|
|
|
|
|
|
|
|
|
| Frequent encouragement by family coordinators to attend | |
|
|
|
|
|
|
||||||
| Access to family coordinator at group | |
|
|
|
|
|
|||||||
| Make-up sessions in home | |
|
|||||||||||
| Tangible Incentives | Door prizes or lotteries | |
|
|
|
|
|
|
|||||
| Baby items or "points" | |
|
|
|
|||||||||
| Other gifts or gift certificates | |
|
|
|
|
|
|
|
|||||
| Cash incentives | |
||||||||||||
Third, meals and refreshments were offered, not just as a nice gesture, but because staff saw them as a necessity in many cases. To accommodate the schedules of working families, most group sessions were held during evening hours or on weekends. Often families were tired and hungry after a long day, and light meals were essential to help them fit the sessions into their schedules and maintain their energy. Sharing meals also was a time to socialize that could help families bond with each other.
Social Rewards/Modeling. Early in the pilot, site staff often noted that BSF couples appreciated the opportunity to meet other expectant couples and new parents who often struggled with issues similar to their own. Site staff sensed that giving couples opportunities to get to know one another would be beneficial in reducing feelings of isolation, building a supportive community spirit, and increasing motivation for continued participation. For this reason, some sites began to sponsor occasional social gatherings, outings, or celebrations that brought BSF couples together as a means of maintaining momentum and retaining participants throughout the program period. The frequency of such gatherings varied both across and within sites, ranging from an average of once a month to once or twice over the first five months.
Despite regular reminders, sites noted that some couples who enrolled in BSF failed to show up at the first or subsequent group sessions. As one way of addressing this problem, at least three sites tried holding “orientations” prior to the first group session. The purpose and content of the orientation session varied substantially across the three sites. One site used the orientation to define the “ground rules” and expectations for participation, and to introduce participants to program staff and the range of resources that would be available to them through the program. This orientation involved little interaction among the newly enrolled participants. For their orientation, another site chose to conduct an actual curriculum session—though not one of the core sessions—so that new enrollees could get a feel for what a typical session would be like. A third site created an orientation that focused more on helping the couples to get to know one another. Refreshments were served, and staff led participants in “icebreaker” games that encouraged interaction with other parents and with staff, with a chance to win door prizes. At the same time, the program was explained and questions answered.
Although many factors determine a site’s effectiveness in engaging and retaining participants in group sessions, the third site generally showed better participation rates. Participants reported that the most helpful aspect of the orientation was meeting the other couples who would be in their group. The orientation helped them see that they had a lot in common with the other couples, and that they would likely fit in and be accepted. This apparently reduced initial anxieties about participating in group sessions with people they had never met while helping to reduce feelings of social isolation.
Individual Attention/Emotional Support. One of the functions of the BSF family coordinator is to support and encourage ongoing participation through personal contact with couples. Couples received this personal attention in a variety of ways and from different staff members, depending on the site and the family’s needs. At the Healthy Families sites, this typically occurred during home visits that are a regular part of the HF programs. At other sites, the personal contact with family coordinators could occur just before or after a group session, through an appointment held at the facility, or by telephone. At most sites, couples received some kind of individual contact at least weekly, but some contacts were less formally scheduled. The form of contact usually depended on how well the family seemed to be doing in terms of participation or personal issues that may have surfaced. For instance, couples who were attending regularly and consistently might need only a brief check-in and reminder of their upcoming group session, unless particular issues or problems were identified. Others who were less consistent in attending might receive a personal visit in the home to determine the problem and offer assistance if needed.
One site reported that having group facilitators visit the couple’s home prior to attending any group sessions was helpful in stimulating participation in groups. They reported that couples were impressed that the people who were going to lead the group sessions took the trouble to come to their homes themselves, and were reassured that they would find a familiar face at the sessions. This strategy was difficult to sustain, however, and decreased as the facilitators’ schedule for group sessions filled up. Other sites relied on family coordinators who had developed rapport with couples through home visits and other contacts to be present at the beginning of group sessions, to fill the same need.
