HEALTH had strong acceptability but gaps in access and lesson delivery

What the study found: HEALTH, an evidence-based intervention embedded in Parents as Teachers home visiting, was generally acceptable to mothers but had gaps in accessibility and usage during COVID-19. The abstract reports strong coverage in acceptability, with weaker coverage in referrals and delivery of lessons.
Why the authors say this matters: The authors conclude that these findings can inform dissemination and implementation strategies to increase HEALTH coverage. They also say the study offers insights into service delivery during COVID-19 and into using dissemination and implementation frameworks to evaluate implementation outcomes.
What the researchers tested: The researchers conducted descriptive analyses using baseline data and home visitor documentation from the HEALTH dissemination and implementation study. They measured coverage using an adapted framework based on RE-AIM and Shengelia et al., including accessibility, acceptability, and usage.
What worked and what didn't: Sixty-seven percent of home visitors made at least one referral to HEALTH, while 33% made none. Most mothers, 80%, reported satisfaction with HEALTH, but only 26% received all 8 core lessons; on average, 39% of all 24 lessons, 66% of the 8 core lessons, and 33% of handouts were delivered.
What to keep in mind: The abstract presents descriptive findings from a specific D&I study conducted during COVID-19, so the results are limited to that setting and sample. Limitations are not described in the available summary beyond these scope constraints.

Key points

• Most mothers (80%) reported satisfaction with HEALTH.
• 67% of home visitors made at least one referral to HEALTH, but 33% made none.
• Only 26% of mothers received all 8 core HEALTH lessons.
• On average, 39% of all 24 lessons and 33% of handouts were delivered.
• The authors say the findings can inform strategies to increase HEALTH coverage.