Durham Connects Program for Child Abuse Prevention

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Duke University

Disqualifiers: Infant birth date, Birth location, Residence location

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a program called Durham Connects, which involves nurse home visits to support new parents and prevent child abuse. The goal is to determine if these visits can reduce child maltreatment, improve child health, and enhance parental functioning. Families with babies born at hospitals in Durham County, North Carolina, from January to June 2014, who still reside in the county, may be eligible. The trial will compare families receiving these visits to those receiving regular services to assess the program's impact. As an unphased trial, participants can contribute to important research that could enhance support for new parents.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that the Durham Connects program is safe for child abuse prevention?

Research has shown that the Durham Connects program, which includes nurse visits to homes, is safe for families. In past studies, 80% of participating families adhered well to the program, and no major safety issues emerged. Notably, babies in the program had 59% fewer emergency room visits, suggesting potential health benefits.

The program connects families with local resources and aims to reduce child abuse. It supports parents and seeks to improve children's well-being. Overall, evidence indicates that families appreciate the program, and it appears beneficial without causing harm. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Durham Connects program because it offers a proactive approach to preventing child abuse by providing nurse home visits to new parents. Unlike traditional reactive measures that address issues after they arise, this program focuses on early intervention by supporting families right from the start. By offering personalized guidance and resources to new parents, it aims to build a strong foundation for healthy family dynamics, potentially reducing the risk of abuse. This innovative method could pave the way for more preventative strategies in child welfare.

What evidence suggests that the Durham Connects program is effective for preventing child maltreatment?

Research has shown that the Durham Connects program, which some participants in this trial will receive, can help reduce child abuse and the need for emergency medical care in young children. In past studies, mothers in the program reported fewer emergency visits for their babies and more connections to local support services. The program also encouraged better parenting practices. By offering short visits from nurses to homes, Durham Connects aims to improve family functioning and boost children's well-being. Overall, evidence suggests the program positively affects family and child health by supporting parents and connecting them to community resources. ^{1 2 3 4 6}

Who Is on the Research Team?

Kenneth A Dodge, Ph.D.

Principal Investigator

Duke University

Karen O'Donnell, Ph.D.

Principal Investigator

Center for Child & Family Health

W. Benjamin Goodman, Ph.D.

Principal Investigator

Duke University

Robert Murphy, Ph.D.

Principal Investigator

Center for Child & Family Health

Are You a Good Fit for This Trial?

This trial is for families with infants born between January 1, 2014 and June 30, 2014 in Durham County, NC hospitals. It aims to help prevent child maltreatment and boost family health. Families living outside of Durham County or with infants born outside the specified dates cannot participate.

Inclusion Criteria

Family of infant resides in Durham County, NC

My child was born between January 1, 2014, and June 30, 2014.

Infant born at a Durham County, North Carolina (NC) hospital (Duke or Durham Regional)

Exclusion Criteria

Infant not born at a Durham County, NC hospital (Duke or Durham Regional)

My child was born outside the period of January 1 to June 30, 2014.

Family of infant resides outside of Durham County, NC

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Initial Home Visit

A hospital birthing visit where a staff member communicates the importance of community support for parenting and schedules an initial home visit

1 visit

1 visit (in-person)

Nurse Home Visits

1-3 nurse home visits between 3-12 weeks of infant age to provide physical assessments for infant and mother, intervention and education, and assessment of family-specific needs

9 weeks

1-3 visits (in-person)

Community Service Connection

1-2 nurse contacts with community service providers to facilitate successful connections for families with significant nurse-identified risk

2 weeks

Follow-up

A telephone follow-up one month after case closure to review consumer satisfaction and community connection outcomes

4 weeks

1 visit (virtual)

What Are the Treatments Tested in This Trial?

Interventions

• Durham Connects

Trial Overview The trial evaluates the 'Durham Connects' program which involves nurse home visits to support child and family well-being. The study will see if this leads to lower rates of child abuse, better pediatric care, improved parental functioning, and enhanced child well-being compared to a control group.

