Instrument 3: LIA Interview Protocol

Family Level Assessment and State of Home Visiting (FLASH-V) Outreach and Recruitment Study

Instrument 3_LIA Interview Protocol

Instrument 3: LIA Interview Protocol

OMB: 0970-0559

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Expiration Date: XX/XX/XXXX

INSTRUMENT 3: LIA INTERVIEW PROTOCOL



Your knowledge and insights are very important to us, and I want to thank you for taking the time to speak with me about the Family Level Assessment and State of Home Visiting project. To begin, I will provide an overview of the project study and what we hope to talk about today and then we will read through the Informed Consent Form that I sent prior to our call.


The purpose of this project is to understand how home visiting programs recruit families for program participation and challenges they may face, as well as accomplishments, in program recruitment and enrollment. During our discussion, I will ask about several topics, including:

  • Your program’s caseload capacity

  • Challenges and accomplishments your program has experienced related to caseload capacity

  • Outreach and recruitment strategies your program uses

  • How you staff program outreach and recruitment activities

  • Your work with community referral partners

We also recognize that many of these topics may have changed due to the COVID-19 pandemic, which we will touch on throughout our discussion. Additionally, there are several questions during our discussion that refer to survey responses your program previously provided. We are hoping that the person that completed the survey is participating in the call today, is that the case? If no, you can refer to the provided summary of survey responses when we reference your program’s survey responses. We will be sure to let you know the exact questions and responses we are referencing as we go through today’s discussion.

Your participation in today’s interview will help contribute to the field’s understanding of how programs find potential eligible families and the strategies programs use to recruit families for home visiting services.

Do you have any questions before we read through the informed consent?


[Read through the Informed Consent Form.]


Do you have any questions before we begin? Do you agree to participate in this interview?


[If interviewee previously indicated they do not want to be recorded.] Before we begin, I wanted to note that my colleague (name of notetaker) is also on the call today to take notes so I can concentrate on our discussion. Is this okay with you?


[If interviewee did not previously indicate they do not want to be recorded.] I was hoping to be able to record this interview, so that I can be more attentive to your responses to the questions and accurately capture your responses. Once we transcribe the recording, it will be destroyed. May I have your permission to record this interview?


[If interviewee has agreed to participate in the interview and has agreed to have the interview recorded, start the recording. If there is more than one participant on the phone, ask each participant to state their name and title so that the transcribers can differentiate the respondents’ voices.]


[If interviewee has agreed to participate and to have note taker participate but does not agree to have the interview recorded, start the interview. If there is more than one participant on the phone, ask each participant to state their name and title so that the notetaker can differentiate the respondents’ voices.]


[If interviewee has agreed to participate and previously agreed to having the call recorded but now does not agree to recording the call, tell the interviewee that you will need to reschedule the call for a time when you can have a note taker participate in the call.]



AA. Participant Names and Titles

Name of LIA: _____________________


Name 1:

Title 1:


Name 2:

Title 2:


Name 3:

Title 3:





  1. Introduction and Background. I would like to start by first understanding more about your home visiting program, your community, and the families you serve.



    1. Let’s start with your home visiting program.

      1. We know that families might participate in home visiting services for a variety of reasons. In your survey, you indicated that you felt several strategies [are important strategies for getting families initially interested and willing to participate in home visiting. For example, you indicated that [provide examples of 2-3 strategies LIA rated as important] are important strategies for getting families initially interested in home visiting.

        1. Based on your experiences with families, which of these strategies would you say are most important in getting families interested and willing to participate in home visiting?

          1. Why do you think these strategies are particularly effective, compared to other strategies?

          2. Can you describe how your program makes sure these strategies are in place? [Prompt: For example, can you describe a specific time when your program used this strategy or type of support to successfully recruit a family for program participation?]

          3. How, if at all, has your program’s ability to make sure these strategies or types of support are in place changed as a function of the COVID-19 pandemic?

        2. How, if at all, have families’ reasons for being interested in home visiting services changed since the COVID-19 pandemic?

      2. We recognize that there are also many reasons why a family may not be interested in receiving home visiting services. In your survey, you indicated that [name most important reasons families do not enroll] are important reasons for why some families are not interested.

        1. Can you describe how your program works to overcome these common barriers? [Prompt: For example, can you provide an example of when your program worked with a family to overcome common reasons for not enrolling? What specific strategies or approaches did you use in this instance? Which were successful?]

