Dialog, 16(1), 194-199 Copyright © 2013 ISSN: 1930-9325 Correspondence concerning the article should be addressed to Patricia Hrusa Williams, Ph.D., Division of Inclusive Early Childhood and Elementary Education, University of Maine at Farmington, 186 High Street, Farmington, Maine, 04938; phone: (207) 778-7109, email: patricia.h.williams@maine.edu The authors wish to thank all of the Parent Child Home Program (PCHP) sites who participated in this study and both the Massachusetts Department of Elementary and Secondary Education and the Department of Early Education and Care for their support. We would also like to acknowledge the research assistance provided by Michelle Higgins and Kimberly Krupa while they were students at Providence College and feedback provided by Suzanne Colby, Christopher Heinrich, and two other anonymous reviewers on earlier drafts of this manuscript. The opinions expressed in this article are of the authors and not of the Massachusetts Department of Elementary and Secondary Education, the Department of Early Education and Care, or the PCHP National Center. RESEARCH-TO-PRACTICE SUMMARY Participation in Early Childhood Home Visiting: The Role of Family, Ethnic, and Community Factors Patricia Hrusa Williams University of Maine at Farmington Emily Caille Participant ethnicity, family risks, resources, and community characteristics influence participation in many different types of early childhood home visiting programs. However, few studies have examined their influence on family participation in literacy- focused home visiting efforts. A sample of 539 families enrolled in one of 25 Parent Child Home Program (PCHP) sites in Massachusetts was tracked from program entry to exit. Families were less likely to complete programs if they were non-Latino and experienced more family educational risks; the ESL rate in their community of residence was predictive of program completion for Latino families. Length of participation was predicted by ethnicity, child age at entry, family involvement in formal school settings, and the graduation rate in the community where the family resides. Implications of study findings for decreasing barriers to program completion and developing long-term associations between home visiting programs and families are considered. Keywords: home visiting, community, Latino, risk factors, literacy Participation in Early Childhood Home Visiting: The Role of Family, Ethnic, and Community Factors Home visiting programs are designed to reduce barriers to program participation for families with young children by bringing interventions directly to them. However, studies examining a variety of home visiting programs including Healthy Families, Parents As Teachers (PAT), and PARTICIPATION IN HOME VISITING 195 the Nurse Home Visitation Program suggest that drop-out rates for programs remain an issue of concern. Program completion rates hover between 20 - 76% depending on the subgroups examined (Gromby, Culcross, & Berman, 1999; McCurdy, Gannon, & Daro, 2003; Middlemiss & McGuigan, 2005). Kahn and Moore’s (2010) review of the research finds that high service intensity is important to service outcomes in early childhood home visiting programs focused on parenting, child development, and providing educational support. Research on programs such as Parents as Teachers (PAT) indicates that the number of visits received by families is important to program success (Wagner & Clayton, 1999; Zigler, Pfannenstiel, & Seitz, 2008). Further, the duration of home visiting has been found to have a direct effect on parents’ understanding of early childhood development and an indirect effect on school readiness (Schull & Anderson, 2008). It is also important to examine differences in family participation in home visiting by families’ ethnic background to ensure program practices and policies optimize participation for diverse families. The number of Latino children in the U.S. is growing, with Latinos under 18 outnumbering non-Latino whites by 11.6% (U.S. Census, 2006). Research on home visiting indicates that Latino families, especially those who are newer to the U.S. and less acculturated, are more receptive to home visiting, and more likely to achieve benefits from programs (Daro et al., 2007; McCurdy et al., 2003; McGuigan, Katzev & Pratt, 2003ab; Middlemiss & McGuigan, 2005; Wagner & Clayton, 1999). Differences in Latino families’ rates of program completion and length of participation have been attributed to cultural differences in familism, extended family networks, and permeability (Landale, Oropesa, & Bradatan, 2006; Middlemiss & McGuigan, 2005). However, there are other factors besides ethnicity that may be linked to family success in programs. They include family educational risks, family literacy skills and resources, and the characteristics of the community where families reside. These factors may be particularly crucial to success in literacy-focused home visiting programs such as the Parent-Child Home Program (PCHP) (see Levenstein, 1988; Levenstein, & Levenstein, 2008) which has the primary goal of strengthening verbal interaction and educational play between parents and their young children. Studies of other literacy-focused home visiting programs have found that young, less educated Latina mothers are less likely to persist in home visiting programs (Wagner, Spiker, Linn, Gerlach-Downie, & Hernandez, 2003). Community factors, including the demographic profile of the community where the program is located and the family resides, also contribute to family participation and programmatic outcomes (Coulton, 1995). Communities challenged by poverty, low rates of high school completion, and high numbers of English Language Learners (ELLs) may create barriers to program completion for families. Conversely, residing in a distressed community could serve as a means further motivate families to stay engaged with programs so as to help ensure their child’s future educational and occupational success in the face of adversity. Hence, the present study examines multiple factors associated with program completion and length of participation for Latino and non-Latino families enrolled in a statewide, multi-site implementation of the Parent Child Home Program (PCHP). 