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Family Connects

Category

Family Support

Child's Age

0-1 years

Participant

Parents/Guardian

Languages

English, Spanish

Brief Description

A universal newborn home visiting program that connects with families after the birth of a newborn to share in the joy of a new baby, assess unique family risks, and respond to immediate needs for support and guidance. The program provides supportive guidance to families, links families to community services based on their individual needs and preferences, and helps new parents connect with their infant by providing them with the confidence and support needed to sustain infant and parent health, child development, and overall family well-being.

Expected Impact

  • Fewer infant emergency care episodes and visits
  • Greater father involvement
  • Greater perception of social support
  • Infants developmentally “on track”- more likely to report meeting 4 or more developmental milestones at 6 months 
  • Reduction in FS30- Percent of children ages 0-5 with investigated report of child abuse/neglect (reduction as a result of initial home visit to identify unique family risks and respond to immediate needs)
  • Increase in parental sensitivity and positive parenting practices
  • Improved child attachment behavior

Core Components for Model Fidelity

  • Home Visiting: Registered Nurses assess newborn, mother, and family health and psychosocial well-being during home visits. They connect families with community resources as needed and provide families with a gift bag of developmentally appropriate items, such as diapers. Nurses use motivational interviewing to deliver necessary assessments and interventions. Ideally schedule the first visit in the hospital after delivery. 
  • Community Alignment: Sites implementing Family Connects impact systems-level change by collaborating with community agencies, systems, and individuals. 
  • Data & Monitoring: Family Connects is intended to serve all eligible families, with at least 60-70% of all eligible families actively participating. Regular supervision, peer collaboration, assessments, and document home visits, family contacts, and referrals are required to ensure program fidelity.

Languages Materials are Available in

English, Spanish

Delivery Mode

In-person home visits.

Dosage

90-minute to 2-hour home visit delivered when child is approximately 3 weeks old. 

Based on needs and interests, families can receive an additional 1-2 home visits and/or telephone calls from the home visitor.

Staffing Requirements

According to Home Visiting Evidence of Effectiveness: Staffing includes nurse home visitors, nurse supervisor, medical director, data manager, program support coordinator, and a community alignment specialist. A program director is recommended, but not required.

Family Connects nurse home visitors are Registered Nurses. Nurse supervisors must also be Registered Nurses. It is recommended that nurse home visitors and data managers hold a bachelor’s degree. Nurse supervisors and program directors are recommended to hold a master’s degree. Community alignment specialists are required to hold a bachelor’s degree, but a master’s degree is preferred. Program support coordinators must hold at least a high school diploma, but a bachelor’s degree is preferred. The medical director must hold a Doctor of Medicine or Osteopathic Medicine in pediatrics, OB-GYN, family medicine, or psychiatry and have expertise in OB-GYN/midwifery, infant or maternal mental/behavioral health, and/or pediatrics. Collaboration with other specialists is necessary.

NCPC strongly recommends staff receive training in the Standards of Quality for Family Support and Strengthening. Contact Positive Childhood Alliance North Carolina (PCANC) or National Family Support Network (NFSN) for more information, training, and certification. 

Training for Model Fidelity

Sites implementing Family Connects receive certification from Family Connects International (FCI). They must adhere to all 13 essential model elements (Fidelity standards) in the Family Connects Implementation and Policies Manual and submit the names of all associated specialists. 

It takes 12-18 months to reach full certification. Nurse home visits begin after pre-service training. After 6-8 weeks of conducting home visits, FCI trainers visit sites to ensure fidelity and then provide ongoing in-person and virtual support.

Pre-service training is required for nurse home visitors and nurse supervisors. This training is delivered both in-person and virtually. Nurses must score at least 75% on an assessment of adherence to protocol and on inter-rater reliability scores of at least 75% on family risk assessment. 

Training materials and ongoing technical assistance are provided by FCI.

Contact Information

https://familyconnects.org/

919-808-1961 

Preferred method: https://familyconnects.org/contact/

Kimberly Friedman: Managing Director of External Operations; kimberly@familyconnects.org, 614-634-8906

Cost Estimates

The per child cost for Family Connects is about $500 to $700, which covers oversight, recruiting families, staff salaries and benefits, local travel reimbursement, and materials. These are considered local programming costs.

There are additional fees associated with Family Connects International (FCI), including the following fees:

  • $25,000 for a 3-month orientation period
  • $150,000 for installation and implementation phases for an 18-month period if less than 5,000 eligible births OR 5% of total local programming costs ($700 per eligible birth) if over 5,000 eligible births
  • $20,000 minimum for certification phase

Purpose Service Code (PSC)

5413 – Prenatal/Newborn Services

Program Identifier (PID)

Family Connects

Minimal Outputs for NCPC Reporting

FY 24-25:

  • Number of parents/guardians participating† 

†Select Family Support Programs data collection will include basic demographic data for parent/guardian participants including race and ethnicity. Data on interpretation and transportation will be collected when appropriate.