          1. How has your program’s ability to overcome these barriers changed as a function of the COVID-19 pandemic?

        2. How, if at all, have families’ reasons for not being interested in receiving home visiting services changed as a function of the COVID-19 pandemic?

      3. Many programs feel there are certain ways of messaging home visiting to families that are more effective. Your survey responses indicate several factors that are important in messaging to families about why they might want to participate in home visiting. For example, you indicated that [list 2-3 factors LIA rated as important] are important ways of messaging to families. From your experience with families, which of these factors are most important?

        1. From you experience, why are these factors important?

        2. Can you describe a time when one of these factors helped your program successfully enroll a family in home visiting services?

      4. I understand that your program offers [name additional services offered by LIA]. I recognize you may not be able to offer these services due to the COVID-19 pandemic, however, can you reflect back on how you feel offering these other services (or programs) influenced your program’s ability to reach out to and recruit families in home visiting services? [Prompt: For example, can you describe a time when you were able to engage a family in home visiting services as a result of them receiving other services at your agency?]



    1. Now, let’s talk about the community your home visiting program operates in.

      1. Can you describe any characteristics of the community your program operates in that influence your ability to reach out to families and get them interested in receiving home visiting services? [Prompt: For example, issues of privacy in small communities or concerns over trust in communities with high rates of involvement in social service or justice systems.]

      2. You indicated in your survey response that [summarize responses related to community need and program capacity]. Can you describe how and if community needs and capacity to meet those needs has changed since COVID-19?

      3. Is there anything you think would be helpful or could be changed to better meet community needs and the demand for home visiting? If yes, please explain.



    1. Next, let’s talk about the families your home visiting program serves.

      1. How would you describe the families that your program typically serves? [Prompt: For example, are they mainly English-speaking families or Spanish speaking families? Mostly two-parent families or more evenly split?] Have the characteristics of families you serve changed at all since the COVID-19 pandemic? If so, how?

      2. Can you describe any family characteristics or circumstances families may be experiencing that influence their interest or ability to enroll in home visiting services?

      3. How, if at all, has the COVID-19 pandemic impacted families’ interest or ability to enroll in home visiting services?



  1. Number of Families Served. Next, I would like to talk about the number of families your program typically serves and how your program feels about the number of families you typically serve.



    1. Does your program track information on eligibility and enrollment in efforts to maintain required caseloads? [If yes, ask questions below.]


      1. What information is tracked?

        1. Percentage of capacity served (y/n)

        2. Initial contact or outreach to a potential eligible family (y/n)

        3. Follow-up attempts to contact a potential eligible family (y/n)

        4. Reasons why potential eligible family does not enroll in services (y/n)

        5. Is any other information, other than what we have already discussed tracked? If yes, what information is tracked?

      2. How often is this information reviewed? [Prompt: For example, monthly or once a year]

      3. Who reviews it? [Prompt: Program supervisor or home visitors]

      4. How is the information used? [Prompt: Does it impact how you engage in program outreach and recruitment?]

      5. Is this information shared with staff that participate in outreach and recruitment efforts, and if so, how? Is this information shared with home visitors, and if so, how?



    1. In your survey responses, it appears that your program has mostly been [either at or under capacity] since March 2020. Tell me about your program’s perspective or thoughts with respect to [being under or at capacity] [Prompt: For example, is being at capacity something your program actively works on and tries to find new avenues and strategies for outreach and recruitment or is it something your program is not necessarily actively working on?]


      1. How has your program’s perspective on capacity changed since the COVID-19 pandemic?

      2. Can you tell me about any discussions, guidance/support, or feedback your program has had or received from either your funder, program leadership, or program model on the topic of program capacity?

        1. What was the nature and content of these conversations or guidance/support? What kind of feedback or suggestions, if any, did you receive?

        2. How do you feel about these conversations or guidance/support? [Prompt: Are they helpful? Why or why not?]

        3. Can you describe any changes, if any, that have been made as a result of these conversations or guidance/support?

        4. Can you recall approximately when you received this guidance/support? [Prompt: In the past two months, a year ago?]


    1. In your survey responses, you mentioned several challenges your program faces in maintaining caseloads. For example, you indicated [list 2-3 challenges LIA identified]] are some of the challenges your program faces in maintaining caseloads.



