Listening to Parent Voices:

How Technology Changed What’s Possible in Home Visiting & Infant Mental Health Programs

In March 2020, the world faced an abrupt shutdown in response to the COVID-19 pandemic, which included most in-person early childhood services. Many of the families who participate in these programs were already isolated and cacing substantial challenges. COVID-19 heightened that isolation by cutting off home visiting options and other opportunities for in-person connection.

Maintaining Engagement Through Technology

A team of researchers, supported by Perigee Fund and The Ford Family Foundation, interviewed providers and families in seven communities around the country about their experience participating in early childhood programs as they shifted to technology-based services. The providers listened to parent needs and responded with creative solutions for keeping families engaged.

A special thank you to the national research team

Beth Green, PhD
Director of Early Childhood & Family Support Research, Portland State University

Rachel Chazan-Cohen, PhD
Associate Professor, Human Development and Family Sciences, University of Connecticut

Deborah F. Perry, PhD
Director of Research and Evaluation, Center for Child and Human Development, Georgetown University

Read the Parent Voices Study Summary

Of study participants, 67% of parents and 68% of providers would like to continue some support remotely.

The Findings

This report is a rare opportunity to hear directly from parents and caregivers who were most impacted by the pandemic about how programs can be better designed to fit their needs — increasing effectiveness and ensuring that programs are reaching the families most in need of support.

  • Families want more flexibility in how they engage with programs.
  • Retention remained stable, and providers were able to recruit and support more families.
  • Having flexibility improved providers own mental health.
  • There was more connection between service providers and families.

“I feel like it’s way easier than having to schedule an appointment and coming, sometimes I’ll be busy so I’ll have to reschedule the visit; I like this better, it’s easier.”

– Caregiver/Parent

To continue operating, program providers removed rigid requirements previously required to participate in the programs.


90-minute Visits

In-person Mandates

“When we’re not talking or whatever or I’m having a bad day, I get a text message from her.… It’s like, how’d she know I’m not doing too great?… I can talk to her like she’s my friend, but she’s not my friend. She’s my support person. It’s a big support for sure. I don’t trust a lot of people like I trust her.”

– Parent/Caregiver

Case Study Spotlight

Family Nurturing Center: Confronting Local and Global Crises

Located in Jackson County in Southern Oregon, the community served by the Family Nurturing Center (FNC) was heavily impacted by some of the most destructive wildfires ever recorded in the state. 40,000 families were displaced due to evacuation orders and 2,800 structures were destroyed in the county alone. Staffed with 5 therapists and 3 home visitors, FNC serves 55 children and 45 families per year through in-home and on-site mental health services. Both local and global crises forced these programs to a halt and providers quickly began to implement a variety of strategies to continue to support their families remotely:

Basic Supports

FNC set up a website where families or providers could complete a form to help families access necessities such as diapers, food, and therapeutic toys, which were delivered to their homes. FNC also worked to provide internet access and devices to families to ensure they could stay engaged in services.

Emotional Support

Both staff and parents shared that emotional supports, such as the implementation of a “warmline” for mental health services and more frequent check-ins from FNC staff helped to maintain valuable relationships and connections between families and FNC providers.

Social Support

Services to increase social supports such as parenting classes were cited as a valuable resource, especially when offered in an online platform during this time of social isolation. All (100%) of the families indicated that they accessed emotional support services and almost all (90%) said that they accessed parenting information and support and received activities for their children.

100% of the families indicated that they accessed emotional support services.

90% said that they accessed parenting information and support and received activities for their children.

Looking Ahead:

This research presented an unprecedented opportunity to hear directly from families about how programs can best meet their needs so that caregivers, parents, and infants receive the care needed to thrive.

1. Find the willingness to change.

What might have seemed impossible before the pandemic, like effectively providing remote and hybrid services, was actually made possible through flexibility and quick responsiveness to the needs of parents. Programs must actively listen to the voices of parents and be open to small or big shifts in practices to reflect those needs.

2. Increase adult mental health services through telehealth.

Both providers and parents voiced the critical need for mental health services. Telehealth proved to be a promising option to increase access to programs and care.

3. Expand availability of Infant and Early Childhood Mental Health Consultation (IECMHC) to infant and toddler programs.

IECMHC — an evidence based model that expands mental health and social, emotional support for families, children, and staff — can provide significant benefits in home visits.

4. Add flexibility into the evidence-based models that are already proven to work.

Loosening requirements, especially those related to frequency and duration of visits, as well as allowing remote options, has shown to improve retention of current and new families, increase equity, work well for staff, and improve the quality of services provided.

5. Embrace hybrid approaches.

Hybrid approaches that incorporate what works best from both in-person and telehealth can blend the best of both worlds (e.g., in-person for initial assessments and relationship-building, virtual for some sessions and check-ins with flexible scheduling).

6. Rethink how programs support family basic needs.

Families’ needs increased dramatically when faced with a crisis. Trusted programs must consider how to expand support to meet basic needs without compromising the time and energy going towards core services. Family stability supports child development and is an important point of entry for many.

7. Invest in planning and advance preparation.

Flexibility needs planning and structure in order to work. Parents appreciated the additional pre-visit preparation offered during the pivot to remote services. Increased planning and pre-visit support, regardless of whether services are in-person or remote, can improve parent engagement and service quality.

8. Explore leaning into a parent-coach model of support.

Pivoting to remote services forced providers to interact less directly with children and more directly with parents, with providers often acting as a coach. Many providers felt it represented an important practice change that may improve service effectiveness overall — even when some services resume face-to-face.

9. Continue to expand organizational support for staff.

Additional staff support — such as mental health services and flexible scheduling — was a key factor in programs’ ability to provide quality services during the pandemic. Retaining those supports and providing additional training could have long-term benefits for staff retention.

10. Consider continuing remote support groups.

Several programs saw highly successful remote playgroups between parents and children, where some families with busy schedules or limited transportation preferred these remote groups as a way to reduce social isolation and connect with other parents in a convenient format.


Special Thanks to Provider and
Family Participants

Brockton Healthy Families in Massachusetts


Oregon Family Building Blocks


Family Nurturing Center in Oregon


Healthy Families America (HFA) Arkansas


Inter-Tribal Council of Michigan


Mary’s Center in Washington D.C.


Southeast Kansas Community Action Program


And Our National Advisory Group

Ernestine Benedict (Zero to Three)

Robin Hill Dunbar (The Ford Family Foundation)

Angel Fettig (University of Washington)

Sara Haight (Aspen Institute)

Neal Horen (Georgetown University)

Cat MacDonald (Association of State and Tribal Home Visiting Administrators)

Mary Louise McClintock (The Oregon Community Foundation)

Lisa Mennet (Perigee Fund)

Aleta Meyer (USDHHS, Administration for Children and Families, Office of Planning, Research and Evaluation)

Shannon Rudisill (Early Childhood Funders Collaborative)

Letty Sanchez (First Five LA)