Implementing Family Connects Meets HHS Criteria

Model implementation summary last updated: 2020

The information in this implementation report reflects feedback, if provided, from this model’s developer as of the above date. The description of the implementation of the model(s) here may differ from how the model(s) was implemented in the manuscripts reviewed to determine this model’s evidence of effectiveness. Inclusion in the implementation report does not mean the practices described meet the HHS criteria for evidence of effectiveness. Please see the Effectiveness button on the left for more information about any research on the effectiveness of the model, including any version(s) of the model with effectiveness research. Versions of the model that are described in the Adaptations and enhancements section of this implementation report may include (1) versions that were identified by the model’s developer and (2) versions that have been implemented by researchers and have manuscripts that HomVEE rated high or moderate, but that are not supported by the model’s developer.

Model overview

Theoretical approach

The Family Connects* model aims to bring families, community agencies, and health care providers together through nurse home visits to provide all families with the support and resources they need to promote the well-being of their newborns. The model uses a triage model of care, providing one to three home visits to every family living within a defined service area, typically when the infant is 2 to 12 weeks old. Families with identified needs can receive further support, including additional home visits, telephone contacts, and connections to community resources for longer-term services.

*The model began as a pilot called Durham Connects, which served Durham County, North Carolina. As part of subsequent replication, the model was renamed Family Connects to reflect the model’s larger service area. The model has not changed between the pilot and replication.

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Implementation support

Family Connects is a program of the Center for Child and Family Policy at Duke University and the Center for Child & Family Health in Durham, North Carolina. The Center for Child and Family Policy houses Family Connects International, which provides sites with ongoing training and implementation support. The Center for Child & Family Health is a child trauma prevention and treatment center that houses the Family Connects Durham program and serves as the location for on-site nurse training. Program sites partner with local agencies, such as the local public health department, that serve families with children whose ages range from birth to 5 years.

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Intended population

The intervention is available to all families with newborns who live within a defined service area, which could be a region, county, city, neighborhood, or other geographic area. The model is designed for families with newborns ages 2 to 12 weeks but may reach families earlier or later (as long as the child is under six months old) when special needs are present (for instance, if an infant had been admitted for neonatal intensive care). Sites must have a recruitment plan to reach all families with newborns in their defined service area.
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Targeted outcomes

The model aims to support families’ efforts to 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) reducing mothers’ and infants’ use of emergency medical care; (4) improving the quality and safety of the home environment; (5) increasing positive parenting behaviors; (6) reducing parental anxiety and depression; and (7) promoting use of high quality child care when non-parental care is desired.
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Model services

Family Connects is a manualized intervention that provides one to three home visits from a registered nurse to all families who have newborns and live in a defined service area. During the initial home visit, the nurse conducts a physical health assessment of the mother and newborn, provides supportive guidance on topics that are common to all families (such as infant feeding and safe sleeping practices), and conducts a systematic assessment of family risks and needs. The risk and needs assessment covers 12 factors in 4 domains associated with the health and well-being of mothers and infants. (Domains and factors are described under Assessment Tools.)

If an assessment reveals a risk or need, nurses directly support families or connect them to community resources, typically through additional home visits and/or telephone contacts. In cases of mild risk, nurses may provide direct support, such as feeding assistance. If a family’s risk is more significant, the nurse collaborates with the family to connect them to desired community services and supports. Supports may include intensive, targeted home visiting programs, mental health services, public assistance programs, or primary health care providers. Nurses use a searchable database of local agencies, created by local program staff, in making referrals.

One month after case closure, a staff member (the nurse home visitor or another staff member) calls families to determine whether they connected with the referred agency(ies), are receiving services, have any additional needs, and were satisfied with the program.

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Model intensity and length

The model provides one to three home visits by a registered nurse about 2 to 12 weeks after the child’s birth, and follow-up contacts with families and community agencies confirm families’ successful linkages with community resources. The initial home visit typically lasts 1.5 to 2 hours. Home visitors provide more than one visit to about 30 percent of families based on their needs and continued interest in the program. An additional 38 percent of families receive at least one telephone support contact from the nurse home visitor. Telephone support contacts after the initial home visit answer families’ questions, ask if the families faced any challenges connecting with referred services, and provide information about additional community resources.

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Program sites must operate within defined service areas, such as a region, county, city, or neighborhood. Family Connects is currently implemented in eight defined service areas across five states: Iowa, Maryland, Minnesota, North Carolina, and Oregon.
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Adaptations and enhancements

Adaptations and enhancements are not available. No information is available on the process, if any, for considering modifications to the model.

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Implementation notes

The information contained on this page was last updated in July 2020. Recommended further reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by Family Connects International in February 2020. HomVEE reserves the right to edit the profile for clarity and consistency.

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