      1. Which of these challenges would you say your program struggles with the most?

      2. Are there any other challenges your program has encountered in maintaining caseloads?

      3. How, if at all, have these challenges changed since the COVID-19 pandemic?

      4. What factors do you think contribute to these challenges?

      5. What is your perspective or thoughts on these challenges? [Prompt: For example, do you see these challenges as problems that need to be addressed or a concern of yours or of program leadership? Why or why not?]

      6. How has your program worked to overcome these challenges? What has worked well? What has not worked as well?

      7. Other than the guidance and support previously discussed, what kind of support or resources might be helpful in addressing these challenges?



    1. What are some of the biggest achievements your program has experienced in maintaining caseloads?



  1. What factors contributed to these achievements? [Prompt: For example, use of specific recruitment and outreach strategies or establishing referral relationships with key community service providers.]

  2. Can you describe the specific steps your program took to make these achievements? Which of these steps do you see as critical and why?

  3. [If staffing is the primary achievement respondent mentions] What other achievements or steps, outside of staffing changes, do you feel like your program made that contributed to maintaining required (or desired) caseloads? [Prompt: For example, maybe you made changes to your outreach and recruitment strategies or started working with a new referral partners or developed new outreach materials.]

  4. How, if at all, have these accomplishments changed since the COVID-19 pandemic?


  1. Strategies for Engaging Families in Home Visiting Services. Next, I would like to learn more about the strategies you feel work best for your program and community in reaching out to families to inform them about available home visiting services and engage them in services.


    1. To start, in your survey, you said that [list of strategies identified as most successful] are the most successful method(s) for reaching out to families. [For each strategy mentioned, ask:]

      1. Can you explain how your program uses this strategy? [Prompt: For example, can you describe a specific time when this strategy was used to successfully recruit a family for program services?]

      2. If I were a new staff member, how would you describe this strategy to me and help me understand when and how to use it?

      3. What makes you say this is one of the most successful strategies? [Prompt: For example, is this based on staff observations and reflections or on program data?]

      4. What percentage of families would you estimate are recruited using this strategy?

      5. How do you decide which families to use this strategy with? [Prompt: For example, do you use it with all families or with specific families?]. Please explain.

      6. In your experience, are there specific types of families that some strategies work better with than others? If yes, please explain.

      7. What challenges or draw backs, if any, are there in using this strategy? How do these challenges/draw backs compare to the benefits of using this strategy? [Prompt: For example, does the time required to use this strategy outweigh the benefits of using this strategy?]

      8. Has use of this strategy changed at all since the COVID-19 pandemic? If yes, please explain.

      9. Have you modified any outreach and recruitment strategies specifically to deal with the COVID-19 pandemic?


    1. Next, I would like to walk through a few additional outreach and recruitment strategies you indicated your program uses according to your survey responses.


      1. [Ask only if LIA said they engage in direct outreach and not addressed above] You indicated your program engages in direct outreach to potentially eligible families. For example, directly talking to families, handing fliers to families or putting fliers in their mailboxes, or directly calling families.

        1. Can you explain how your program uses this strategy? [Prompt: For example, can you describe a specific time when this strategy was used to successfully recruit a family for program services?]

        2. What challenges or draw backs, if any, are there in using this strategy? How do these challenges/draw backs compare to the benefits of using this strategy? [Prompt: For example, does the time required to use this strategy outweigh the benefits of using this strategy?]



      1. [Ask only if LIA said they host or participate in program outreach and recruitment events and not addressed above] You indicated that your program offers or collaborates with others to offer program outreach and recruitment events like special events, fairs, or parent nights.

        1. Can you describe the purpose and broad nature of the main outreach and recruitment events your program offered or collaborated in hosting in the past year?

        2. What challenges or draw backs, if any, are there in using this strategy? How do these challenges/draw backs compare to the benefits of using this strategy? [Prompt: For example, does the time required to use this strategy outweigh the benefits of using this strategy?]



      1. [Ask only if LIA said they attend other community events for recruitment purposes and not addressed above] You indicated that your program attends other community events, like health fairs, where you know potential eligible families may be present.

        1. Can you describe the purpose and nature of the main community events you recall your program attending in the past year?

          1. Did you attend these events for the sole purpose of program outreach and recruitment? Or, did you attend these events for other reasons but to also spread the word about the benefits of home visiting in doing so?

