How Satisfied Are Home Visitors With Their Caseloads? A National Look at Home Visitors’ Perspectives on Caseload Fit

Publication Date: October 28, 2021
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  • Published: 2021

Introduction

Research Questions

  1. How do home visitors feel about their caseload size?
  2. How do home visitors’ perceptions of caseload burden relate to their reports of on-the-job stress, work-life conflict, and turnover intentions?
  3. What types of home visitors report their caseloads are lighter or heavier than they can handle?

The success of home visiting programs depends on home visitors establishing trusting relationships with families. To allow home visitors sufficient time to develop these relationships and work with families, caseloads—defined as the number of children or families a home visitor serves—should be manageable. Caseloads differ for a variety of reasons. Yet little is known about how home visitors feel about their caseloads and how their caseload size affects their work experiences. This brief summarizes descriptive findings from the Home Visiting Career Trajectories project regarding staff perceptions of client caseloads.

Purpose

This brief draws on data about home visiting caseloads from a national survey of home visitors in programs receiving Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program funding and focus groups with home visitors across 26 local implementing agencies (LIAs). Analyses explore how home visitors feel about their caseloads and associations between perceived caseload burden and home visitors’ report of job stress, work-life conflict, and turnover intentions. The brief also describes program characteristics and personal characteristics of home visitors related to perceived caseload fit.

Key Findings and Highlights

Key findings include the following:

  • Overall, 75 percent of home visitors are somewhat or completely satisfied with their caseload size. Most home visitors (68 percent) report that their caseloads are “about right,” while 14 percent feel their caseloads are too heavy and 18 percent feel their caseloads are too light.
  • When caseloads are heavier than home visitors feel they can handle, they are more likely to report on-the-job stress and less work-life balance.
  • Perceived caseload fit varies by program and staff characteristics. Home visitors who perceive caseloads as too light are typically new staff in their first year on the job. Home visitors are more likely to perceive their caseloads as heavier than they can handle when their programs have at least one staff vacancy. Reports of experiencing heavy caseloads are most common among home visitors with three to five years of experience.

Methods

The Home Visiting Career Trajectories project includes two major components: (1) a two-stage national survey of the home visiting workforce in local implementing agencies (LIAs) receiving MIECHV Program funding and (2) case studies in eight states involving interviews with program leaders and supervisory staff, as well as focus groups with home visitors in 26 LIAs. Findings for this brief draw primarily on the home visitor surveys and focus groups.

Citation

Sandstrom, Heather, Cary Lou, and Sarah Benatar. 2021. “How Satisfied Are Home Visitors With their Caseloads? A National Look at Home Visitors’ Perspectives on Caseload Fit.” OPRE Report #2021-194. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.

Glossary

Early Childhood Home Visiting:
A service delivery strategy for achieving greater child and family health and well-being. Local home visiting programs connect new and expecting parents with a designated support person—a trained nurse, social worker, parent educator, or early childhood specialist—who provides services in the home. Services generally consist of screening, case management, family support or counseling, and caregiver skills training.
Local implementing agency (LIA):
A local organization, such as a community action agency, community nonprofit, or public health or education department, that receives funding to implement home visiting services under MIECHV. States, territories, and tribes work with LIAs to train a high-quality home visiting workforce, establish data reporting and financial accountability systems, and develop recruitment and referral networks.
Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program:
Administered by the Health Resources and Services Administration in partnership with the Administration for Children and Families, the MIECHV Program was established in 2010 to support voluntary, evidence-based home visiting for at-risk pregnant women and parents with children up to kindergarten entry. The program provides grants to states, US territories, and tribes, which conduct needs assessments to identify eligible at-risk communities and serve priority populations.
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