Helping Families Through Upheaval: How Home Visiting Programs Supported Families’ Economic Well-Being During the COVID-19 Pandemic

This work was designed to provide information that early childhood home visiting programs can use to support families’ economic well-being, both during regular operations and if they face other disruptions to service delivery, such as natural disasters. 

We highlight findings in two areas: (1) families’ economic experiences during the COVID-19 pandemic and (2) early childhood home visiting programs’ experiences supporting families’ economic well-being during the pandemic.

Families’ economic experiences during the COVID-19 pandemic

• Being able to meet their basic needs was the biggest economic challenge families faced during the pandemic. Many families already had difficulty meeting their basic needs before March 2020, and the pandemic made things worse. The challenges spanned the areas of food, housing, employment, and more.  
• These challenges were even greater for families of color, who continued to experience economic hardships due to historic and structural factors that existed prior to the pandemic, and families in rural areas.

Early childhood home visiting programs’ experiences supporting families’ economic well-being during the pandemic  

• Early childhood home visiting programs had to change existing processes in real time and find different ways to support and connect with families when they could no longer meet in person. They did so while facing restrictions on in-person services, supply shortages, public transportation shutdowns, and increased unemployment and economic instability. Programs pivoted to offer virtual services in response to these restrictions.  
• Programs adjusted their focus to help families address critical, short-term economic needs. For example, programs covered economic well-being more extensively in home visits during the pandemic compared to those held before, and provided more direct assistance for basic necessities, such as food assistance and baby supplies.  
• Having strong, existing relationships with community organizations and businesses enabled programs to support families’ economic well-being, and program often expanded their work with existing partners and developed relationships with new ones.
• Programs’ strong relationships with families meant they were often a trusted resource for families in a confusing and unstable time. Engaging families, assessing their needs, and supporting them through direct services and connections to other resources enabled programs to safely serve families when other supports might have been less available.  

To answer the research questions, we reviewed literature and interviewed staff from early childhood home visiting programs. We first examined literature published since 2020 on economic well-being and early childhood home visiting, to coincide with the period of the COVID-19 pandemic. We searched databases and other literature for peer-reviewed, published literature and did a Google Scholar search to find federal- and foundation-funded research. We met with a technical work group of researchers and practitioners to identify additional sources. For the identified literature, we screened and selected relevant articles for review.

We also conducted 90-minute virtual interviews with  staff at nine early childhood home visiting programs. We interviewed a director or supervisor from each of the selected early childhood home visiting programs. All interviewed staff members worked for early childhood home visiting programs that supported family economic well-being; provided home visiting services during the pandemic either in person, virtually, or in combination; served families with young children and/or a pregnant family member; and worked with families prioritized by the Maternal, Infant, and Early Childhood Home Visiting Program, such as families with low incomes, families with a history of child abuse or neglect, or families with children who have developmental delays or disabilities.

The findings are not representative of all families or early childhood home visiting programs. Although some of the literature included representative samples—which we note when applicable—other literature did not. In addition, our sample of early childhood home visiting programs was small, purposively selected, and not representative of a larger group of programs. However, other early childhood home visiting programs might find the findings relevant for improving services to families they serve now or in the future. 

The team developed the following actionable themes from the interviews and literature, which early childhood home visiting practitioners might apply to their work:

• Normalize economic challenges. During the pandemic, families’ economic needs were often greater than before the pandemic, making it even more important for staff and families to be comfortable discussing it, which would likely be true during future disruptions as well. Understanding the shame that families may experience if they are struggling financially might help home visitors connect with families and encourage them to share information about what they need. Home visitors can also discuss how common economic challenges are, particularly during times of disruption or crisis. More broadly, programs might also want to train staff about the larger historical and structural factors that affect the communities they serve. This knowledge could help staff better understand that certain families face barriers to their economic well-being that are beyond their control. Programs can build on their foundation of trust with families by engaging in empathic listening, being compassionate and understanding, and communicating that economic challenges are common.
• Be specific when asking families about their economic well-being. Some programs found that families did not disclose their economic challenges in response to general questions such as, “Are you doing okay?” Instead, specific questions like, “Do you have enough food for your family?” or “Do you have enough formula and diapers for the next month?” were better for encouraging families to share information about their pressing needs. During the pandemic, families often had critical, immediate needs, and so it was essential that program staff learned about them as quickly and precisely as possible to provide appropriate support and assistance.
• Expand services—including direct material or financial assistance—to address families’ basic needs during national emergencies. Many families’ ability to meet their basic needs—such as having enough food, stable housing, and adequate baby and household supplies—worsened during the pandemic. Programs pivoted to address these needs by, for example, delivering free meals provided by schools and food banks and partnering with other organizations to offer direct financial and material assistance to families. Recognizing that many families’ economic challenges persisted after the end of the public health emergency, some programs decided to continue these expanded services themselves or by partnering with other organizations. Programs receiving funding from the Maternal, Infant, and Early Childhood Home Visiting Program cannot use these funds to provide direct material assistance outside of the scope of the approved program after May 2023.  
• Invest in partnerships. Partnerships with food and diaper banks, places of worship, and other organizations were key to providing needed services during the pandemic. Early childhood home visiting programs used their existing community partnerships to quickly meet families’ needs at the beginning of the pandemic. They also developed partnerships with other organizations to expand their services. Some program staff also talked about their community’s desire to help those in need during the pandemic. Programs could consider assessing new opportunities for partnerships and community support by increasing community awareness about themselves and their mission, or sharing ways people can volunteer their time or resources to support families. 

Avellar, Sarah, Jill Filene, Megan Hague Angus, Anna Beckham, and Patrice Cachat. (2024). Helping Families Through Upheaval: How Home Visiting Programs Supported Families’ Economic Well-Being During the COVID-19 Pandemic, OPRE Report #2024-019, Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.