Tangible Incentives. To encourage initial and ongoing attendance, most sites offered incentives such as door prizes, gift certificates, raffles, baby items, or cash. However, sites varied in the type of incentives they offered and the frequency at which they were offered. One site did not provide any tangible incentives, believing that doing so could undermine participation by sending a message that the program itself was not intrinsically valuable. The other sites thought incentives would be useful as an extra little nudge for participants who generally enjoyed attending but on some occasions might find it difficult to leave the house. The majority of these other sites provided gift certificates to each couple at each group session they attended, or awarded each couple “points” for each attendance that they could later redeem for a gift of their choice. The gift certificates, which usually ranged from $10 to $25, most often were for stores like Wal-Mart or Target, but sometimes were for a local grocery store or gas station. Three subsites did not provide weekly incentives for each couple but instead held periodic or weekly raffles through which one couple in the group could win a prize. These prizes ranged from movie tickets to a $100 gift certificate. Only one site elected to offer a significant cash incentive during the pilot period: this site offered $100 cash for attending the first two group sessions.
The early nature of sites’ experiences prevents us from drawing clear conclusions about the effect of incentives on participation. During the pilot period, sites varied in the types of incentives they offered—not only across, but within sites. That is, within each site, a variety of strategies were often tried out during the early months of operation. In addition, sites varied in terms of how long they had been in operation at the time of our analysis. Once full program implementation is achieved, future analyses will explore in more detail the usefulness of various types of incentives on program participation. For now, the anecdotal evidence raises the possibility that offering modest incentives might both encourage participation and be appreciated by couples.
B. EARLY PARTICIPATION RESULTS
Participation in the BSF group sessions can be examined in several ways. In this section, we first examine initial engagement, looking at the number who began attending the curriculum sessions as a proportion of all those who were enrolled in the BSF program. Next, we examine the average dosage or intensity of treatment received by participants. We do this by focusing on those couples who began attending the group sessions, and looking at the total number of sessions they attended as a share of the total number of sessions they could have attended—their “opportunities to attend.” This approach allows us to take account of the fact that groups were at different points in their sequence and duration. Finally, we present patterns of participation among groups that had proceeded through the entire curriculum sequence.
Table IV.2 presents information on the rate and intensity of group attendance during early BSF pilot operations. The table presents conservative estimates in two respects. First, it counts couples as attending only if both parents participated. Second, it does not count sessions that include curriculum content but which were not group meetings.4 It is important to note that although differences among sites may be affected by variation in program practices, these early results also are likely to be affected by differences in the duration of operations, number of groups begun, and number of couples scheduled for each group. For example, at the time these data were reported, some sites had not yet had an opportunity to run the full sequence of classes, while others already had run multiple cohorts through the entire group workshop component. Thus, the data for the sites that had operated the longest included participation during the later weeks and months of the curriculum sequence, when patterns might differ.
1. Participation Rates
Based on an early cohort of participants, column 1 shows the percentage of all couples enrolled in the BSF program group who attended at least one group session within four months after enrollment. The sites show wide variation in this measure of attendance, ranging from 34 to 100 percent. Among the four sites with the most experience (having begun recruitment between February and April 2005), about one-third to one-half of couples attended one or more sessions. The three remaining sites, which began recruitment more recently (May-September 2005), show higher attendance rates—ranging from 69 to 100 percent.
| Site and Month Recruitment Began (2005) | Average Intensity of Participation | |||
|---|---|---|---|---|
| 1 | 2 | 3 | 4 | |
| Percent of All Couples Enrolled Who Attended at Least One Session | Total Session Opportunities for Couples Who Began Attending | Total Sessions Attended by Couples | Percent of Session Opportunities Attended by Couples | |
| Site A (July) | 69 | 164 | 72 | 44 |
| Site B (September) | 100 | 55 | 47 | 85 |
| Site C (April) | 50 | 339 | 148 | 44 |
| Site D (February) | 52 | 224 | 104 | 46 |
| Site E (February) | 37 | 642 | 369 | 57 |
| Site F (August) | 73 | 76 | 55 | 72 |
| Site G (February) | 34 | 264 | 139 | 53 |
| Total | 1,764 | 934 | 53 | |
|
Source: For Sites A, C, and G: Building Strong Families management information system (BSFIS). For remaining sites: reports generated from local site records. Column 1. Percentage is based on an early cohort of participants. To count, participation had to occur within four months of enrollment in the program, and both parents had to attend together. Column 2. Total opportunities represents the sum, across couples, of all sessions each couple was expected to attend from the initiation of enrollment to October 2005 (among those couples who participated at least once). Column 3. Total attendance is the sum, across couples, of all sessions actually attended as of October 2005 (among those couples who participated at least once). Attendance is counted only if both parents attended the session together. Column 4. Percentage of sessions attended is column 3 divided by column 2.