196 WILLIAMS AND CAILLE SUMMARY OF RESEARCH METHODS Data were collected from families representing 25 state-funded Parent Child Home Programs (PCHP) in Massachusetts. Families’ progress was tracked from program entry to exit, with complete data available on 539 families who were enrolled in the program between September 2003 and June 2006. Information collected included data on family risks (income, single parenthood, parental educational attainment, and language) and child age at entry to the program. The Familia Inventory: A Questionnaire for the Assessment of Literacy Practices in Families (Infant-Toddler Version) (Taylor, 2001) was used to examine family literacy skills and resources. Three city-level indicators were used to examine the socioeconomic and educational characteristics of communities in which PCHP programs were located including the percentage of (1) individuals in the community who have not graduated from high school, (2) families below the poverty line and (3) families in the community who speak a language other than English. These variables were used to predict two indicators of family participation in home visiting: program completion and length of enrollment. MAJOR FINDINGS Results show that Latino families enrolled in PCHP faced twice the number of risks to their participation in home visiting than non-Latino families enrolled in the program. Latino program participants were more likely to have lower incomes, use literacy skills less frequently (individually or in interaction with their children), to be single parents, have less extended family support, and to reside in urban areas than non-Latino families. They were also less likely to use community resources such as the library at program entry. Despite these risks, non-Latino families were at greater risk for program non-completion and Latinos were more likely to participate longer in programs. Further, different sets of factors were important in understanding program completion and length of enrollment for Latinos and non-Latinos. For Latino families, the odds were greater of dropping out of the program if the family lived in a community with a high ESL rate. For non-Latino families, the odds of dropping out of the program were greater for families who experienced more risks. For both Latino and non-Latino families, child age at entry and the high school graduation rate of the community were statistically significant predictors of the length of time families remained enrolled in the program. Those children who entered the program when they were younger and had families that resided in communities with a lower rate of individuals not graduating from high school remained in the program longer. IMPLICATION FOR PRACTICE There are several findings of this study which may inform practice and policy in Head Start programs. This study found different sets of factors predict program completion for Latino and non-Latino families. Family experiences, patterns of organization, and interaction may differ for these two groups, influencing their participation patterns in home visiting programs (Coatsworth, Duncan, Pantin, & Szapocznik, 2006). Overall, the odds of dropping out of PCHP in Massachusetts are higher for non-Latinos and those experiencing more family educational risks. While cultural issues may have played a role in the higher completion rate for Latino families PARTICIPATION IN HOME VISITING 197 enrolled in PCHP, as other studies have shown (Daro et al., 2007; McCurdy et al., 2003, McGuigan et al, 2003ab; Middlemiss & McGuigan, 2005; Wagner & Clayton, 1999), an alternative explanation may also apply. It is likely that because Latino families experience far more risks in this sample than non-Latinos, home visitors perceived them as needier and provided more assistance than they do to non-Latino families; this in turn enables then to complete the program at a higher rate than their non-Latino counterparts. This has been found in other work (Sharp, Ispa, Thornburg, & Lane, 2003). Follow-up work should examine home visitor-parent interaction and how patterns differ for Latino and non-Latino families to assess biases in interaction toward Latino families or against non-Latino families participating in literacy-focused programs. For non-Latinos, family educational risk was an important predictor of program completion. Family educational risks, including low parental education level, language barriers, poverty, and single parenthood may serve to impede families’ ability to meet program participation requirements in literacy-focused home visiting programs. For Latinos, only the ESL rate of the community was a significant predictor of program completion. McGuigan et al. (2003a) found those families living in communities with poorer community health are less likely to engage in programs. In this study, a higher ESL rate decreased the odds that families would be able to complete the required number of home visits. In communities where there are large numbers of individuals struggling with the same issue, whether it be to learn a new language, adapt to a new culture, or have their child succeed educationally where few do, there may competition for resources and fewer models of success in the community for families to learn from and to use for inspiration. These factors may collectively impact program completion. The use of peer mentors by home visiting programs operating in areas with high rates of second language learners may be important to help promote family success. In addition, work with families may need to extend out from the home into the community. Collaboration between programs that serve English Language Learners (ELLs) may assist home visiting professionals in understanding the challenges and needs of second language families, help link parents enrolled in home visiting programs and their family members with educational supports, and facilitate the development of social networks for Latino families. The present study also found child age at entry and the high school graduation rate in communities to be important predictors of length of participation in home visiting. This highlights the importance of program outreach and targeting in locating and registering children early. In Massachusetts many PCHP programs were based within public schools where preschool services typically start at age three. Hence, it is crucial that home visiting programs collaborate with early intervention programs, pediatricians, and family child care providers in order to effectively outreach to families with older infants and toddlers who may qualify for programs like PCHP. Finally, the high school completion rate of the community was an important predictor of length of enrollment in PCHP for both Latino and non-Latino families. McGuigan et al. (2003b) found in their study of Healthy Families programs that higher rates of community violence predicted whether families would receive more home visits. Similarly, the present study found that greater education risk in the community, as indicted by a lower high school completion rate, was associated with an increased length of enrollment in PCHP. Home visiting in these communities may serve as a means for families who want to have their children succeed in school to gain needed support that may not be readily available in the larger community. 198 WILLIAMS AND CAILLE Conversely, PCHP families residing in communities with higher high school completion rates may feel isolated and separated from their community. They may feel that there is a stigma to utilizing literacy-support services in a community where there is a history of educational success, as evidenced by the high number of individuals completing high school. Home visiting programs may need to work harder with families in these communities to assist them in feeling comfortable and less isolated in the literacy environment of their community, such as the library. Isolation may play a role in length of enrollment, as has been suggested by McGuigan et al. (2003a). 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