How Is the Trial Designed?

Group I: Durham Connects Eligible Experimental Treatment 1 Intervention

From January 1, 2014 - June 30, 2014, all odd-birth-date residential births in Durham County, North Carolina will be randomly assigned to receive the Durham Connects nurse home visiting program.

Group II: Control Active Control 1 Intervention

From January 1, 2014 - June 30, 2014, all even-birth-date residential births in Durham County, North Carolina will be randomly assigned to a control group condition. These families will be assigned to receive services as usual and serve as the randomized comparison group for evaluating Durham Connects program impact.

Who Is Running the Clinical Trial?

Duke University

Lead Sponsor

Trials

2,495

Recruited

5,912,000+

Laura and John Arnold Foundation

Collaborator

Trials

13

Recruited

30,500+

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Collaborator

Trials

2,103

Recruited

2,760,000+

Coalition for Evidence-Based Policy

Collaborator

Trials

1

Recruited

1,700+

The Duke Endowment

Collaborator

Trials

17

Recruited

48,100+

Published Research Related to This Trial

The Family Success Network, a pilot program in Northeast Ohio, aims to prevent child maltreatment by addressing social determinants of health, such as socioeconomic status and intergenerational trauma, through various support services.

The initiative includes family coaching, financial assistance, and parenting education, with the goal of improving family functioning and reducing the need for child protective services and foster care in economically disadvantaged areas.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Social Determinants of Health and Child Maltreatment Prevention: The Family Success Network Pilot. Johnson-Motoyama, M., Moon, D., Rolock, N., et al.[2023]

The North Carolina Plan of Safe Care (NC POSC) was implemented to support substance-affected infants and their families, but many healthcare providers were unaware of the program, highlighting a need for better communication and education among stakeholders.

From January 2018 to October 2019, 91% of notifications for substance-affected infants were screened for maltreatment, with a significant portion (70%) related to prenatal marijuana exposure, indicating a critical area for intervention and support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Implementation of the North Carolina Plan of Safe Care in Wake County, North Carolina. Austin, AE., Shanhan, ME., Rosemond, P., et al.[2022]

In a study of 595 children, those who underwent investigations for suspected child maltreatment did not show significant improvements in key risk factors like social support, family functioning, or child behavior by age 8, compared to those who were not investigated.

The findings suggest that Child Protection Services investigations may not effectively address or improve the underlying risk factors associated with child maltreatment, indicating a potential gap in secondary prevention efforts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Household, family, and child risk factors after an investigation for suspected child maltreatment: a missed opportunity for prevention. Campbell, KA., Cook, LJ., LaFleur, BJ., et al.[2021]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4011097/

Implementation and Randomized Controlled Trial ... Durham Connects mothers reported fewer infant emergency care episodes and more community connections, more positive parenting behaviors, participation in higher ...

2. pew.org pew.org/~/media/legacy/uploadedfiles/pcs_assets/2013/durhamconnectsreportpdf.pdf

Durham Connects Impact Evaluation Final Report The current report provides an overview of 1) the DC program, including the home visiting model and a description of an 18-month randomized ...

3. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/34232300/

Effect of a Universal Postpartum Nurse Home Visiting Program ... A brief postpartum nurse home visiting program can reduce population rates of child maltreatment and emergency medical care use in early childhood.

4. clinicaltrials.gov clinicaltrials.gov/study/NCT01843036

NCT01843036 | Durham Connects RCT Evaluation II The Durham Connects program is an innovative, community-based, universal nurse home-visiting program that aims to lower the population rate of child ...

5. homvee.acf.gov homvee.acf.gov/models/family-connects

Family Connects Specific targeted outcomes include (1) increasing families' connections to community resources; (2) reducing child maltreatment investigations and ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3943376/

Randomized Controlled Trial of Universal Postnatal Nurse ... This brief, universal, postnatal nurse home visiting program improves population-level infant health care outcomes for the first 12 months of life.