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A Healthy Start for All

Center for Child & Family Policy starts home health visits for Durham babies

The Durham Family Initiative (DFI) has birthed a new program that will help Durham County reach out to support its youngest new residents.

Durham Connects, a collaborative research effort to discover ways to reduce community rates of child maltreatment, will provide in-home visits of newborns by licensed public health nurses. At the same time, the nurses will "connect" the families with referrals for additional support services and information as needed.

The program got under way in January when five nurses were hired through the Durham County Health Department. Five more will be hired this spring, and another 10 in 2009. The 20 nurses plan to visit about 200 families each year in an effort to reach the more than 4,000 newborns expected annually. A copy of the newborn's health assessment will be provided to the family's pediatrician.

"This program has the potential to create better outcomes for all of our children," said Ken Dodge, William McDougall Professor of Public Policy and director of the Center for Child and Family Policy (CCFP), which oversees the DFI. "Being a parent myself, I know that every new mom and dad can use the extra assurance that a public health nurse can provide about a newborn's health, as well as information on available community resources."

Christina Christopoulos, a senior DFI researcher, said, "Durham Connects is a public health program available to all families in Durham, at all income levels and in all areas. The nurses will be assigned to cover specific neighborhoods so that they will earn credibility with the families and develop deeper local connections."

"There is no stigma attached to these visits, she said. "Much like the district nurse program that operates in the United Kingdom, Durham Connects will provide similar services to the families of every newborn in the county," she said.

The nurses follow a standardized protocol developed through research and intensive piloting. The initial visit is made when the babies are two to six weeks of age. The assessments address four areas: infant and maternal health; parenting readiness; family financial stability; and child care. Research conducted by the CCFP shows that problems in these areas can increase the risk of child maltreatment.

To support Durham Connects, the newly created Office of Community Resources will maintain lists of community resources, provide individual case consultations for the nurses and market the program. Jeannine Sato joined the office as its first director in January.

Jeff Quinn, a project coordinator with DFI, worked in collaboration with the Network of Care to create community resource databases. Durham Connects will make efforts to involve the faith-based community as well, "to explore how everyone can work together for the well-being of Durham's youngest residents."

An accountability team will monitor and evaluate the program's implementation and outcomes. DFI will compare data during implementation to data available for the five years preceding creation of the program.

Comparisons also will be made between areas that have launched the program and areas where the launch is not scheduled until 2010. In addition, the team will compare child maltreatment rates and emergency room visits for Durham County during the full implementation of the program with that of five other North Carolina counties.

"By coordinating this program, we are putting all of our research to work in a real-life setting" Dodge said. "Durham Connects is the embodiment of the center's mission to bridge the gap between research and public policy to improve the lives of children and families. If Durham Connects makes strides toward eliminating child maltreatment in this community, that would be the best ‘research to practice' outcome imaginable."

Durham Connects partners include the Durham County Health and Social Services departments, Durham's Partnership for Children and local pediatricians. The Durham Family Initiative is a collaborative effort between Duke's Center for Child and Family Policy and the local nonprofit Center for Child and Family Health. DFI is supported by the Duke Endowment as part of its effort to enhance the welfare of North Carolina's children.