Abstract
Background
More than two million U.S. families receive home visiting services each year, yet little is known about the content and process of home visit interventions. Home visit observations are a recommended tool to address this gap in knowledge, but guidance regarding how much observation time is needed to provide a trustworthy picture of home visits is not available.
Objective
This study estimated the length of observation needed to provide a reliable description of the content and process of home visits delivered through an Early Head Start (EHS) home-based program.
Methods
Observations of 555 home visits involving 88 families and 17 home visitors were coded with the Home Visit Observation Form-Revised (HVOF-R). The HVOF-R describes the proportions of time spent among several subcategories within each of three major categories: Primary Interaction Partners, Content of Interactions, and Nature of the Home Visitor’s Interactions. The psychometric theory of test reliability guided use of bootstrap resampling and the Spearman-Brown prediction formula to estimate the duration of observation necessary to achieve conventional psychometric standards of reliability (r = .90 and r = .80).
Results
Results showed that 40–60 min of a home visit observation yields a reliable estimate of the proportion of time spent on most key features of home visits, especially those behaviors observed most frequently, including interactions among the home visitor, parent, and/or child.
Conclusion
Fairly brief observations yield reliable description of home visit activities, and use of observation is recommended to guide program implementation efforts and enhance program quality.