VisitBoost: A Home Visiting Enhancement to Reduce Harm for Families Affected by Substance Misuse

Project Summary Stigmatization of people with substance use disorders (SUD) during perinatal results from the toxic belief that people who use substances are incapable of being good parents and do not care about their children. This belief perpetuates cyclical and systemic harm towards people with SUD and their children. Home visiting programs are less likely to sustain engagement with parents with SUD because those parents experience and perceive stigmatization. However, home visitors want to do better. Despite home visitors reporting that it is difficult to support parents with SUD, most home visitors want additional training in this area. Additionally, harm reduction practices are becoming more common and home visitors want more training to be able to support parents in this area. The current home visiting programs are not equipped to support parents within this changing landscape. There is the potential to improve current practices, reduce harm, and improve overall parent and child outcomes for people with SUD during perinatal by reducing stigmatization within home visiting programs. This change cannot just be a one-time training for home visitors. It must be a comprehensive solution to change home visiting organizations including de-implementation of polices that cause harm, implementation of policies to provide support, leadership education and guidance, identification of community resources for warm hand-offs, training and support for home visitors, and ongoing opportunities for practice and reflection. Our proposed solution, VisitBoost, includes strategies to address multiple levels of stigma and improve home visiting services for people with SUD during perinatal. The overall goal of the proposed Phase I project is to create VisitBoost and demonstrate feasibility for reducing stigmatization among home visitors towards clients with SUD. We will accomplish our goal through two specific aims: 1. Use an iterative formative process to develop a prototype of the VisitBoost mobile application to develop modules to support de-stigmatization practices among organizational leaders and home visitors. 2. Evaluate VisitBoost prototype for acceptability, usability, and effectiveness using a mixed-methods program evaluation approach with our advisory boards. We will assess home visitor attitudes, knowledge, self-efficacy, practices, practices intentions (post-training only), and usability with 52 home visitors to optimize successful use of the mobile application.