Minimal Outcomes for NCPC Reporting

FY 24-25:

  • Increase in parent use of services

Minimal Measures for NCPC Reporting

FY 24-25:

  • Parent Use of Services Calculation

NCPC Evidence Categorization

Evidence Based- 3 publications. 1 quasi-experimental study with a natural comparison group, 1 quasi-natural experiment with a natural comparison group, and 1 non-experimental evaluation.

Research Summary

Three of the most recent publications on Family Connects include a quasi-experimental study with a natural comparison group,1 a quasi-natural experiment conducted by independent evaluators,2 and a non-experimental evaluation of virtual home visiting efficacy during the COVID-19 pandemic.3 These studies provide support for Family Connects’ efficacy and impact, including in virtual delivery modes. Program success may be most observable at mature sites (certified for over 18 months). Participants can expect greater social support, knowledge and use of community resources, and father-involvement, among other outcomes. When assessed at six months after birth, treatment birthing parents reported more emergency care episodes and visits than non-treatment birthing parents. They also reported fewer infant emergency care visits. 

  1. ^ See Goodman et al. (2022). Quasi-experimental study with natural comparison group. The families of 994 births in four rural eastern NC counties were assigned to receive Family Connects treatment. A representative subsample participated in an impact evaluation survey when their infants were 6 months old, including a natural comparison group of infants born outside of eligible dates for the original sample. Participant demographics included low-income families, racial/ethnic minorities, and both married and unmarried parents. Initial home visits were primarily scheduled via telephone calls. Home visits were conducted in accordance with Family Connects fidelity protocol. Short-form birth records were used to identify when the infant reached 6 months of age, at which point families were invited to complete a survey over the phone. Measures include Family Support Matrix, child baseline demographics, parent-reported community services, parenting and childcare, infant health and well-being, and birthing parent health and well-being.
  2. ^  See Mersky et al. (2022). Quasi-natural experiment with natural comparison group conducted by independent evaluators. Sampled over 1,500 women who gave birth at a major hospital in Racine County, WI in a 13-month timeframe. Population includes racial/ethnic minorities and low-income families. Due to capacity concerns, eligible families were only recruited on weekdays. Births outside of these parameters formed a natural comparison group. Family Connects visits were implemented according to fidelity protocol with willing and eligible (weekday) families. All families, including those in the natural comparison group and those who opted out of receiving Family Connects services, were mailed an invitation to complete a survey at 6 months post-partum. Measures include PROMIS Global-10, PROMIS Sleep Disturbance-4a, Generalized Anxiety Disorder-2, Patient Health Questionaire-2, and Parents’ Evaluation of Developmental Status: Developmental Milestones. Participants were also surveyed on their smoking habits, breastfeeding practices, infant vaccination status, infant sleeping arrangements, and frequency of reading to children.
  3. ^ See Rybińska et al. (2022). Non-experimental evaluation of 5 certified and mature Family Connects sites. Site activity data was collected from March to November in 2019 and 2020 and analyzed. Families receiving Family Connects services in this period completed the COVID-19 Modification Survey to share their perceptions of Family Connects’ virtual home visits during the COVID-19 pandemic.

Researched Population

  • Rural counties
  • Low-income families
  • Racial/ethnic minorities
  • Married and unmarried parents
  • Children ages birth to 1 year

Clearinghouse and Compendium References

Bright Start Tennessee

Home Visiting Evidence of Effectiveness- meets criteria for the general population but not tribal populations

National Home Visiting Resource Center- rated Evidence-Based

Goodman, W. B., Dodge, K. A., Bai, Y., Murphy, R. A., & O’Donnell, K. (2022). Evaluation of a Family Connects Dissemination to Four High-Poverty Rural Counties. Maternal and Child Health Journal, 26, 1067-1076. https://doi.org/10.1007/s10995-021-03297-y

Mersky, J. P., Choi, C., & Plummer Lee, C. (2022). Quasinatural Experiment of Postnatal Home Visiting: An Independent Impact Study of Family Connects. American Journal of Preventative Medicine, 1-7. https://doi.org/10.1016/j.amepre.2022.05.008

Rybińska, A., Best, D.L., Goodman, W.B., Weindling, W., & Dodge, K. A. (2022). Home Visiting Services During the COVID-19 Pandemic: Program Activity Analysis for Family Connects. Maternal and Child Health Journal, 26, 70–78. https://doi.org/10.1007/s10995-021-03337-7



Local Partnerships Currently Implementing

Local Partnerships in purple have adopted Family Connects. Local Partnership contact information can be found here.