|
It is possible that the sites that started BSF services more recently will see their participation rates decline as they continue to enroll and begin more groups. On the other hand, it also is possible that variation in procedures or practices is responsible for the higher initial attendance at these sites during this early period. For instance, Site F is the only BSF site that provides a large cash incentive for attendance while also offering day-long sessions (meaning that more curriculum material can be covered at once). The two other sites that recently began recruitment, Sites A and B, also showed strong initial participation at the time of our analysis, but did not use any practices that were not also in use in other sites. Given the very early nature of these data, and the varying length of operations among sites, these initial attendance rates should be interpreted with caution. As sites completed their pilots, they often developed new procedures to address emerging issues. For example, after observing the initially poor group participation, Site G modified its approach by encouraging group attendance from the beginning rather than only after a long period of home visits.
2. Intensity of Participation
Among couples who attended at least one group session, we examined the average intensity of participation. In Table IV.2, column 2 presents the total number of sessions offered to couples. For each site, column 3 shows the sum of sessions attended across all couples, and column 4 indicates the percentage of “session opportunities” attended. For all but two of the most recent sites, couples who had attended at least one group session tended to participate in about half of all the sessions offered to them (44 to 57 percent).
As another measure of participation intensity, we examined rates of attendance across the full curriculum sequence. To do so, we focused on couples whose groups had completed the entire sequence of sessions. At the time of our study, seven groups had been completed in four different sites. In these groups, the curriculum was presented in 18 to 23 weekly sessions, totaling between 30 and 44 hours. As shown in Table IV.3, across the seven groups, 45 percent of the couples who began participating attended 15 or more sessions equaling between 30 and 44 hours of curriculum material. More than two-thirds attended 8 or more sessions equaling at least 16 hours of group sessions.
| Number of Sessions Attended | Percent of Couples |
|---|---|
| 1 | 1% |
| 2–7 | 31% |
| 8–14 | 23% |
| 15–23 | 45% |
3. Participation Patterns Across Time
Understanding the overall intensity of participation across the full workshop sequence does not reveal much about the pattern of participation over time; understanding these patterns may provide useful guidance for program design and implementation. For example, it is possible that average participation rates are low because, after some time, couples drop out of the program entirely. Alternatively, the overall average may be explained by a steady decline in attendance over time. Both patterns might suggest that couples become bored, lose interest, or feel that they have little to gain from continued participation. Such patterns might suggest a need to reduce the number of sessions for future groups, or to hold sessions less frequently. A third possibility is that couples might be attending over the full program period, but intermittently. Such a pattern may suggest that participants continue to be interested but that events or circumstances interfere with their ability to attend every week.
To shed light on these possibilities, we examined the percentage of couples attending a majority of the sessions in four quarters of the workshop sequence. Using data from the seven completed curriculum groups discussed above, Table IV.4 shows the percentage of “high attendance” couples—those who attended at least three out of five sessions within four five-week blocks—among those couples who ever began to attend.
| Site and Group Number | Percent of Couples Attending at Least Three Sessions Out of Each Block of Five | |||
|---|---|---|---|---|
| Block 1 Weeks 1-5 |
Block 2 Weeks 6-10 |
Block 3 Weeks 11-15 |
Block 4 Weeks 16-20 |
|
| Site C, Group 1 | 83 | 67 | 67 | 50 |
| Site D, Group 1 | 60 | 29 | 14 | 13 |
| Site E, Group 1 | 100 | 80 | 60 | 40 |
| Site E, Group 2 | 100 | 50 | 25 | 50 |
| Site E, Group 3 | 67 | 67 | 67 | 50 |
| Site E, Group 4 | 100 | 75 | 100 | 75 |
| Site G, Group 1 | 50 | 33 | 50 | 50 |
| Overall | 75 | 55 | 53 | 41 |
Attrition Cliffs. One way to determine whether participation drops off markedly is to determine whether rates of high attendance declined substantially from any one five-week period to the next. One group (Site E, Group 2) saw a drop of 50 percentage points from the first 5-week block to the second. Across the remaining groups, the decline over this same period ranged from zero to 31 percentage points, Site E, Group 3 and Site D, Group 1, respectively. Overall, the rate of high attendance declined from 75 to 55 percent, an overall drop of 20 percentage points from the first to the second block. The overall declines from block 2 to 3 and from block 3 to 4 are relatively more modest. Given this pattern, we conclude that to the extent that attrition occurs, it is observed mostly during the first 10 weeks.
