title: Toward Population Impact from Home Visiting.
abstract: Although some home-visiting programs have proven effective with the families they serve, no program has yet demonstrated an impact at the population level. We describe theDurham Connects (DC)initiative, which aims to achieve population impact by coalescing community agencies to serve early-intervention goals through a Preventive System Of Care and by delivering a universal, short-term, postnatal nurse home-visiting program. The home-visitor delivers brief intervention, assesses family needs in 12 domains, and connects the family with community resources to address individualized family needs. Evaluation ofDCoccurred through a population randomized controlled trial of all 4,777 births in Durham, NC, over an 18-month period.DCwas implemented with high penetration and high fidelity. Impact evaluation indicated that by age 6 months,DCinfants had 18 percent fewer emergency room visits and 80 percent fewer overnights in the hospital than did control families. We conclude that population impact is achievable if a program attends to challenges of community partnership, universal reach and assessment, rigorous evaluation, and models for sustaining funding.
authors.affiliation: Duke University.
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Dodge
authors.forename: W Benjamin
authors.initials: WB
authors.lastname: Goodman
authors.forename: Robert
authors.initials: R
authors.lastname: Murphy
authors.forename: Karen
authors.initials: K
authors.lastname: O'Donnell
authors.forename: Jeannine
authors.initials: J
authors.lastname: Sato