        2. What challenges or draw backs, if any, are there in using this strategy? How do these challenges/draw backs compare to the benefits of using this strategy? [Prompt: For example, does the time required to use this strategy outweigh the benefits of using this strategy?]



      1. [Ask only if LIA said they reach out to or physically visit other programs for recruitment purposes and not addressed above] You indicated that your program reaches out to or visits other programs or community service organizations where you know potential eligible families may be present.

        1. How do you decide which programs or community service organizations to target?

          1. Are these programs/organizations targeted because there is overlap in the populations they serve and the populations you target for home visiting services?

        2. What challenges or draw backs, if any, are there in using this strategy? How do these challenges/draw backs compare to the benefits of using this strategy? [Prompt: For example, does the time required to use this strategy outweigh the benefits of using this strategy?]



    1. What challenges, if any, has your program experienced in reaching potential eligible families in your community? [Prompt: For example, are there certain types of families, like first time moms or Spanish speaking families, you are trying to serve that you have had a hard time reaching?]

        1. If yes, how do you know this is a challenge? Is it something you track using program data? Is it something you know based on your knowledge of your program?

        2. [Ask only if program has not described the types of families they are struggling to reach] Which kinds of families are you struggling to reach? Why do you think that is?

        3. Has your program experienced challenges reaching potential eligible families due to the presence of other programs in your service area that target similar families or offer similar types of services? [Prompt: For example, competition with other home visiting programs, parenting groups, or similar social services families participate in?]

          1. If yes, how do you know this is a challenge? Is it something you track using program data? Is it something you know based on your knowledge of your program?

          2. What specifically is the challenge? How does this challenge influence your ability to find and enroll families in home visiting services?

        4. Have any of these challenges changed as a function of the COVID-19 pandemic? If yes, please explain.


    1. Can you describe your program’s accomplishments in reaching potential eligible families within your community? [Prompt: For example, are there certain types of families your program has been especially successful at reaching?]

          1. If yes, how do you know this is an accomplishment? Is it something you track using program data? Or, is it something you know based on your knowledge of your program?

          2. Which kinds of families is your program reaching particularly well? Why do you think that is?

          3. Have any of these accomplishments changed as a function of the COVID-19 pandemic? If yes, please explain.


    1. Do you think there are certain types of families in your community that could benefit from home visiting services that you aren’t serving? And if so, do you have challenges serving those types of families? If yes, please explain.


    1. How do you feel about the outreach and recruitment strategies we have discussed?

      1. Do you feel like the strategies your program uses are enough? Why or why not?

      2. How could outreach and recruitment strategies be improved or expanded?



  1. Outreach and Recruitment Materials. Now, I would like to talk about the outreach and recruitment materials you mentioned your program uses, according to your survey responses. In your survey, you indicated that your program uses [name selected outreach and recruitment materials] to recruit families for program participation.



    1. How frequently do you use each of these materials? Which of these materials does your program use most often?



    1. Can you describe how these materials were developed? [Ask questions below if not already addressed]

      1. Who developed the materials? [Prompt: For example, did program staff develop materials, did you receive materials from your funder or the national program model, or did you adapt existing materials?]

      2. [If any materials were developed by the program.] Did you receive input from anyone, like your funder, model representatives, or families when developing the material?

      3. How are materials used? [Prompt: For example, are they provided directly to families in person? Or, provided to representatives at community organizations to give to families?]

      4. What do you expect families or referral partners to do after receiving the materials?



    1. Have you ever received feedback from families or referral partners about the outreach and recruitment materials? [Prompt: For example, a family said they were confused by the material or referral partner mentioned the material is particularly useful.] If yes, have you made changes to materials based on this feedback?


    1. Are there any types of outreach and recruitment materials your program would find helpful that you do not currently have? If yes, please explain what kind of material would be helpful and why.


  1. Staffing for Program Outreach and Recruitment. Next, let’s talk about how your program staffs program outreach and recruitment efforts.



    1. Let’s start with the different roles and responsibilities associated with your program’s outreach and recruitment efforts. [Prompt: For example, someone might be responsible for hosting outreach events and someone else is responsible for working with referral partners or engaging in direct outreach to families.] What are the main roles, or positions, at your program as it relates to program outreach and recruitment? [For each role mentioned]



      1. [If not already mentioned] Who is responsible for each role?

      2. [If not already mentioned] What are their specific responsibilities associated with this role as it relates to outreach and recruitment?

