title: Implementation and randomized controlled trial evaluation of universal postnatal nurse home visiting.
abstract: OBJECTIVE
  We evaluated whether a brief, universal, postnatal nurse home-visiting intervention can be implemented with high penetration and fidelity, prevent emergency health care services, and promote positive parenting by infant age 6 months.
  
  
  METHODS
  Durham Connects is a manualized 4- to 7-session program to assess family needs and connect parents with community resources to improve infant health and well-being. All 4777 resident births in Durham, North Carolina, between July 1, 2009, and December 31, 2010, were randomly assigned to intervention and control conditions. A random, representative subset of 549 families received blinded interviews for impact evaluation.
  
  
  RESULTS
  Of all families, 80% initiated participation; adherence was 84%. Hospital records indicated that Durham Connects infants had 59% fewer infant emergency medical care episodes than did control infants. Durham Connects mothers reported fewer infant emergency care episodes and more community connections, more positive parenting behaviors, participation in higher quality out-of-home child care, and lower rates of anxiety than control mothers. Blinded observers reported higher quality home environments for Durham Connects than for control families.
  
  
  CONCLUSIONS
  A brief universal home-visiting program implemented with high penetration and fidelity can lower costly emergency medical care and improve family outcomes.
authors.affiliation: Kenneth 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.
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Dodge
authors.forename: W Benjamin
authors.initials: WB
authors.lastname: Goodman
authors.forename: Robert A
authors.initials: RA
authors.lastname: Murphy
authors.forename: Karen
authors.initials: K
authors.lastname: O'Donnell
authors.forename: Jeannine
authors.initials: J
authors.lastname: Sato
authors.forename: Susan
authors.initials: S
authors.lastname: Guptill
mesh_terms: D000328:Adult; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D064650:Home Health Nursing / Q000379:methods*; D006801:Humans; D007223:Infant; D007229:Infant Welfare; D008297:Male; D016487:Parenting; D011181:Postnatal Care / Q000379:methods*; D016730:Program Development; D015397:Program Evaluation; D011795:Surveys and Questionnaires