Promoting Long-Term Parent and Caregiver Mental Health Through Universal Postnatal Nurse Home Visiting: Intervention Effects and Mechanisms of Action.
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2025-08
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Abstract
Poor mental health affects millions of parents and caregivers each year. In the absence of intervention, the duration and magnitude of mental health symptoms can have an adverse impact on parent and caregiver well-being, parenting practices, and subsequent children's development. Although home visiting is hypothesized to impact parent mental health, most studies do not demonstrate sustained benefits over time. Family Connects (FC) is a short-term, universal postnatal nurse home-visiting program designed to support children and families. Evaluations of FC demonstrate 6-month impacts on parent mental health, but longer-term (5-years post intervention) benefits have not been investigated, nor the potential mechanisms of the sustained effect. Every resident birthing family in Durham, NC, over an 18-month period (total n = 4777) was randomly assigned by birth date to FC or control condition. Implementation was strong, allowing an intent-to-treat evaluation of the model on maternal mental health. At infant age 60 months, a random, representative sample of parents (FC n = 201; control n = 200) was interviewed by condition-blind researchers with two screening instruments, the Center for Epidemiological Studies Depression Scale (CES-D) and the Mental Health Continuum scale (MHC - SF). Regression analyses with relevant covariates tested hypothesized (one-tailed) effects on these self-report scales. Parents randomly assigned to FC were significantly (p < .02) less likely to receive a depression score in the clinical range, reported a lower number of depressive symptoms (p < .04), and received better scores for social well-being (p < .04). Quality of the home environment (p < 0.10) was a significant mediator of intervention impact on later parent mental health.
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Baziyants, Gayane A, Kenneth A Dodge, W Benjamin Goodman, Yu Bai, Robert A Murphy and Karen O'Donnell (2025). Promoting Long-Term Parent and Caregiver Mental Health Through Universal Postnatal Nurse Home Visiting: Intervention Effects and Mechanisms of Action. Prevention science : the official journal of the Society for Prevention Research, 26(6). pp. 921–931. 10.1007/s11121-025-01827-6 Retrieved from https://hdl.handle.net/10161/33157.
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Gayane Baziyants
Joint-Degree Ph.D. Candidate at the Sanford School of Public Policy and Psychology & Neuroscience
Gayane is a Joint-Degree Ph.D. Candidate of Public Policy and Psychology & Neuroscience. Her research focuses on identifying evidence-based policies and practices for supporting child development and family well-being. Gayane utilizes diverse research methods, such as randomized control trials, quasi-experimental methods, and implementation science to inform research on supporting families. Her research projects evaluate longitudinal impacts of a universal home visiting program and investigate effects of an unconditional cash transfer on rates of child maltreatment. Gayane is also conducting an implementation evaluation of a developmental monitoring tool across diverse sites that serve children and families.
Gayane received her Bachelor’s Degree in Education and International Studies from the University of North Carolina Chapel Hill in 2017. Before matriculating at Duke, she worked as a Research Analyst at Child Trends. In this role, she conducted national, state, and community level research analyzing the impact of various early childhood policies and programs.
Kenneth A. Dodge
Kenneth A. Dodge is the William McDougall Distinguished 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, as well as the founder of Family Connects International.
Dodge 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 framework for intervening early to prevent the costly consequences of violence for children and their communities.
Dodge joined the faculty of the Sanford School of Public Policy in September 1998. He is trained as a clinical and developmental psychologist, having earned his B.A. in psychology at Northwestern University in 1975 and his Ph.D. in psychology at Duke University in 1978. Prior to joining Duke, Dodge served on the faculty at Indiana University, the University of Colorado, and Vanderbilt University.
Dodge's research has resulted in the Family Connects Program, an evidence-based, population health approach to supporting families of newborn infants. Piloted in Durham, NC, and formerly known as Durham Connects, the program attempts to reach all families giving birth in a community to assess family needs, intervene where needed, and connect families to tailored community resources. Randomized trials indicate the program's success in improving family connections to the community, reducing maternal depression and anxiety, and preventing child abuse. The model is currently expanding to many communities across the U.S.
Dodge has published more than 500 scientific articles which have been cited more than 120,000 times.
Elected into the National Academy of Medicine in 2015, Dodge has received many honors and awards, including the following:
- President (Elected), Society for Research in Child Development
- Fellow, Society for Prevention Research
- Distinguished Scientist, Child Mind Institute
- Research Scientist Award from the National Institutes of Health
- Distinguished Scientific Award for Early Career Contribution from the American Psychological Association
- J.P. Scott Award for Lifetime Contribution to Aggression Research from the International Society for Research on Aggression
- Science to Practice Award from the Society for Prevention Research
- Inaugural recipient of the “Public Service Matters” Award from the Network of Schools of Public Policy, Affairs and Administration
- Inaugural recipient of the Presidential Citation Award for Excellence in Research from the Society for Research on Adolescence
Ben Goodman
Ben Goodman is a research scientist at the Center for Child and Family Policy. His research interests focus broadly on the implementation and evaluation of population-based interventions to reduce child maltreatment and improve parent and child health and well-being, including the evidence-based Family Connects postpartum nurse home visiting program. His research also examines how sources of stress and support shape the quality of parent-child relationships, parents’ own well- being, and child development.
Research Interests:- Home Visiting
- Child Maltreatment
- Parenting
- Program Evaluation
- Ph.D. The Pennsylvania State University - 2009
Yu Bai
Robert A. Murphy
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 at Chapel Hill, and North Carolina Central University) dedicated to research, training, and intervention related to child trauma and maltreatment. Interests include treatment and prevention of child maltreatment and traumatic stress, dissemination of evidence based interventions, and improving mental health care for military families. In partnership with the Duke Sanford School of Public Policy Center for Child and Family Policy, he has been active in the development and evaluation, via two randomized controlled trials, of a brief, postnatal, universal nurse home visiting program (Family Connects) that has demonstrated improved parenting and parental distress, as well as reduced emergency medical care costs and lower rates of reported child maltreatment. Since 2003, CCFH has been a community treatment and services center within the National Child Traumatic Stress Network focused on improving access to evidence based mental health care for foster care youth and developing trauma informed child welfare systems.
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