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Implementation and randomized controlled trial evaluation of universal postnatal nurse home visiting
Kenneth A Dodge1, W Benjamin Goodman, Robert A Murphy
1Kenneth A. Dodge, W. Benjamin Goodman, Robert A. Murphy, Karen O'Donnell, and Jeannine Sato are with the Center for Child and Family Policy, Duke University, Durham, NC. Susan Guptill is with the Durham County Department of Health, Durham.
American Journal of Public Health
|December 21, 2013
Summary
A postnatal nurse home-visiting program significantly reduced infant emergency care by 59%. This intervention also promoted positive parenting and improved infant well-being, demonstrating its effectiveness.
Area of Science:
- Public Health
- Pediatrics
- Nursing
Background:
- Postnatal care is crucial for infant health and parental well-being.
- Home-visiting programs can support families but require high implementation fidelity.
- Previous interventions varied in scope and effectiveness.
Purpose of the Study:
- To evaluate the implementation, penetration, and fidelity of a brief, universal postnatal nurse home-visiting program.
- To assess the program's impact on preventing emergency health care utilization.
- To determine the program's effect on promoting positive parenting and infant well-being.
Main Methods:
- The Durham Connects program involved 4-7 sessions to assess needs and connect families with resources.
- A randomized controlled trial assigned 4777 births to intervention or control groups.
- Impact evaluation used blinded interviews with a subset of 549 families.
Main Results:
- 80% of families initiated participation with 84% adherence.
- Infants in the intervention group had 59% fewer emergency medical care episodes.
- Intervention mothers reported improved parenting, reduced anxiety, and increased community connections.
Conclusions:
- A brief, universal home-visiting program can be implemented with high penetration and fidelity.
- This intervention effectively reduced costly emergency medical care for infants.
- The program demonstrated significant improvements in family well-being and parenting outcomes.
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