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Family Connects

Category

Family Support

Child's Age

0-1 years

Participant

Children, Parents/Guardian

Languages

English, Spanish

Brief Description

Family Connects is a universally offered nurse 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 needs, and respond to family needs for information or connection to community resources and supports. Trained nurses can provide supportive guidance and link families to community services based on their individual needs and preferences. Family Connects helps new parents connect with their infant (newborn to age 12 weeks) 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 and connect families with community resources as needed. Ideally, program staff visit with families in the birth hospital after delivery to schedule the nurse home visit which typically takes place at 3 weeks after discharge from the birth hospital. 
  • 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% of all eligible families actively participating. Family Connects sites use a centralized database to track assessments and referrals.  
  • Fidelity: Programs work towards meeting fidelity metrics and quality standards. For more information, please contact the purveyor. 

Languages Materials are Available in

English, Spanish

Delivery Mode

In-person home visits. Visits can be made by telehealth if this is the preference of the family.

Dosage

Families receive a 90-minute to 2-hour home visit at approximately 3 weeks postpartum.  

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

Infrastructure for Implementation

Materials: Start up and ongoing medical supplies. Handouts and folders for families. Incentive materials for families such as diapers, books, etc. Brochures and outreach materials for family engagement.

Space: Space to meet for weekly case conference. 

Staffing Requirements

Staffing includes nurse home visitors, nurse supervisor, medical director, data manager, program support specialist, and a community alignment specialist.  A program administrator is required (.20 FTE). 

Family Connects nurse home visitors are Registered Nurses. Nurse supervisors must also be Registered Nurses. 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 specialists are recommended to hold a bachelor’s degree. The program administrator must hold a bachelor’s degree or higher in a relevant field. The medical director is .10 FTE and may be an MD, DO, CNM, PA or NP. A data manager and/or communications specialist are optional positions.  

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

Training materials and ongoing technical assistance are provided by FCI. Programs must participate in the Family Connects Academy and complete a full implementation plan before launching (requires approximately 12 weeks to complete). Training is available virtually both live and asynchronously and specific to the staff member’s role, including use of the FCI centralized data system. It can take 24-36 months or longer to reach fidelity in delivering the model (primarily related to reaching at least 60% of eligible participants).  

Contact Information

https://familyconnects.org/

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
  • $100,000 for installation and implementation phases for a 12-month period if less than 5,000 eligible births (pricing available upon request if over 5,000 births per year).
  • $20,000 minimum for certification phase (sites may take 24-36 months or longer to reach the 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.