      3. Why was the staff member assigned this role? [Prompt: For example, because of a certain skill set, experience, or knowledge they have]

      4. Is a certain percentage of their time set aside for carrying out their program outreach and recruitment responsibilities?


    1. Are there times when staff must stop or complete fewer program outreach and recruitment responsibilities in order to prioritize other job responsibilities? If yes, how so? How often?


    1. What kind of training or support do staff receive for carrying out their program outreach and recruitment responsibilities?

      1. How often do they receive this training or support?

      2. [If not already addressed] Has any training or support been provided to staff on how to develop relationships and establish trust with families during program outreach and recruitment? If yes, please explain.


    1. Are staff expected to develop or maintain relationships with organizations/agencies for the purposes of receiving incoming referrals? If yes, please explain.


  1. Work with Community Referral Partners. Now, I would like to talk about your program’s community referral partners. By community referral partners we mean any organizations or agencies that refer families to your home visiting program.

    1. In thinking about the referral partners that provide the most referrals, compared to referral partners that provides fewer referrals, what kind of differences, if any, have you noticed with respect to how your program works with those organizations or your program’s relationship with them?

    2. How does your program typically communicate with your referral partners overall? For example, in-person contact with an identified point person, through email, by telephone.

      1. Does the way you communicate with referral partners vary across referral partners that provide more referrals compared to referral partners that provide fewer referrals? If yes, how so?

    3. In thinking about your communication with referral partners, those that provide more referrals and partners that provide fewer referrals, what kind of information is typically shared?

      1. Do you communicate when program slots are available for families? If yes, how do you share this information? How often do you share this information? Does this vary across the referral partners? If yes, please explain.

      2. Do you provide feedback or information on the status of referrals received? If so, what type of feedback or information do you provide? [Prompt: For example, whether families are typically eligible for or enroll in services or whether families seem to have a good understanding of the services you provide.] Does this vary across the referral partners? If yes, please explain.

      3. Have you ever received any information from the organization/agency about why families are hesitant to or do not access referrals or enroll in services? Does this vary across the referral partners? If yes, please explain.

      4. Do these referral agencies ever communicate any other kind of information to you? [Prompt: For example, if families are trying to reach the program, if they have questions or clarifications about the referral process, or if they have a lot of families that might be eligible for services during a time]. Does this vary across the referral partners? If yes, please explain.

      5. What kind of communication do you find most beneficial in developing and maintaining effective relationships with referral partners, overall? Does this vary across the referral partners? If yes, please explain.


    1. How has your program’s relationships with referral partners changed since the COVID-19 pandemic?[Prompt: For example, less frequent or different types of communication with referral partners or receipt of fewer referrals from partners?]



    1. Can you describe what typically happens after you receive a referral from referral partners?


      1. Do you contact the family or does the family contact you?

      2. Who does the family initially speak with at your program?

      3. How long does it usually take, from the time you receive a referral to making initial contact with the family?

      4. When, in this process, does the family typically make their first in-person appointment or home visit?


    1. Has this process of what happens after you receive a referral changed since the COVID-19 pandemic? If yes, how so?


    1. Do you ever provide referrals to your referral partner organizations for families that you serve? If yes, what kinds of services are you typically referring families to? How often would you say this happens?

    2. Can you describe any challenges your program has experienced in developing and maintaining effective relationships with referral partners?

    3. Can you describe any successes your program has experienced in developing and maintaining effective relationships with referral partners? [Prompt: For example, has anything worked particularly well to increase the number of eligible referrals you receive from referral partners?]

    4. Are there any other challenges or successes your program has experienced related to program outreach and recruitment, that we have not discussed already, that you think are important to mention? If yes, please describe.

    5. Are there any other community organizations or agencies your program would like to receive referrals from that you do not currently work with? If yes, what kinds of organizations/agencies would you like to work with more or do you think could provide referrals to your program? Why is this a particular organization/agency you would like to work with more? What are challenges or barriers to working with these organizations/agencies?




  1. Wrap-up. That covers all the questions I had for you today. Thank you so much for taking the time to speak with me. Before we end, I wanted to see if you have any questions for me or any clarifications that you would like to make? Is there anything else you think I should know about your recruitment and referral processes that I have not already asked about? Also, when we review our notes from today’s call, if we have any questions or clarifications, may we contact you again?

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