Overview of the Family Connects Model Duke University

Overview of the Family Connects Model Duke University ● Box 90539 ● Durham, NC 27708 -0539 www. familyconnects. org

Topics we will be covering: • • • History and Research Core Components of the Model Program Operations Engineering Problem Q&A

Family Connects was Born in Durham, NC • Evolved out of Durham Connects, a program of the Center for Child and Family Health in Durham, NC • Partnership between: The Center for Child & Family Health, Duke’s Center for Child and Family Policy, and Durham County • Research and evaluation in Durham resulted in this proven model • Demand from other communities led to creation of Family Connects International

Where are we located?

RCT Evaluation Results: Age 6 -Month in-Home Interviews Compared to control families, Durham Connects-eligible families had: • More connections to community services / resources • More mother-reported positive parenting behaviors • Higher quality (blinded observer-rated) mother parenting behavior • Higher quality and safer (blinded observer-rated) home environments • Higher quality child care for those that chose out of home care • Less maternal reported anxiety

RCT Evaluation Results: Child Hospital Administration Records Results at infant age 12 months from aggregate hospital records Results at infant age 24 months from aggregate hospital records § 37% less total infant emergency medical care (ER visits + overnights in hospital) 1. 6 Cumulative Emergency Episodes § 50% less total infant emergency medical care (ER visits + overnights in hospital) 1. 8 1. 4 1. 2 1 Control Families DC Families 0. 8 0. 6 0. 4 0. 2 0 0 1 2 3 4 5 6 7 8 Infant Age in Months 9 10 11 12

RCT Evaluation Results: Age 60 -month CPS Investigations 0. 5 Cumulative Mean Investigations 0. 45 0. 4 39% Reduction b = -0. 34, p < 0. 05 Effect Size = 0. 18 0. 35 0. 3 0. 25 Control Mean 0. 2 DC Mean 0. 15 0. 1 0. 05 0 0 6 12 18 24 30 36 Child Age in Months 42 48 54 60

18 month RCT-What did we learn? Every family is vulnerable at the birth of a child 94% of families had 1+ need for community resources Community-wide eligibility is essential to population change Does not replace intensive, targeted programs, but informs what families need Population reach requires both a top down and bottom up approach Identify preventive system of care, align resources, reach all families Assess risk, provide intervention, improve connections

Components for Impact

Community Alignment Harnessing relationships as a catalyst for change

Model Basics Program offered/visit scheduled prior to discharge at birthing hospitals Visit scheduled ideally at 3 weeks post partum up to 12 weeks post partum but may engage later if special needs are present Available to all families with newborns residing within a defined service area, which could be a region, county, city, or other area, such as all births at a birthing hospital. 6 -8 new cases per nurse per work week (est. 44 work weeks per year – 264 -352 new cases per nurse per year) Follow-up contact with families 4 weeks post visit to confirm families’ successful linkages with community resources Nurse is an RN but is not required to be a BSN

Family Support Matrix Domains Support for Health Care Support for a Safe Home Support for Infant Care Support for Parent(s) 1. Maternal Health 2. Infant Health 3. Health Care Plans 4. Child Care Plans 5. Parent-Child Relationship 6. Management of Infant Crying Each factor is rated as: 1 = No family needs 2 = Needs addressed during visit 7. Household Safety/Material 8. Family and Community Safety 9. History with Parenting 10. Parent Well-Being 11. Substance Abuse in Household 12. Parent Emotional Support 3 = Community resources needed 4 = Emergency intervention needed

Program Cost • Need to plan to reach 60 -70% of defined community • Cost is typically $500 -700 per birth • Family Connects International staff are available to assist in developing program budgets. • Budgets will include time and resources for a thorough planning process in advance of program start up.

A Key Decision: The Program Home Replication sites have employed differing options based on their communities. Common options include: • Health System(s) • County Public Health • Child/Family serving non-profit 501(c)3

Essential Staffing Executive/ Program Director Community Alignment Manager Nurse Home Visitor Program Support Specialist Data & Evaluation Manager

Preparation & Planning for program initiation includes: • Engagement with all key community partners • Development of a fully customized implementation plan scaling to true universal delivery of the Family Connects Model • Initial program implementation with fidelity supporting initial program certification Stage PHASE 1: SITE PREPARATION & IMPLEMENTATION PLAN DEV. PHASE 2: PLANNING & COMMUNITY PREPARATION PHASE 3: PROGRAM INSTALLATION PHASE 4: INITIAL IMPLEMENTATION PHASE 5: PREPARATION FOR PROGRAM CERTIFICATION PHASE 6: INITIAL PROGRAM CERTIFICATION Y 1 Y 2 Y 3

Engineering Problem

Common Referral Examples by Matrix Factor

Discuss within your group the following: • What types of agencies, programs, and services might a family need? • How would a family get connected to programs and services today? • What would they do if they had trouble? • What do you think would be possible if there was a connected system with troubleshooting built in? Please prepare to report out your main points of discussion.

Questions? Megan Squires, MPH/MSW Implementation Specialist 919 -668 -3283 megan. squires@duke. edu