MCH Nurse Home Visitation: Durham Connects and the Family Connects Model

Background: Postpartum home visitation is a widespread early-intervention strategy for most industrialized nations.  It is often free, voluntary, and embedded in a comprehensive child and maternal health system.  In the US, however, most home visiting programs provide long-term, intensive services for targeted groups.  To date, no home visitation program has been scaled up to achieve population-level impact.

Description: Family Connects is a model for postpartum home visitation based on evaluation of the Durham Connects program.  Nurses conduct a high-inference interview to assess needs and connect families with appropriate community resources.  Participating families are found to have more community service connections, more positive parenting behaviors, safer home environments, higher quality child care utilization, less maternal clinical anxiety, and less infant emergency medical care.  These findings suggest $3.02 in savings for each $1.00 spent.

Lessons Learned: As the only HomVEE-approved model for universal home visiting, Family Connects is a promising approach nationwide.  It remains to be seen whether these impacts can be achieved across all settings.  To date, the model is replicated in one rural and two urban communities.  Family Connects must remain true to its evidence base while flexible in its implementation to be truly community-owned.

Implications: Further research is needed in a variety of communities to conclude whether universal postpartum home visitation can be viable as a national policy.  In today’s fiscal climate, the Family Connects model must show positive health and parenting outcomes as well as financial savings.  Further evaluation should be an integral part of Family Connects dissemination.