Implementing Following Baby Back Home (FBBH)

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

Following Baby Back Home (FBBH) serves families of medically complex, high-risk infants as they transition home from the neonatal intensive care unit (NICU). FBBH aims to foster developmentally appropriate parenting and promote child health. The home visitor works with the family to set goals based on the family’s strengths and challenges. The goal development process incorporates family resilience, family stress and adaptation, attachment, and adult learning theories.

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Implementation support

FBBH is a home visiting model implemented in Arkansas that is administered by the Department of Pediatrics at the University of Arkansas for Medical Sciences and the Arkansas Home Visiting Network. The Arkansas Home Visiting Network offers training to FBBH staff.

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Intended population

The model serves families residing in Arkansas with medically complex, high-risk infants discharged from the NICU. Families are enrolled immediately following the infant’s discharge from the NICU.

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Targeted outcomes

FBBH aims to reduce morbidity and mortality rates among medically complex, high-risk infants by reducing preventable infant rehospitalizations, improving adherence to infants’ medical appointments and immunizations, and increasing families’ skills and self-efficacy in caring for their high-risk infants.

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Model services

The model consists of home visits with a registered nurse and a licensed social worker. The home visiting team provides care coordination, helps families identify local resources to meet the service needs of the infant, and provides referrals to support families’ social functioning and overall well-being. The team also follows up with families by phone between visits.

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Model intensity and length

FBBH offers services immediately following discharge from the NICU until the child’s third birthday. The FBBH intervention includes two home visits per month for the first two months after enrollment, one home visit per month until the child is one year old, and one visit every other month until the child's third birthday. Home visits typically last 60 minutes.

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Staffing requirements

Two-person teams consisting of a registered nurse (RN) and a licensed social worker conduct home visits. A medical director provides medical consultation and a program director provides operational and clinical oversight. A part-time social work manager oversees the social work component of the model.

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Adaptations and enhancements

FBBH allows local programs to adapt the curriculum or model to meet their program’s and families’ needs; however, it recommends that all programs adhere to the core elements of basic infant and toddler care.

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Implementation notes

The information contained on this page was last updated in May 2020. Recommended further reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by Following Baby Back Home in April 2020. HomVEE reserves the right to edit the profile for clarity and consistency.

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Data systems/technology requirements

FBBH requires the use of a web-based data management system to enter clients’ data and document home visits.

Home visitors need a laptop and cell phone.

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Requirements for program certification

There is no program certification process. Organizations interested in replicating FBBH should contact the FBBH program director. The developer recommends, but does not require, that interested organizations conduct a community needs assessment to determine the need for home visiting and case management services for medically complex, high-risk infants and their families; develop a plan for financing services; and identify procedures for participant referrals.

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Staff ratio requirements

FBBH home visiting teams have a caseload capacity of 45 infants.

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Supervision requirements

The program director and the social work manager must be available to the home visitors at all times for telephone consultation. In addition, the home visitors receive the following types of supervision:

  • Monthly reflective supervision focused on the home visitor’s professional development that includes caseload review, family engagement strategies, home visit planning, and staff development;
  • Monthly 1.5-hour team case conference presentations with the medical director that include evaluating the family’s needs and developing strategies to assist the family with health-related concerns and community resource needs; and
  • Monthly clinical supervision focused on supporting high quality service delivery that covers developing home visits, delivering the curriculum, identifying family strengths, and setting goals with the family.

The ratio of supervisor to home visitors is 1:12.

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Where to find out more

Carmen Irby
Program Director
Department of Pediatrics
University of Arkansas for Medical Sciences
Phone: (501) 526-8732
Email: cirby@uams.edu
Website: http://www.arhomevisiting.org/modelname/following-baby-back-homehttp://kidsfirst.uams.edu/services/following-baby-back-home/

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Recommended further reading

The following references were sources for the implementation profile or were recommended by the developer for further reading.

Arkansas Home Visiting Network. Following Baby Back Home. (n.d.). Retrieved May 7, 2018, from http://www.arhomevisiting.org/modelname/following-baby-back-home/

Kids First. Following Baby Back Home. (n.d.). Retrieved March 19, 2018, from http://kidsfirst.uams.edu/services/following-baby-back-home/

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