1. Social norms: Understanding community perceptions of voluntary services and its effect on parental engagement Emily Stiles Mentor: Dr. Bart Klika The University of Montana

2. Home Visiting Services  Overview of home visiting  How and why it is used  Benefits:  Improvement of child health and development  Preventive strategy for child abuse and neglect  Prenatal and parenting skills education  Nutritional care  Connection to additional resources and supports 1 1. U.S. Department of Health and Human Services (2016).

3. Missoula County Missoula City-County Health Department (MCCHD) Voluntary home visiting services for new & expecting mothers Already universal- open to anyone Hospital registration packets with “consent for call” flyers Implementation of the Universal Home Visiting pilot program First, are people currently engaged in services?

4. Referrals & Contacts Recent engagement with home visiting services: 2014: 874 referrals, 97 individualized face-to-face contacts (11%) 2015: 821 referrals, 75 individualized face-to-face contacts (9%) ~1,200 births/year in Missoula County Why are engagement rates so low?

5. McCurdy, K., & Daro, D. (2001).

6. Social Norms For this presentation, social norms are defined as: Social norms are the unwritten rules of a society that dictate how people should behave. Social norms also incorporate the values and beliefs of a given group.

7. The Research Recruitment Flyers, intake packets at the hospital 16 semi-structured qualitative interviews 10 service providers (public health nurses, social workers) 6 new/expecting mothers Main demographics: Caucasian, college-educated, mid 30’s *The focus of this presentation is on these 6 mothers Thematic analysis (current project) A way to recognize, analyze, and categorize main themes in data 1 1. Braun, V., & Clarke, V. (2006).

8. Rigor Reflexivity Self-reflection on personal values Acknowledgement of own biases Influences on thematic analysis/coding of transcripts Audit trails 1 Detailed log of meetings Shows decision-making steps 1. Cohen, D., & Crabtree, B. (2006).

9. Emerging Themes Lack of awareness “Honestly, I don’t even know what it is, I don’t, I don’t know what that means.” Misinformed “…probably requires to go off your base income too and I’m just not going to qualify….” Services for “other populations” “…for people with fewer other kinds of resources, um, like lower income…”

10. Emerging Themes- Continued Fear “…I would be afraid of being judged...will they think I’m not doing a good enough job.” “…public health…sounds more like a negative thing…I almost heard, like CPS.” Suggestions for improvement “…the nurses that you met when you were getting care…one of them would come to your house so you already knew them…” “…if it was something that was offered… in my little mommy group, I think people would really value it.”

11. Moving Forward Adopting suggestions into Universal Home Visiting pilot program (UHV) Addressing social norms through UHV Analysis of interviews with service providers Marketing of services to the public

12. Thank You! A huge thank you to Dr. Bart Klika of UM’s Department of Social Work for his mentorship over the past three years. Thank you to UMCUR for this opportunity.

13. References Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3 (2), 77-101. Cohen, D., & Crabtree, B. (2006). Qualitative research guidelines project. Robert Wood Johnson Foundation. McCurdy, K., & Daro, D. (2001). Parent involvement in family support programs: An integrated theory. Family Relations, 50 (2), 112-121. U.S. Department of Health and Human Services. (2016). Maternal, infant, and early childhood home visiting. Health Resources and Services Administration.

14. Funding Funding provided by the University of Montana Research Grant Program- Office of Research and Sponsored Programs

15. Questions?