Introduction
The coronavirus disease (COVID-19) resulted in a global pandemic that caused wide-spread illness, death, and major disruptions to daily life. Just as families found themselves needing more support, most health and human services programs reduced in-person service delivery to minimize spread of the virus. This brief highlights the remarkable way that 17 Tribal Maternal, Infant, and Early Childhood Home Visiting (Tribal MIECHV) programs continued to show up for families in this challenging time through ongoing service delivery. This brief describes how Tribal MIECHV programs provided home visiting services by shifting to the virtual environment and focuses on how program services and implementation changed during COVID-19. It also reflects on the extra efforts of staff and how they may have enhanced benefits and mitigated challenges of virtual service delivery.
Primary Research Questions
This brief is the result of a special analysis of the impact of the COVID-19 pandemic on Tribal MIECHV program implementation. Analysis focused on two of the three MUSE study aims:
Identify and describe how Tribal MIECHV programs are being implemented
Explore supports and challenges to home visiting implementation in Tribal communities
Purpose
Sustaining home visiting service delivery was a critical goal for Tribal MIECHV programs during the COVID-19 pandemic. Analyzing Tribal MIECHV program implementation through the COVID-19 pandemic was a unique opportunity to better understand how social services can be continued during times of significant societal and community-level change.
Key Findings and Highlights
The brief describes changes in Tribal MIECHV program implementation related to the COVID-19 pandemic. Several key findings featured in the brief highlight the following:
Shifting to the virtual environment enabled Tribal MIECHV programs to continue to serve families during COVID-19. There were both benefits and challenges to virtual home visiting.
Shifts in enrollment and retention during COVID-19 may have had different impacts, depending on caregiver circumstance.
Extra efforts of home visiting staff may have mitigated challenges and enhanced benefits of service delivery in and around the pandemic.
Methods
MUSE is a mixed-methods study that integrates quantitative and qualitative methodologies to examine how Tribal MIECHV programs operate in diverse contexts. Through a community-engaged approach, MUSE partnered with Tribal MIECHV programs to design and carry out a study that will return meaningful findings to partnering communities and to the Administration for Children and Families (ACF). Nine months after initiating data collection, the study paused due to the inherent risks and stressors of COVID-19, resuming adapted data collection efforts in July 2020. This brief is the result of an analysis of interview, survey, and administrative data to assess the impact of the COVID-19 pandemic on Tribal MIECHV program implementation.
Recommendations
The brief includes several lessons learned with accompanying recommendations for home visiting programs to consider:
Establish and revise protocols and allocate resources to support the extra work of virtual home visiting
Institutionalize workforce supports related to virtual service delivery to mitigate negative impacts on staff
Develop strategies for families to complete paperwork online to reduce data burden and create more space for prioritized activities during in-person visits
Provide virtual environments for parents to connect, especially in communities that serve expansive geographic areas
Citation
Salvador. M., Sturmfels, N., Voinot-Baron, W., Lyon, K., Wang, Y., Asdigian, N., & Whitesell, N. (2025). Continuing home visiting services during COVID-19: A brief from the Multi-Site Implementation Evaluation of Tribal Home Visiting (OPRE Report No. 2025-089). Office of Planning, Research, and Evaluation; Administration for Children and Families; U.S. Department of Health and Human Services.