Publication Date


Date of Final Oral Examination (Defense)


Type of Culminating Activity


Degree Title

Master of Public Health in Systems Analysis and Innovation


Community and Environmental Health

Major Advisor

Ellen Schafer, Ph.D.


Sandina Begic, Ph.D.


Sarah Toevs, Ph.D.



Home visiting pairs expectant parents and those with young children with an early childhood professional who builds a long-term relationship with each family by regularly meeting with them in their homes and providing knowledge and skills that supports both parent and child health and well-being. In spring 2020, due to the COVID-19 pandemic, home visitors had to quickly transition from exclusively in-person services to virtual services, which created new challenges and opportunities.


To explore (1) the degree to which virtual home visiting practice has been normalized, as defined by Normalization Process Theory, by home visitors in Idaho, (2) which components of virtual practice home visitors want to continue implementing in a hybrid setting and resources needed to sustain them, and (3) the ways virtual home visiting impacts health outcomes for families, based on home visitors’ perceptions.


Data were collected from a statewide convenience sample of home visitors in Idaho through an online quantitative survey and qualitative individual interviews (via Zoom). Quantitative data were analyzed with descriptive statistics and interviews were transcribed. Transcripts were reviewed and helped to place quantitative findings within the context of home visitors’ experiences.


Out of a possible 22 participants in Idaho, 21 completed the online survey and 8 completed a follow-up individual interview. Cumulative scoring of the qualitative survey revealed high degrees of normalization. Participants responded that virtual home visiting feels familiar, is currently being utilized, and will continue to be utilized in the future; furthermore, virtual home visiting should not replace in-person services but be utilized as a tool that improves communication with families and allows them more flexibility and autonomy. By providing virtual services, participants reported they were able to continue supporting families’ health through emotional connection during a stressful and isolating time, conduct virtual health assessments, and provide referrals to community resources. Participants highlighted technical orientation for both home visitors and families when starting implementation and stronger support from senior leadership, including a better understanding of home visiting and daily work, as needs that would strengthen the continuation of virtual home visiting practice.


High degrees of normalization indicate that virtual home visiting will be sustained by home visiting staff; however, barriers related to support from senior leadership may negatively impact the continued implementation of virtual home visiting. For virtual practice to be successful, there is a need to build healthy work culture within parent organizations and establish evidence of the effectiveness of virtual practice to produce outcomes and serve the health and social needs of the participating families.


Available for download on Wednesday, May 01, 2024