Evaluation of Universal Nurse Home Visiting in Low-Income, Rural Counties

The aim of project is to evaluate the population-level impact of a brief, universal, newborn nurse home visiting program that is currently being disseminated to four low-income, rural counties in eastern North Carolina through North Carolina’s Race to the Top Early Learning Challenge Grant.  Family Connects reaches universally to all families at birth to assess individual family needs, intervene briefly between 3-12 weeks of infant age, and direct matched community resources to families based on self-identified risks and needs. The model is in contrast with programs that rely on targeting families by demographic markers, such as young maternal age or poverty, which may lead to discrepancies between families’ needs and the services provided, decreasing overall program effectiveness (Dodge et al., 2013).

Results from an initial RCT evaluation of the program in Durham, North Carolina show highly promising impact on multiple domains of family and child well-being, including significant reductions in infant emergency medical care (Dodge et al., 2013; Dodge et al., 2014). However, it is unclear whether similar program effects would be observed in other communities, particularly those with differing demographic resources and profiles.  The current proposal seeks to expand existing knowledge of Family Connects efficacy and impact through interviews and administrative record reviews for approximately 1000 families residing in four low-income, rural counties in eastern North Carolina.

Objectives:

1. Toward the goal of understanding Family Connects program efficacy, we will evaluate program implementation in these counties, including program uptake, fidelity of nurse home visits, and successful nurse referrals to community resources.

2. Toward the goal of understanding Family Connects program impact, we will attempt to conduct blinded interviews with all Family Connectseligible families at infant age 4-months to evaluate program effectiveness in improving (1) family connections to community supports and services; (2) parenting and parenting-child relationship quality; (3) utilization of high-quality child care; (4) mother mental health and well-being; (5) mother and infant health and healthcare, including utilization of emergency medical care.