Implementing Family Connects

The Family Connects* model aims to intervene with families early to help them address health concerns and access support to reduce potential disparity gaps later, especially among families that are part of historically marginalized groups. Families in need might be unaware of local resources and how to navigate various systems to access services. Thus, registered nurses working as Family Connects home visitors provide free check-ups to mothers and babies during the early postpartum period and help connect families to local resources.

Family Connects is a universal model built on the premise that all families can benefit from postpartum nursing support or referrals. The model is designed to serve all families in a community, including families with surrogate, adoptive, and bereaved parents. The model’s aim to achieve population-level results is informed by a socioecological framework in which communities’ beliefs, practices, and environmental structures influence the choices, and thereby the actions, of the communities’ families. Similarly, communities are influenced by their state’s context, and each state is nested within a broader setting of national influences. Thus, Family Connects International (FCI) works at the national, state, community, and family levels to support newborns and their families.

*The model began in 2008 as Durham Connects—a pilot that served Durham County, North Carolina. As part of subsequent replication, the model was renamed Family Connects to reflect its larger service area. The model has not changed between the pilot and replication.

FCI provides technical support to interested entities, ranging from local organizations to state-level partners, through the following stages of replication: (1) consultation, (2) orientation, (3) installation, (4) implementation, (5) certification, and (6) expansion.

FCI takes a human-centered design approach in building trusting relationships with communities and recognizing that its partners are local experts acting as change agents for families. FCI implementation specialists partner with communities to tailor the services and trainings to their needs based on the following factors:

• Scope of service area (statewide, regional, clusters, localized)
• Locale (urban, suburban, rural)
• Sustainability plan for five-year financing
• Population demographics, community characteristics, and assets
• Scaling plan to reach the total birth population
• Implementation plan for achieving FCI certification
• Plan to align local early childhood resources

The Family Connects model is a universal model in which all parents of newborns in a community are offered a home visit with a nurse within about three weeks of birth.

The model aims to help families enhance maternal and child health and well-being. Specific targeted outcomes include (1) increasing families’ connections to community resources; (2) reducing child maltreatment investigations and substantiations; (3) improving mothers’ and infants’ healthcare utilization; (4) improving the quality and safety of families’ home environments; (5) increasing positive parenting behaviors; and (6) reducing parental anxiety and depression.

Family Connects nurses assess newborns and their mothers. The nurses then use the assessment results to speak with families about concrete next steps to address opportunities and concerns. For example, they might advise a family to seek immediate medical care when necessary. Family Connects nurses consider the needs of the entire family and might recommend mental health services or medical care for other family members as needed. Program staff follow up with families to ensure their needs are met.

Please contact the model developer for information about the model’s curriculum.

The model typically provides families with one home visit from a registered nurse about three weeks after the child’s birth, with a follow-up contact to confirm families’ successful linkages with community resources. The initial home visit typically lasts 1.5 to 2 hours. Nurses may make one or two follow-up visits or calls to provide additional focused support.

Adaptations and enhancements to the model are made in partnership with communities to tailor services and staff training to communities’ specific needs. Please contact the model developer for additional information about the process for modifying the model.

Organizations interested in implementing the model must complete a readiness assessment and sign a contract with FCI. The organization can then participate in an orientation to learn about FCI’s approach to model implementation and begin designing their local plans.

Organizations currently implementing the model include state- and county-level health agencies, hospitals, health services associations, nonprofit organizations, and community-based organizations. Please contact the model developer for additional information about the requirements for the types or characteristics of organizations that can implement the model and for information about the model’s fidelity guidelines.

Staff include nurse home visitors and nurse supervisors, administrative leaders, a medical director (typically staffed at 0.10 full-time equivalent), a community alignment specialist to coordinate connection to community resources, and program support specialists to oversee family recruitment and post-visit follow-up. Some local programs also have data specialists and communication staff.

Nurse home visitors and nurse supervisors must be registered nurses with an active license in their state.

The community alignment specialist meets with the nurses weekly for case conferences. Please contact the model developer for additional information on nurse supervision requirements and whether supervision or support is offered to the nurse supervisors.

FCI provides initial training and ongoing learning opportunities for all local implementing staff. Please contact the model developer for more information on pre-service and ongoing professional development requirements.