Effect of a Community Agency–Administered Nurse Home Visitation Program on Program Use and Maternal and Infant Health Outcomes

Dodge, Kenneth A.; Goodman, W. Benjamin; O’Donnell, Karen; Murphy, Robert A.

doi:10.1001/jamanetworkopen.2019.14522

Cited by 49 publications

(46 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…10,11 Findings from a second, independent FC RCT identified multiple positive effects: increased community connections, reduced postpartum mental health symptoms, reduced emergency medical care use for infants with 1 or more medical risks at birth, and a 44% decrease in child maltreatment investigations through 24 months of age. 12 Although these results indicate a consistent, positive pattern of benefits through the first 2 years of life, long-term child and family outcomes have yet to be investigated. This is an important lacuna, because the short-term benefits of many early childhood interventions are not sustained over time.…”

Section: Introductionmentioning

confidence: 92%

Effect of a Universal Postpartum Nurse Home Visiting Program on Child Maltreatment and Emergency Medical Care at 5 Years of Age

et al. 2021

Self Cite

View full text Add to dashboard Cite

IMPORTANCE The Family Connects (FC) program, a community-wide nurse home visiting program for newborns, has been shown to provide benefits for children and families through the first 2 years of life. Potential longer-term outcomes for child well-being remain unknown. OBJECTIVE To determine the effect of randomization to FC on child maltreatment investigations and emergency medical care through 5 years of age. DESIGN, SETTING, AND PARTICIPANTS In this randomized clinical trial, families of all 4777 resident births in Durham County, North Carolina, from July 1, 2009, to December 31, 2010, were randomly assigned to receive the FC program or treatment as usual. Impact evaluation was on an intent-totreat basis and focused on a subsample of 549 families randomly selected from the full population and included review of hospital and Child Protective Services (CPS) administrative records. Statistical analysis was conducted from November 6, 2020, to April 25, 2021. INTERVENTIONS The FC programs includes 1 to 3 nurse home visits beginning at the infant age of 3 weeks designed to identify family-specific needs, deliver education and intervention, and connect families with community resources matched to their needs. Ongoing program engagement with service professionals and an electronic resource directory facilitate effective family connections to the community. MAIN OUTCOMES AND MEASURES Two primary trial outcomes were CPS-recorded child maltreatment investigations and emergency medical care use based on hospital records. RESULTSOf the 4777 randomized families, 2327 were allocated to the intervention, and 2440 were allocated to services as usual. Among the children in the full study population, 2380 (49.8%) were female, 2397 (50.2%) were male, and 3359 (70.3%) were from racial/ethnic minority groups; of the 531 children included in the impact evaluation follow-up, 284 (53.5%) were female, 247 (46.5%) were male, and 390 (73.4%) were from racial/ethnic minority groups. Negative binomial models indicated that families assigned to FC had 39% fewer CPS investigations for suspected child maltreatment through 5 years of age (95% CI, −0.80 to 0.06; 90% CI, −0.73 to −0.01; control = 44 total investigations per 100 children and intervention = 27 total investigations per 100 children); intervention effects did not differ across subgroups. Families assigned to FC also had 33% less total child emergency medical care use (95% CI, −0.59 to −0.14; 90% CI, −0.55 to −0.18; control = 338 visits and overnight hospital stays per 100 children and intervention = 227 visits and overnight hospital stays per 100 children). Positive effects held across birth risk, child health insurance, child sex, single-parent status, and racial/ethnic groups. Effects were larger for nonminority families compared with minority families. (continued) Key Points Question What is the association of the Family Connects (FC) program, a universal newborn nurse home visiting program, with child maltreatment investigations and child emergency medical care use between birth a...

show abstract

Section: Introductionmentioning

confidence: 92%

Effect of a Universal Postpartum Nurse Home Visiting Program on Child Maltreatment and Emergency Medical Care at 5 Years of Age

