Universal Reach at Birth: Family Connects

How do we screen all families in a population at a single time point, identify family-specific risks, and connect each family with evidence-based community resources that can help them overcome those risks-an approach known as targeted universalism? In this article, Kenneth A. Dodge and W. Benjamin Goodman describe Family Connects, a program designed to do exactly that. Developed and tested in Durham, NC, Family Connects-now in place at 16 sites in the United States-aims to reach every family giving birth in a given community. The program rests on three pillars. The first is home visiting: trained nurses (or other program representatives) welcome new babies into the community, typically at the birthing hospital, then work with the parents to set up one or more home visits when the baby is about three weeks old so they can identify needs and connect the family with community resources. The second pillar, community alignment, is an assembly of all community resources available to families at birth, including child care agencies, mental health providers, government social services, and long-term programs for subgroups of families with identified needs, such as Healthy Families and Early Head Start. The third pillar, data and monitoring, is an electronic data system that acts as a family-specific psychosocial and educational record (much like an electronic health record) to document nurses' assessments of mother and infant, as well as connections with community agencies. In randomized clinical trials, Family Connects has shown promising results. Compared to control group families, families randomly assigned to the program made more connections to community resources. They also reported more positive parenting behaviors and fewer serious injuries or illnesses among their infants, among other desirable outcomes. And in the first five years of life, Family Connects children were significantly less likely to be subject to Child Protective Services investigations than were children in a control group.