Steady Decline over Time. Substantial successive drops across all periods would indicate a steady decline in participation over the entire sequence of group sessions. We have no basis at this point for judging what is “substantial,” since we do not know what program dosage is required to affect couples’ outcomes. The patterns observed are varied. In a few instances, participation actually increased after a previous decrease: In Site E, the rate of high attendance in Group 4 went from 75 to 100 percent from the second to third blocks, while Group 2 rose from 25 to 50 percent from the third to the fourth block. And Site G, Group 1 saw an increase from 33 to 50 percent between the second and third periods. Only one group, Group 1 in Site E, showed a pattern of steady decline although Site D, Group 1 also tends toward this pattern. Looking across all these early data, we cannot conclude that there has been a general pattern of steady participation decline in these groups.
Long-Term but Intermittent Participation. The participation patterns observed in most of these early groups might be better characterized as long-term but intermittent. For many, though not all couples, participation (or the lack thereof) in one period does not necessarily predict future participation. To the extent that this early pattern is sustained, it provides some guidance as to whether a long curriculum sequence is tenable. A pattern of sustained but intermittent participation suggests that reducing the number of weekly sessions would not be likely to increase overall participation rates substantially. In sites that did observe an attrition cliff, the drop occurred before the 10th session. For intensive programs like BSF, this data suggests that reducing the number of sessions even by half would do little to reduce overall attrition.
As illustrated in Figure IV.1, the intermittent pattern of attendance also has implications for program efficiency. At a given session, group facilitators might see anywhere from the full complement of couples to only one or two, and occasionally none. One site tried at first to deal with this problem by canceling sessions when only one or two couples showed up. Unfortunately, that decision compounded an already spotty participation problem, further protracting the expected time required to get through all of the curriculum modules. Other sites realized that it was more efficient to conduct sessions with whoever showed up and provide some form of make-up for those couples who were unable to attend the scheduled session. Providing make-up opportunities meant that participants who had to be absent did not have to feel left behind, which could discourage them from attending the next group session. It also ensured that the program stayed on schedule and was completed in the time allocated.
[D]
|
In addition to providing make-up sessions, several sites attempted to deal with spotty attendance and the resulting small groups by adding new couples to established groups. This approach was sometimes effective, particularly when the ongoing group was in the early part of the curriculum sequence, when it had at least three active couples, and when the new couples could “catch up” in some way. However, adding new couples to a group that had been meeting for some time and had dwindled almost to the point of dissolution did not solve the attendance problem.
4. Reasons for Nonattendance
Generally, nonparticipation at group sessions was of two varieties. Some enrolled couples never showed up for any group session, while some who did show up and began attending were occasionally or frequently absent over the curriculum sequence. Most sites made many attempts to contact individuals in the first category to encourage their attendance at group sessions through phone calls, visits, or other means. In some cases, enrollees explained that they no longer planned to attend due to such changes as moving out of the area, incarceration, or a breakup of the relationship. Sometimes enrollees indicated that they planned to attend, but then did not show up. Across sites, some proportion of enrolled couples could not be reached to determine why they were not attending.
