Manuscript Detail | Home Visiting Evidence of Effectiveness

Goodman, W. B., Dodge, K. A., Bai, Y., O’Donnell, K. J., & Murphy, R. A. (2019). Randomized controlled trial of Family Connects: Effects on child emergency medical care from birth to 24 months. Development and Psychopathology, 31(5), 1863–1872.

Manuscript screening details
Screening decision	Screening conclusion	HomVEE procedures and standards version
Passes screens	Eligible for review	Version 2

Study design details
Rating	Design	Attrition	Baseline equivalence	Compromised randomization	Confounding factors	Valid, reliable measure(s)
High	Randomized controlled trial	Low	Not assessed for randomized controlled trials with low attrition	No	No	Yes

Notes:

Findings about physician cost data are not eligible for HomVEE review, because they are not in one of HomVEE's eligible outcome domains.

Study characteristics
Study participants	Families were eligible for this study if they lived in Durham County and the pregnant person gave birth in one of two Durham County hospitals between July 1, 2009, and December 31, 2010. Families were randomly assigned to one of two groups based on the infant’s birth date. Families whose infants had an even-numbered birth date were assigned to receive Family Connects, and families whose infants had an odd-numbered birth date were assigned to the comparison group and received other community services as usual. Out of all eligible families randomly assigned to receive Family Connects or other community services, 682 families were randomly selected via birth records to participate in an impact evaluation when their infants were 6 months old. A total of 549 families (269 families in the intervention group and 280 in the comparison group) participated in this impact evaluation. Eighteen families (nine families in the intervention group and nine comparison group families) were declared ineligible after an examination of hospital discharge records. Hospital administrative records were received and coded between birth and age 24 months and between ages 12 and 24 months. An at-home interview was conducted when infants were six months old.
Setting	The study took place in Durham County, North Carolina.
Intervention services	The Family Connects model involves four to seven contacts with families—the first shortly after birth (ideally in the hospital, where a staff member schedules the initial home visit), followed by one to three home visits with a registered nurse, one or two follow-up contacts between the nurse and family or community service providers to facilitate successful connections, and a telephone follow-up one month after the nurse closes the case. During home visits, the nurse engages with the mother to provide a brief educational intervention, to answer the family’s questions and concerns about infant care, and to assess the family’s needs. Assessment results for each area indicate whether no subsequent intervention is needed; whether the nurse should deliver a short-term, educational intervention; or whether the family should be connected to community resources that address that need.
Comparison conditions	Families in the comparison condition were not offered Family Connects, but did receive other community services as usual.
Subgroups examined	This field lists subgroups examined in the manuscript (even if they were not replicated in other samples and not reported on the summary page for this model’s report). • Medicaid/no insurance at birth • Mother minority status • Mother single-parent status • Infant gender
Funding sources	This research was supported by Award Number R01HD069981 from the Eunice Kennedy Shriver National Institute for Child Health and Human Development, the Duke Endowment, and the Pew Center on the States.
Author affiliation	Authors were affiliated with the Center for Child and Family Policy, the Sanford School of Public Policy, and the Center for Child and Family Health at Duke University. The authors participated in the Family Connects model dissemination.
Peer reviewed	Yes

Study Registration:

Clinicaltrials.gov Identifier: None found. SocialScienceRegistry.org Identifier: None found. Registry of Efficacy and Effectiveness Studies Identifier: None found. Study registration was assessed by HomVEE for Clinicaltrials.gov beginning with the 2014 review, and for other registries beginning with the 2021 review.

Findings that rate moderate or high

Child health
Rating	Outcome measure	Effect	Sample	Timing of follow-up	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
High	Inpatient hospital overnights (component of total child emergency medical care)	FavorableUnfavorable or ambiguousNo Effect	Children born in Durham County, North Carolina during the 18-month study period	Through age 24 months	531 children	Adjusted mean = 0.13	Adjusted mean = 0.86	Mean difference = -0.73	Study reported = 0.24	Statistically significant, p= <0.001	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
High	Inpatient hospital overnights (component of total child emergency medical care)	FavorableUnfavorable or ambiguousNo Effect	Children born in Durham County, North Carolina during the 18-month study period	Age 12 - 24 months	531 children	Adjusted mean = 0.02	Adjusted mean = 0.11	Mean difference = -0.09	Study reported = 0.12	Not statistically significant, p= 0.06	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
High	Outpatient ER visits (component of total child emergency medical care)	FavorableUnfavorable or ambiguousNo Effect	Children born in Durham County, North Carolina during the 18-month study period	Through age 24 months	531 children	Adjusted mean = 1.39	Adjusted mean = 1.55	Mean difference = -0.16	Study reported = 0.08	Not statistically significant, p= 0.47	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
High	Outpatient ER visits (component of total child emergency medical care)	FavorableUnfavorable or ambiguousNo Effect	Children born in Durham County, North Carolina during the 18-month study period	Age 12 - 24 months	531 children	Adjusted mean = 0.71	Adjusted mean = 0.72	Mean difference = -0.01	Study reported = 0.01	Not statistically significant, p= 0.88	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
High	Total child emergency medical care	FavorableUnfavorable or ambiguousNo Effect	Children born in Durham County, North Carolina during the 18-month study period	Age 12 - 24 months	531 children	Adjusted mean = 0.73	Adjusted mean = 0.84	Mean difference = -0.11	Study reported = 0.07	Not statistically significant, p= 0.73	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
High	Total child emergency medical care	FavorableUnfavorable or ambiguousNo Effect	Children born in Durham County, North Carolina during the 18-month study period	Through age 24 months	531 children	Adjusted mean = 1.52	Adjusted mean = 2.41	Mean difference = -0.89	Study reported = 0.24	Statistically significant, p= <0.001	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.

Reductions in child maltreatment
Rating	Outcome measure	Effect	Sample	Timing of follow-up	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
High	Emergency medical care for accidents or injuries	FavorableUnfavorable or ambiguousNo Effect	Children born in Durham County, North Carolina during the 18-month study period	Through age 24 months	531 children	Adjusted mean = 0.27	Adjusted mean = 0.30	Mean difference = -0.03	Study reported = 0.07	Not statistically significant, p= 0.45	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
High	Maltreatment-related injuries	FavorableUnfavorable or ambiguousNo Effect	Children born in Durham County, North Carolina during the 18-month study period	Through age 24 months	531 children	Adjusted mean = 0.02	Adjusted mean = 0.02	Mean difference = 0.00	Not available	Not statistically significant, p= <0.30	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
High	Multiple emergency visits for accidents and injuries	FavorableUnfavorable or ambiguousNo Effect	Children born in Durham County, North Carolina during the 18-month study period	Through age 24 months	531 children	Adjusted mean = 0.03	Adjusted mean = 0.06	Mean difference = -0.03	Not available	Not statistically significant, p= 0.10	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.