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…Data on early childhood injury outcomes and suspected abuse and neglect will come from South Carolina all-payer hospital discharge records, Medicaid inpatient and outpatient claims, and mortality records. Previous work examining the impact of home visiting programs on abuse and neglect has considered the impact of the program on investigation for child abuse and neglect [71]. We focus on health care encounters and mortality in order to mitigate potential reporting bias introduced because NFP home visiting nurses are mandated reporters of child abuse and neglect.…”

Section: Primary Study Outcomesmentioning

confidence: 99%

Protocol for a randomized controlled trial evaluating the impact of the Nurse-Family Partnership’s home visiting program in South Carolina on maternal and child health outcomes

McConnell

Zhou

Martin

et al. 2020

Trials

View full text Add to dashboard Cite

Background Policy-makers are increasingly seeking rigorous evidence on the impact of programs that go beyond typical health care settings to improve outcomes for low-income families during the critical period around the transition to parenthood and through early childhood. Methods This study is a randomized controlled trial evaluating the impact of the Nurse-Family Partnership’s expansion in South Carolina. The scientific trial was made possible by a “Pay for Success” program embedded within a 1915(b) Waiver from Medicaid secured by the South Carolina Department of Health and Human Services. This protocol describes study procedures and defines primary and secondary health-related outcomes that can be observed during the intervention period (including pregnancy through the child’s first 2 years of life). Primary study outcomes include (1) a composite indicator for adverse birth outcomes including being born small for gestational age, low birth weight (less than 2500 g), preterm birth (less than 37 weeks’ gestation), or perinatal mortality (fetal death at or after 20 weeks of gestation or mortality in the first 7 days of life), (2) a composite outcome indicating health care utilization or mortality associated with major injury or concern for abuse or neglect occurring during the child’s first 24 months of life, and (3) an indicator for an inter-birth interval of < 21 months. Secondary outcomes are defined similarly in three domains: (1) improving pregnancy and birth outcomes, (2) improving child health and development, and (3) altering the maternal life course through changes in family planning. Discussion Evidence from this trial on the impact of home visiting services delivered at scale as part of a Medicaid benefit can provide policy-makers and stakeholders with crucial information about the effectiveness of home visiting programs in improving health and well-being for low-income mothers and children and about novel financing mechanisms for cross-silo interventions. Trial registration The trial was registered prospectively on the American Economic Association Trial Registry (the primary registry for academic economists doing policy trials) on 16 February 2016 (AEARCTR-0001039). ClinicalTrials.gov NCT03360539. Registered on 28 November 2017.

show abstract

“…Requiring such feedback will reinforce the notion that program design should consider consumer preferences and that programs are implemented in a way that are consistent with the values and predilections of the people they are intended to serve. Programs such as the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV; Olds et al 2014) and Family Connects (Dodge et al 2019) offer additional models for reducing the population-level prevalence of maltreatment and substantiations in African American communities. The Family Connects Program employs a prevention model in which all parents of a newborn receive a home visit from a nurse who assesses baby health and family access to needed services.…”

Section: Move Child Protection Away From Investigating Negligent Famimentioning

confidence: 99%

Racial Disparities in the U.S. Child Protection System Etiology and Solutions

Barbarin

2020

Int. Journal on Child Malt.

View full text Add to dashboard Cite

Effect of a Community Agency–Administered Nurse Home Visitation Program on Program Use and Maternal and Infant Health Outcomes

Cited by 49 publications

References 13 publications

Effect of a Universal Postpartum Nurse Home Visiting Program on Child Maltreatment and Emergency Medical Care at 5 Years of Age

Effect of a Universal Postpartum Nurse Home Visiting Program on Child Maltreatment and Emergency Medical Care at 5 Years of Age

Protocol for a randomized controlled trial evaluating the impact of the Nurse-Family Partnership’s home visiting program in South Carolina on maternal and child health outcomes

Racial Disparities in the U.S. Child Protection System Etiology and Solutions

Contact Info

Product

Resources

About