Skip to main content Accessibility help
×
Home
Hostname: page-component-cf9d5c678-j7tnp Total loading time: 0.317 Render date: 2021-08-03T12:09:40.370Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Randomized controlled trial of Family Connects: Effects on child emergency medical care from birth to 24 months

Published online by Cambridge University Press:  03 September 2019

W. Benjamin Goodman
Affiliation:
Center for Child and Family Policy, Duke University, Durham, NC, USA
Kenneth A. Dodge
Affiliation:
Sanford School of Public Policy, Duke University, Durham, NC, USA
Yu Bai
Affiliation:
Center for Child and Family Policy, Duke University, Durham, NC, USA
Karen J. O'Donnell
Affiliation:
Center for Child & Family Health, Duke University, Durham, NC, USA
Robert A. Murphy
Affiliation:
Center for Child & Family Health, Duke University, Durham, NC, USA
Corresponding
E-mail address:

Abstract

One of Tom Dishion's most significant contributions to prevention science was the development of affordable, ecologically valid interventions, such as the Family Check-Up, that screen for child and family risk factors broadly, but concentrate family-specific interventions on those with greatest potential for population impact. In the spirit of this approach, investigators examined effects of a brief, universal postnatal home visiting program on child emergency medical care and billing costs from birth to age 24 months. Family Connects is a community-wide public health intervention that combines identification and alignment of community services and resources with brief, postpartum nurse home visits designed to assess risk, provide supportive guidance, and connect families with identified risk to community resources. Over 18 months, families of all 4,777 resident Durham County, North Carolina, births were randomly assigned based on even or odd birth date to receive a postnatal nurse home visiting intervention or services as usual (control). Independently, 549 of these families were randomly selected and participated in an impact evaluation study. Families, blind to study goals, provided written consent to access hospital administrative records. Results indicate that children randomly assigned to Family Connects had significantly less total emergency medical care (by 37%) through age 24 months, with results observed across almost all subgroups. Examination of billing records indicate a $3.17 decrease in total billing costs for each $1 in program costs. Overall, results suggest that community-wide postpartum support program can significantly reduce population rates of child emergency medical care through age 24 months while being cost-beneficial to communities.

