Health Access Nurturing Development Services (HANDS) Program
Model effectiveness research report last updated: 2015
HANDS is based on several key assumptions:
- All families have strengths.
- Families are responsible for their children.
- Families are the primary decision makers regarding their children.
- Communities recognize their roles in children’s lives.
- Communities recognize that all children must succeed.
- Prevention and early intervention improve the community’s well-being.
- Public and private partnerships are vital to a successful program.
HANDS providers first screen referred families for risk factors. Screening may occur prenatally or after birth until the child is 3 months old. Risk factors include unemployment; isolation; substance abuse; unstable housing; low parental education; domestic violence; poor prenatal care; depression; single parenting; noncompliance with prenatal care; unsuccessful abortion; or current use of tobacco, including prenatal and infant exposure to secondhand smoke. Any family that (1) is single, separated, or divorced; (2) began prenatal care after 12 weeks of pregnancy or has had poor care compliance or no prenatal care; (3) has considered abortion during this pregnancy; or (4) has two or more risk factors is eligible to receive services.
A trained home visitor conducts home visits; frequency is determined on the basis of the family’s needs. Home visitors use the Growing Great Kids™ (GGK) curriculum and provide services that focus on supporting the family, family-child interaction, child development, and personal responsibility. Services include developmental and social-emotional screenings for children and domestic violence and perinatal depression screening for parents. Health prevention is also a key focus of HANDS home visitation. Visitors work with families to establish medical homes and maintain up-to-date immunizations and well-child checks. In addition, a registered nurse or social worker provides quarterly visits to focus on the signs of premature labor, labor and delivery, home safety, basic care, nutrition, exercise, safe sleeping, effects of smoking and secondhand smoke, stress, babies’ cues, injury prevention, child development and temperament, and adjusting to parenting.
HANDS targets first-time parents beginning during pregnancy or any time before a child is 3 months old. Eligible families face multiple challenges, including single-parent status, low incomes, substance abuse, and domestic violence.