Black or African American
39%
Source
Dodge, K. A., Goodman, W. B., Murphy, R. A., O’Donnell, K., Sato, J., & Guptill, S. (2014). Implementation and randomized controlled trial evaluation of universal postnatal nurse home visiting. American Journal of Public Health, 104(S1), S136–S143.
Model(s) Reviewed
Study Registration
Funding Sources
The Duke Endowment, the Pew Center on the States, NIH Grants K05DA15226 and P30DA023026.
Study Design
| Design | Attrition | Baseline equivalence | Confounding factors | Valid, reliable measures? |
|---|---|---|---|---|
| Randomized controlled trial | Low | Established on race; not established on SES; not established on outcome measures assessable at baseline | None |
Study Participants
Among 4,777 residential births from July 1, 2009, through December 31, 2010, the authors randomly selected one family with a birth on each even day to receive Durham Connects, and one family with a birth on each odd day to be followed as the control group. If those selected did not consent to be studied, the authors replaced them with a randomly selected family from the same birth date with the same race/ethnicity. Among the 664 families enrolled in the study, 531 participated in follow-up data collection. Participating families were approximately one-quarter non-Hispanic white, 40 percent black, one-quarter Hispanic, and 9 percent were another race or ethnicity. Mothers were about 28 years old on average. Control group babies had slightly worse birth outcomes (on average) than control group babies. Eight percent of control group babies had a birth complication, whereas only 4 percent of Durham Connects babies had a birth complication (a statistically significant difference, p less than 0.05).
Setting
Durham, North Carolina
Home Visiting Services
Durham Connects services consist of a total of four to seven contacts: a contact at the birthing hospital, one to three nurse home visits when infants are age 3 to 12 weeks, one or two nurse contacts with a community service provider, and a telephone or in-person follow-up contact one month later.
Comparison Conditions
Families in the comparison condition could receive other services in their community, but were not eligible to receive Durham Connects services.
Subgroups examined
• Maternal childcare use (uses out-of-home care)
Study Participants
Among 4,777 residential births from July 1, 2009, through December 31, 2010, the authors randomly selected one family with a birth on each even day to receive Durham Connects, and one family with a birth on each odd day to be followed as the control group. If those selected did not consent to be studied, the authors replaced them with a randomly selected family from the same birth date with the same race/ethnicity. Among the 664 families enrolled in the study, 531 participated in follow-up data collection. Participating families were approximately one-quarter non-Hispanic white, 40 percent black, one-quarter Hispanic, and 9 percent were another race or ethnicity. Mothers were about 28 years old on average. Control group babies had slightly worse birth outcomes (on average) than control group babies. Eight percent of control group babies had a birth complication, whereas only 4 percent of Durham Connects babies had a birth complication (a statistically significant difference, p less than 0.05).
Setting
Durham, North Carolina
Home Visiting Services
Durham Connects services consist of a total of four to seven contacts: a contact at the birthing hospital, one to three nurse home visits when infants are age 3 to 12 weeks, one or two nurse contacts with a community service provider, and a telephone or in-person follow-up contact one month later.
Comparison Conditions
Families in the comparison condition could receive other services in their community, but were not eligible to receive Durham Connects services.
