News Release 

Infant home visiting program linked to less child abuse

Duke University

DURHAM, N.C. -- Family Connects, a program where nurses conduct home visits for newborns and their families, is linked to substantial reductions in child maltreatment investigations in children's earliest years, according to new research from Duke University.

Program participants had 44 percent lower rates of child maltreatment investigations during children's first 24 months of life, compared with parents who did not receive the program, researchers found.

"We now have evidence from a rigorous evaluation that the Family Connects program can reduce the community rate of early child abuse investigations," said lead author Kenneth Dodge, Pritzker Professor of Early Learning Policy Studies at Duke's Sanford School of Public Policy. "Supporting families with newborns is key to child and family well-being."

The study also found improvements in maternal health among Family Connects participants. The rate of maternal mental health problems was lower among those visited by a nurse -- 18.2 percent, versus 26 percent among those who did not participate.

The results appear in JAMA Network Open.

Key contributors to the positive results included high rates of program participation and careful implementation, Dodge said. The study examined 936 births in Durham, N.C., from Jan. 1 through June 30, 2014. Among the 456 families randomly assigned to receive a home visit, 76 percent agreed to participate and were successfully reached, and nurses followed protocols 90 percent of the time.

Family Connects provides home visits from a trained registered nurse shortly after the birth of a child. The nurse conducts infant and mother health checks and refers new parents to resources within their community that meet their individual needs and preferences. These may include substance abuse treatment, maternal depression counseling, general parenting support, housing assistance or childcare resources.

The research-based public health program aims to improve health at a population level, reaching as many families as possible in communities where it is available. The Family Connects program is unusual in emphasizing community-wide impact, short-term duration and relatively low cost of about $500 per family, the study's authors note.

Managed by Duke University's Family Connects International, the model originated as a partnership between the Center for Child and Family Policy at Duke and the nonprofit Center for Child & Family Health in Durham, N.C. Family Connects International has since grown, with 19 communities across the United States currently implementing the program and many more in various stages of planning. The model has been evaluated through two randomized controlled trials. As the program continues to expand, research and evaluation will continue.

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Funding for this study was provided by The Duke Endowment, the Eunice Kennedy Shiver National Institute for Child Health and Human Development (grant R01HD069981), and the Laura and John Arnold Foundation.

CITATION: "Effect of a Community Agency-Administered Nurse Home Visitation Program on Program Use and Maternal and Infant Health Outcomes: A Randomized Clinical Trial," K.A. Dodge, W.B. Goodman, Y. Bai, K. O'Donnell, R. A. Murphy. JAMA Network Open, November 1, 2019.

DOI:10.1001/jamanetworkopen.2019.14522

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