Implementation and randomized controlled trial evaluation of universal postnatal nurse home visiting.

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Date

2014-02

Authors

Dodge, KA
Goodman, WB
Murphy, RA
O’Donnell, K
Sato, J
Guptill, S

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Abstract

OBJECTIVES: We evaluated whether a brief, universal, postnatal nurse home-visiting intervention can be implemented with high penetration and fidelity, prevent emergency health care services, and promote positive parenting by infant age 6 months. METHODS: Durham Connects is a manualized 4- to 7-session program to assess family needs and connect parents with community resources to improve infant health and well-being. All 4777 resident births in Durham, North Carolina, between July 1, 2009, and December 31, 2010, were randomly assigned to intervention and control conditions. A random, representative subset of 549 families received blinded interviews for impact evaluation. RESULTS: Of all families, 80% initiated participation; adherence was 84%. Hospital records indicated that Durham Connects infants had 59% fewer infant emergency medical care episodes than did control infants. Durham Connects mothers reported fewer infant emergency care episodes and more community connections, more positive parenting behaviors, participation in higher quality out-of-home child care, and lower rates of anxiety than control mothers. Blinded observers reported higher quality home environments for Durham Connects than for control families. CONCLUSIONS: A brief universal home-visiting program implemented with high penetration and fidelity can lower costly emergency medical care and improve family outcomes.

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Subjects

Adult, Emergency Medical Services, Female, Home Health Nursing, Humans, Infant, Infant Welfare, Male, Parenting, Postnatal Care, Program Development, Program Evaluation, Surveys and Questionnaires

Citation

Published Version (Please cite this version)

10.2105/AJPH.2013.301361

Publication Info

Dodge, KA, WB Goodman, RA Murphy, K O’Donnell, J Sato and S Guptill (2014). Implementation and randomized controlled trial evaluation of universal postnatal nurse home visiting. Am J Public Health, 104 Suppl 1. pp. S136–S143. 10.2105/AJPH.2013.301361 Retrieved from https://hdl.handle.net/10161/15881.

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Scholars@Duke

Goodman

Ben Goodman

Research Scientist

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
Education:
  • Ph.D. The Pennsylvania State University - 2009
Murphy

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 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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