Subgroups examined
• Maternal childcare use (uses out-of-home care)
Findings that rate moderate or high in this manuscript
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| No. of total emergency medical care episodes (hospital records) | Infant Age 6 months | Moderate | 0.26 | Statistically significant, p<0.001 | 531 families | Interviewed subsample, 7/2009-12/2010 births | ||
| No. of emergency department visits (hospital records) | Infant Age 6 months | Moderate | 0.09 | Not statistically significant, p = 0.36 |
531 families | Interviewed subsample, 7/2009-12/2010 births | ||
| No. of total emergency medical care episodes (parent report) | Infant Age 6 months | Moderate | 0.21 | Statistically significant, p<0.001 | 531 families | Interviewed subsample, 7/2009-12/2010 births | ||
| Did not have emergency medical care episodes (parent report) proportion | Infant Age 6 months | Moderate | 0.03 | Not statistically significant, p=0.70 | 531 families | Interviewed subsample, 7/2009-12/2010 births | ||
| Two or more emergency medical care episodes (parent report), proportion | Infant Age 6 months | Moderate | 0.13 | Not statistically significant, p=0.13 | 531 families | Interviewed subsample, 7/2009-12/2010 births | ||
| Three or more emergency medical care episodes (parent report), proportion | Infant Age 6 months | Moderate | 0.26 | Statistically significant, p<0.01 | 531 families | Interviewed subsample, 7/2009-12/2010 births | ||
| No. of emergency medical visits (parent report) | Infant Age 6 months | Moderate | 0.12 | Not statistically significant, p = 0.07 |
531 families | Interviewed subsample, 7/2009-12/2010 births | ||
| No. of overnights in hospital (parent report) | Infant Age 6 months | Moderate | 0.20 | Statistically significant, p<0.001 | 531 families | Interviewed subsample, 7/2009-12/2010 births | ||
| Did not have emergency medical care episodes (hospital records), proportion | Infant Age 6 months | Moderate | 0.06 | Not statistically significant, p=0.50 | 531 families | Interviewed subsample, 7/2009-12/2010 births | ||
| Two or more emergency medical care episodes (hospital records), proportion | Infant Age 6 months | Moderate | 0.31 | Statistically significant, p<0.01 | 531 families | Interviewed subsample, 7/2009-12/2010 births | ||
| Three or more emergency medical care episodes (hospital records), proportion | Infant Age 6 months | Moderate | 0.65 | Statistically significant, p<0.01 | 531 families | Interviewed subsample, 7/2009-12/2010 births | ||
| Most recent well-baby visit within past month | Infant Age 6 months | Moderate | 0.07 | Not statistically significant, p = 0.54 |
531 families | Interviewed subsample, 7/2009-12/2010 births |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| No. of community connections | Infant Age 6 months | Moderate | 0.28 | Statistically significant, p<0.001 | 531 families | Interviewed subsample, 7/2009-12/2010 births |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Mother positive parenting behaviors | Infant Age 6 months | Moderate | 0.25 | Statistically significant, p<0.01 | 531 families | Interviewed subsample, 7/2009-12/2010 births | ||
| Mother negative parenting behaviors | Infant Age 6 months | Moderate | 0.03 | Not statistically significant, p = 0.59 |
531 families | Interviewed subsample, 7/2009-12/2010 births | ||
| Mother knowledge of infant development | Infant Age 6 months | Moderate | 0.11 | Not statistically significant, p = 0.10 |
531 families | Interviewed subsample, 7/2009-12/2010 births | ||
| Mother sense of parenting competence | Infant Age 6 months | Moderate | 0.02 | Not statistically significant, p = 0.83 |
531 families | Interviewed subsample, 7/2009-12/2010 births | ||
| Father–infant relationship quality | Infant Age 6 months | Moderate | 0.21 | Not statistically significant, p = 0.08 |
524 families | Interviewed subsample, 7/2009-12/2010 births |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Mother possible clinical depression disorder | Infant Age 6 months | Moderate | 0.29 | Not statistically significant, p = 0.25 |
531 families | Interviewed subsample, 7/2009-12/2010 births | ||
| Mother possible anxiety disorder | Infant Age 6 months | Moderate | 0.27 | Statistically significant, p<0.05 | 531 families | Interviewed subsample, 7/2009-12/2010 births | ||
| Mother possible substance use problems | Infant Age 6 months | Moderate | 0.19 | Not statistically significant, p = 0.58 |
530 families | Interviewed subsample, 7/2009-12/2010 births |
This study included participants with the following characteristics at enrollment:
Race/Ethnicity
Maternal Education
Other Characteristics
This study included participants from the following locations:
- North Carolina