Center for Child and Family Policy, Duke University, Durham, NC, USA.
Sanford School of Public Policy, Duke University, Durham, NC, USA.
Matern Child Health J. 2022 May;26(5):1067-1076. doi: 10.1007/s10995-021-03297-y. Epub 2022 Jan 7.
Home visiting is a popular approach to improving the health and well-being of families with infants and young children in the United States; but, to date, no home visiting program has achieved population impact for families in rural communities. The current report includes evaluation results from the dissemination of a brief, universal postpartum home visiting program to four high-poverty rural counties.
The study utilized a quasi-experimental design. From Sept. 1, 2014-Dec. 31, 2015, families of all 994 resident births in four rural eastern North Carolina counties were assigned to receive Family Connects (FC; intervention group). A representative subsample of families participated in impact evaluation when the infants were 6 months old: 392 intervention group families and 126 families with infants born between Feb. 1, 2014-July 31, 2014 (natural comparison group). Data were analyzed preliminarily for reporting to funders in 2016 and, more comprehensively, using propensity score matching in 2020.
Of FC-eligible families, 78% initiated participation; 83% of participating families completed the program (net completion = 65%). At age 6 months, intervention parents reported more community connections, more frequent use of community services, greater social support, and greater success with infants sleeping on their backs. Intervention infants had fewer total emergency department and urgent care visits. Intervention parents had more total emergency department and urgent care visits and (marginally) fewer overnights in the hospital.
FC can be implemented successfully in high-poverty rural communities with broad reach and positive benefits for infants and families.
家访是改善美国家庭中婴儿和幼儿健康和福祉的一种流行方法；但是，迄今为止，没有任何家访计划对农村社区的家庭产生了广泛影响。本报告包括向四个高贫困农村县推广简短、普遍的产后家访计划的评估结果。
该研究采用了准实验设计。从 2014 年 9 月 1 日至 2015 年 12 月 31 日，四个北卡罗来纳州东部农村县的所有 994 名常住出生家庭都被分配接受家庭联系（FC；干预组）。当婴儿 6 个月大时，对一个有代表性的干预组家庭样本进行了影响评估：392 个干预组家庭和 126 个 2014 年 2 月 1 日至 7 月 31 日出生的婴儿的自然对照组家庭。数据于 2016 年初步分析，以便向资助者报告，并于 2020 年使用倾向评分匹配进行更全面分析。
在符合 FC 条件的家庭中，有 78%的家庭开始参与；83%的参与家庭完成了该计划（净完成率为 65%）。在 6 个月大时，干预组父母报告了更多的社区联系、更频繁地使用社区服务、更多的社会支持以及婴儿仰卧睡觉的成功率更高。干预组婴儿的总急诊和紧急护理就诊次数较少。干预组父母的总急诊和紧急护理就诊次数更多（略有），住院过夜次数更少。
FC 可以在高贫困农村社区成功实施，覆盖面广，对婴儿和家庭有积极影响。