Type
Special Issue Articles
Copyright
Copyright © Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage.Google Scholar
Alonso-Marsden, S., Dodge, K. A., O'Donnell, K. J., Murphy, R. A., Sato, J. M., & Christopoulos, C. (2013). Family risk as a predictor of initial engagement and follow-through in a universal nurse home visiting program to prevent child maltreatment. Child Abuse & Neglect, 37, 555565. doi:10.1016/j.chiabu.2013.03.012CrossRefGoogle Scholar
Brennan, L. M., Shaw, D. S., Dishion, T. J., & Wilson, M. (2012). Longitudinal predictors of school-age academic achievement: Unique contributions of toddler-age aggression, oppositionality, inattention, and hyperactivity. Journal of Abnormal Child Psychology, 40, 12891300. doi:10.1007/s10802-012-9639-2CrossRefGoogle ScholarPubMed
Brennan, L. M., Shelleby, E. C., Shaw, D. S., Gardner, F., Dishion, T. J., & Wilson, M. (2013). Indirect effects of the Family Check-Up on school-age academic achievement through improvements in parenting in early childhood. Journal of Educational Psychology, 105, 762773. doi:10.1037/a0032096CrossRefGoogle ScholarPubMed
Chang, H., Shaw, D. S., Dishion, T. J., Gardner, F., & Wilson, M. N. (2014). Direct and indirect effects of the Family Check-Up on self-regulation from toddlerhood to early school-age. Journal of Abnormal Child Psychology, 42, 11171128. doi:10.1007/s10802-014-9859-8CrossRefGoogle ScholarPubMed
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.Google Scholar
Coxe, S., West, S. G., & Aiken, L. S. (2009). The analysis of count data: A gentle introduction to poisson regression and its alternatives. Journal of Personality Assessment, 91, 121136. doi:10.1080/00223890802634175CrossRefGoogle ScholarPubMed
Crane, J., & Barg, M. (2003). Do early childhood programs really work? Washington, DC: Coalition for Evidence-Based Policy. Retreived from https://pdfs.semanticscholar.org/90f5/fe541b5641037518041e66fe6b5af6d4a51a.pdfGoogle Scholar
Dishion, T. J., & Kavanagh, K. (2003). Intervening in adolescent problem behavior: A family-centered approach. New York: Guilford Press.Google Scholar
Dishion, T. J., Nelson, S. E., & Kavanagh, K. (2003). The Family Check-Up with high-risk young adolescents: Preventing early-onset substance use by parent monitoingin. Behavior Therapy, 34, 553571.CrossRefGoogle Scholar
Dishion, T. J., Shaw, D., Connell, A., Gardner, F., Weaver, C., & Wilson, M. (2008). The Family Check-Up with high-risk indigent families: Preventing problem behavior by increasing parents’ positive behavior support in early childhood. Child Development, 79, 13951414. doi:10.1111/j.1467-8624.2008.01195.xCrossRefGoogle ScholarPubMed
Dodge, K. A., & Goodman, W. B. (2019). Universal reach at birth: Family Connects. Future of Children, 29, 4160.CrossRefGoogle Scholar
Dodge, K. A., Goodman, W. B., Bai, Y., O'Donnell, K., & Murphy, R. A. (2019). Evaluation of the implementation and impact of Family Connects when led by a community agency: A randomized clinical trial. Unpublished manuscript, Sanford School of Public Policy, Duke University.Google Scholar
Dodge, K. A., Goodman, W. B., Murphy, R. A., O'Donnell, K., Sato, J., & Guptill, S. (2014). Implementation and randomized controlled trial evaluation of universal postnatal nurse home visiting [Special Issue]. American Journal of Public Health, 104, S136S143. doi:10.2105/AJPH.2013.301361CrossRefGoogle Scholar
Dodge, K. A., Goodman, W. B., Murphy, R. A., O'Donnell, K., & Sato, J. (2013a). Randomized controlled trial evaluation of universal postnatal nurse home visiting: Impacts on child emergency medical care at age 12-months [Special Issue]. Pediatrics, 132, S140S146. doi:10.1542/peds.2013-1021MCrossRefGoogle Scholar
Dodge, K. A., Goodman, W. B., Murphy, R. A., O'Donnell, K., & Sato, J. (2013b). Toward population impact from home visiting. Zero to Three, 33, 1723.Google Scholar
Drummond, M., O'Brien, B., Stoddart, G., & Torrance, G. (1997). Methods for the economic evaluation of health care programmes (2nd ed). Oxford: Oxford University Press.Google Scholar
Fergusson, D. M., Grant, H., Horwood, L. J., & Ridder, E. M. (2005). Randomized trial of the Early Start program of home visitation. Pediatrics, 116, e803e809. doi:10.1542/peds.2005-0948CrossRefGoogle ScholarPubMed
Gardner, F., Shaw, D. S., Dishion, T. J., Burton, J., & Supplee, L. (2007). Randomized prevention trial for early conduct problems: Effects on proactive parenting and links to toddler disruptive behavior. Journal of Family Psychology, 21, 398406. doi:10.1037/0893-3200.21.3.398CrossRefGoogle ScholarPubMed
Green, B. L., Tarte, J. M., Harrison, P. M., Nygren, M., & Sanders, M. B. (2014). Results from a randomized trial of the Healthy Families Oregon accredited statewide program: Early impacts on parenting. Children and Youth Services Review, 44, 288298. doi:10.1016/j.childyouth.2014.06.006CrossRefGoogle Scholar
Holm, S. (1979). A simple sequentially rejective method procedure. Scandinavian Journal of Statistics, 6, 6570.Google Scholar
Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159174.CrossRefGoogle ScholarPubMed
Ludwig, J., Sanbonmatsu, L., Gennetian, L., Adam, E., Duncan, G. J., Katz, L. F., … McDade, T. W. (2011). Neighborhoods, obesity, and diabetes—A randomized social experiment. New England Journal Medicine, 365, 15091519. doi:10.1056/NEJMsa1103216CrossRefGoogle ScholarPubMed
Lunkenheimer, E. S., Dishion, T. J., Shaw, D. S., Connell, A. M., Gardner, F., Wilson, M. N., & Skuban, E. M. (2008). Collateral benefits of the Family Check-Up on early childhood school readiness: Indirect effects of parents' positive behavior support. Developmental Psychology, 44, 17371752. doi:10.1037/a0013858CrossRefGoogle ScholarPubMed
McEachern, A. D., Fosco, G. M., Dishion, T. J., Shaw, D. S., Wilson, M. N., & Gardner, F. (2013). Collateral benefits of the Family Check-Up in early childhood: Primary caregivers' social support and relationship satisfaction. Journal of Family Psychology, 27, 271281. doi:10.1037/a0031485CrossRefGoogle ScholarPubMed
Olds, D. L., Henderson, C. R., Chamberlin, R., & Tatelbaum, R. (1986). Preventing child abuse and neglect: A randomized trial of nurse home visitation. Pediatrics, 78, 6578.Google ScholarPubMed
Schafer, J. L., & Graham, J. W. (2002). Missing data: Our view of the state of the art. Psychological Methods, 7, 147177.CrossRefGoogle ScholarPubMed
Schnitzer, P. G., Slusher, P. L., Kruse, R. L., & Tarleton, M. M. (2011). Identification of ICD codes suggestive of child maltreatment. Child Abuse & Neglect, 35, 317. doi:10.1016/j.chiabu.2010.06.008CrossRefGoogle ScholarPubMed
Shaw, D. S., Connell, A., Dishion, T. J., Wilson, M. N., & Gardner, F. (2009). Improvements in maternal depression as a mediator of intervention effects on early childhood problem behavior. Development and Psychopathology, 21, 417439. doi:10.1017/S0954579409000236CrossRefGoogle ScholarPubMed
Shaw, D. S., Dishion, T. J., Supplee, L., Gardner, F., & Arnds, K. (2006). Randomized trial of a family-centered approach to the prevention of early conduct problems: 2-year effects of the Family Check-Up in early childhood. Journal of Consulting and Clinical Psychology, 74, 19. doi:10.1037/0022-006X.74.1.1CrossRefGoogle ScholarPubMed
Stroup, W. W. (2012). Generalized linear mixed models: Modern concepts, methods and applications. Boca Raton, FL: CRC Press.Google Scholar
6
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Randomized controlled trial of Family Connects: Effects on child emergency medical care from birth to 24 months
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Randomized controlled trial of Family Connects: Effects on child emergency medical care from birth to 24 months
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Randomized controlled trial of Family Connects: Effects on child emergency medical care from birth to 24 months
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *