Toward Population Impact from Home Visiting.
Abstract
Although some home-visiting programs have proven effective with the families they
serve, no program has yet demonstrated an impact at the population level. We describe
the Durham Connects (DC) initiative, which aims to achieve population impact by coalescing
community agencies to serve early-intervention goals through a Preventive System Of
Care and by delivering a universal, short-term, postnatal nurse home-visiting program.
The home-visitor delivers brief intervention, assesses family needs in 12 domains,
and connects the family with community resources to address individualized family
needs. Evaluation of DC occurred through a population randomized controlled trial
of all 4,777 births in Durham, NC, over an 18-month period. DC was implemented with
high penetration and high fidelity. Impact evaluation indicated that by age 6 months,
DC infants had 18 percent fewer emergency room visits and 80 percent fewer overnights
in the hospital than did control families. We conclude that population impact is achievable
if a program attends to challenges of community partnership, universal reach and assessment,
rigorous evaluation, and models for sustaining funding.
Type
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https://hdl.handle.net/10161/15883Collections
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Kenneth A. Dodge
Pritzker Professor of Early Learning Policy Studies
Kenneth A. Dodge is the Pritzker Professor of Public Policy and Professor of Psychology
and Neuroscience at Duke University. He is also the founding and past director of
the Center for Child and Family Policy.
He is a leading scholar in the development and prevention of aggressive and violent
behaviors. His work provides a model for understanding how some young children grow
up to engage in aggression and violence and provides a fram
Ben Goodman
Research Scientist
Ben Goodman, PhD, is a research scientist at the Center for Child and Family Policy
(CCFP) and a senior fellow at the Center for Child & Family Health at Duke University.
He currently serves as the co-director of the Family Connects home visiting programs
at CCFP: Durham Connects. In this capacity, he oversees program evaluation for all
communities implementing Family Connects and leads the impact evaluation
Robert A. Murphy
Associate Professor in Psychiatry and Behavioral Sciences
Dr. Murphy is a licensed clinical psychologist focused on child traumatic stress,
including its treatment and prevention and development and dissemination of evidence-based
interventions. He is an Associate Professor in the Department of Psychiatry and Behavioral
Sciences at Duke University School of Medicine. Dr. Murphy serves as Executive Director
for the Center for Child & Family Health (CCFH), a community and three university
partnership (Duke University, the University of North Carolina
Karen O'Donnell
Affiliate
My research interests are in early development risk: drug exposure, HIV infection,
and iodine deficiency. I have ongoing research in developmental outcomes of children
exposed prenatally to drugs and alcohol. They include the Infant Care Project (Pediatrics)
and the Family Care Project (Psychiatry). I am co-investigator on a NIDA study of
SIDS risk with prenatal cocaine exposure. I am involved at Duke and nationally in
the study of the neurodevelopmental effects of pediatric HIV infecti
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