Home Visitor Professional Well-Being: What It Is and Why It Matters

This report seeks to build understanding of how to support and strengthen professional well-being in home visiting. It summarizes knowledge and gaps in the research in home visiting and adjacent fields, and in related measures and materials (i.e., trainings, resources, strategies); it also introduces a conceptual model that views home visitor professional well-being as part of a complex, multilevel home visiting system.

A companion report focuses on reflective supervision in home visiting.

Research is lacking on professional well-being within the home visiting field. Most articles focus on common workforce concerns, such as burnout and turnover, rather than defining or examining professional well-being. Most of the literature is correlational and cannot conclude that workplace factors or contexts have a causal association with outcomes of interest.              

Nineteen measures assess some aspect of professional well-being, but none assess it as multidimensional, and none were developed for home visiting. Very few materials focus on structural, organizational, or systemic approaches for promoting professional well-being. They instead center on resources and supports for individual home visitors to recognize signs of stress or identify safety concerns and provide strategies—through self-care techniques or mindfulness—to manage stress.

The new conceptual model of home visitor professional well-being depicts how five key drivers across levels of a home visiting system influence four positively framed dimensions hypothesized to influence outcomes at the home visitor, program, family, and child levels. Individual home visitor factors affect how the key drivers may influence the dimensions and, thus, outcomes.

The project team completed a literature review of 116 journal articles/pieces of grey literature to understand how home visiting and adjacent fields, such as child welfare and early childhood education, address aspects of professional well-being.

The team created a conceptual framework informed by preliminary literature review findings; a review of existing conceptual models and relevant theories; and engagement with local program staff, Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program awardees, Tribal MIECHV grantees, home visiting model representatives, training and technical assistance providers, and project consultants.

The team also conducted an environmental scan of the field to assess the availability and nature of trainings, resources, strategies, and measures related to home visitor professional well-being. The scan examined the extent to which existing materials address key components of the conceptual model and identified gaps.

The field should develop an agreed-upon definition of home visitor professional well-being that includes key dimensions of well-being associated with workplace performance and staff retention.

Researchers should focus on professional well-being in the home visiting context and examine causal associations between dimensions of professional well-being and desired workplace and workforce outcomes.

Home visitors’ professional well-being may benefit from supervisor support, adequate pay and benefits, role clarity, and flexibility and autonomy in carrying out job roles and expectations.

Sparr, M., Morrison, C., Joraanstad, A., Cachat, P., & West, A. (2022). Home visitor professional well-being: What it is and why it matters (OPRE Report No. 2022-102). Office of Planning, Research, and Evaluation; Administration for Children and Families; U.S. Department of Health and Human Services.