In one site, the low initial participation rate was reported to be due in part to the site’s having decided not to invite couples to group sessions before building trust with participants through intensive home visits for an extended period. By the time couples were invited to group sessions, it is likely the opportunity did not seem as urgent and adding attendance at group meetings to attendance at home visits seemed like an extra burden. Staff in this site have recently decided to engage couples in group activities earlier in the program. It was somewhat easier to identify reasons for absences among enrollees who began participating in the group sessions. During our site visits and numerous telephone conversations with BSF pilot sites, we asked program staff and participants themselves about reasons for nonattendance.5 The most frequently cited reason for absences was changes in participants’ work schedules. Some sites reported that the type of jobs in which their low-skilled workers were engaged, such as the fast food industry, required them to work irregular schedules or report to work on a new schedule with little prior notice. Site staff and participants both reported that work demands or variations in schedules during peak periods (seasonal work) necessarily took priority over attendance at group sessions. New jobs were a frequent event for enrolled families and could change their availability to attend a group. Men frequently lost, gained, or changed jobs, and women who were on maternity leave at the time they began the group sessions sometimes needed to return to work shortly after delivering the baby. Sometimes sites were able to change participants’ group assignments in these circumstances, but this was limited by the availability of other groups and their place in the curriculum sequence.
A wide range of other reasons for absences were cited both by participants and program staff. These included health related issues such as illness, childbirth, surgery, medical restrictions on taking the newborn outside the home, or a death in the family. Many absences in Louisiana and Florida resulted from the hurricanes and dangerous weather that occurred during the pilot period. Other reasons cited by programs included evictions or legal issues, as well as personal challenges that sometimes interfered with participation, such as being ashamed of a hearing impairment or illiteracy.
C. LESSONS AND IMPLICATIONS
The BSF pilot experience suggests that creative strategies are needed to engage couples in group sessions. Even when couples agree to participate, a considerable proportion fail to show up at any group sessions. Although attention must be given to improve the rate of attendance, the results from this initial experience should not be too surprising. In other evaluations of marriage education programs—focused on less disadvantaged couples—only a small fraction of those offered the program actually completed it. For example, in a longitudinal randomized evaluation of the Prevention and Relationship Enhancement Program (PREP), only about one-third of all the couples who were offered the program actually participated (Markman et al. 1993).
Although BSF’s rate of nonparticipation may not be unusual in the context of past evaluation experiences, the sites are taking steps to improve it. The data suggest that once couples begin attending group sessions, they tend to keep coming. Therefore, finding ways to engage the initial participation of enrolled couples may be particularly useful. BSF sites are taking steps to improve the rate at which enrolled couples come to at least one session by using several strategies currently in development. These include a brief video showing real couples participating in group sessions, which can be shown to enrolled couples to portray more fully what the sessions are like. Another strategy is to use BSF “graduate” couples to assist or function as outreach/recruitment staff, since they are in the best position to describe their experiences with the program.
Participation rates are likely to evolve as programs incorporate such strategies and move further into their program operations. At some sites, rates of program participation may improve as sites and group facilitators gain more experience and family coordinators become more adept at encouraging participation. On the other hand, at sites where early participation was very high, there actually may be some decline as program staff deal with a more complex operation as they enroll more couples, limiting the attention staff can pay to each new couple. For these reasons, the early participation results described in this chapter, often taken from sites’ first trial runs, should be interpreted with caution.
The finding that many participants who have attended at least one group session continue to participate (at some level) for up to five months suggests that couples’ interest can be sustained over a long period. Although a significant drop in attendance was observed at some sites after the first five weeks, the overall pattern appeared to be more of steady but intermittent participation. This pattern is consistent with explanations for absences given by participants and program staff; unavoidable circumstances interfere with the ability to attend every week, and participation at one period does not fully predict later participation. Once the problem is corrected, whether it is an illness or other problem, participants often make up missed sessions and return to groups. The most difficult issue to address is what to do when participants begin attending a group and then have their availability change because of a new work schedule. As sites expand and begin running more curriculum groups at different times, it may get easier to reassign such participants.
Although more experience is needed to confirm our conclusions, the BSF experience suggests that better participation was associated with certain operational strategies. These can be summarized as the following emerging promising practices:
-
Provide program supports to facilitate attendance, especially child care, transportation, and meals or refreshments.
-
Invite couples to their first group session as soon as possible after recruitment; encourage reluctant enrollees to try the group at least once.
-
Follow up on absences with telephone calls, home visits, or other personal contact.
-
Find ways to foster couple-to-couple support and friendship.
-
Provide make-up sessions rather than canceling a group session when fewer couples than expected show up.
| Table of Contents | Previous | Next |