Durham Connects for Preventing Child Abuse

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: 2

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if the Durham Connects nurse home-visiting program can prevent child abuse and improve child well-being. Families in Durham County, North Carolina, with babies born in local hospitals between July 1, 2009, and December 31, 2010, may have participated in this study. The trial compares families who received nurse visits to those who did not, assessing whether the program reduces child maltreatment and improves family health. It also examines if the program benefits higher-risk groups more and how community resources might influence positive outcomes. Families who gave birth during the specified period in Durham County and lived locally were eligible. As an unphased trial, this study provides families the chance to contribute to research that could enhance community health programs.

Do I need to stop my current medications for 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 preventing child abuse?

Research has shown that the Durham Connects program is safe and well-received by families. In a previous study, 84% of families participated actively, indicating the program's ease of use. Hospital records revealed that infants in the program had 59% fewer emergency visits due to maltreatment compared to those not in the program. This suggests the program may help lower the risk of child maltreatment. No reports of negative effects have been directly linked to the nurse home visits, indicating safety for families. ^{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 through nurse home visits. Unlike traditional methods that often rely on intervention after issues arise, Durham Connects focuses on early support for families, aiming to strengthen parenting skills and community connections from the start. This forward-thinking method could significantly reduce the incidence of child abuse by addressing potential challenges before they escalate.

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

Research has shown that the Durham Connects program, which participants in this trial may receive, is promising in reducing child abuse and improving children's well-being. In previous studies, mothers in the program reported fewer emergency visits for their babies and better access to community resources. They also demonstrated more positive parenting behaviors. The program includes visits from nurses who help families connect with local services and support. These visits have been linked to better family functioning. Overall, evidence suggests that Durham Connects effectively supports healthier family environments and lowers the risk of child abuse. ^{1 2 3 4 6}

Who Is on the Research Team?

Kenneth Dodge, Ph.D.

Principal Investigator

Duke University

Robert Murphy, Ph.D.

Principal Investigator

Center for Child & Family Health

W. Benjamin Goodman, Ph.D.

Principal Investigator

Duke University

Karen O'Donnell, 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 in Durham County, NC hospitals between July 1, 2009 and December 31, 2010. It aims to help prevent child maltreatment and improve child well-being. Families living outside of Durham County or with infants born before or after these dates cannot participate.

Inclusion Criteria

My child was born between July 1, 2009, and December 31, 2010.

Family of infant resides in Durham County, NC

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

Exclusion Criteria

Family of infant resides outside of Durham County, NC

My child was not born between July 1, 2009, and December 31, 2010.

Infant not born at Durham County, NC hospital

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 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 week

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

4 weeks

Follow-up

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

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Durham Connects

Trial Overview The 'Durham Connects' program is being tested through a randomized controlled trial to see if it lowers the rates of child abuse and improves pediatric care, parental functioning, and overall child well-being compared to those who do not receive the intervention.

How Is the Trial Designed?

Group I: Durham Connects Eligible Group Experimental Treatment 1 Intervention

From July 1, 2009 - December 31, 2010, all even-birth-date residential births in Durham County, North Carolina were randomly assigned to receive the Durham Connects nurse home visiting program.

Group II: Control Group Active Control 1 Intervention

From July 1, 2009 - December 31, 2010, all odd-birth-date residential births in Durham County, North Carolina were randomly assigned to a control group condition. These families were assigned to receive services as usual and served 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+

Robert Wood Johnson Foundation

Collaborator

Trials

161

Recruited

697,000+

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

Collaborator

Trials

2,103

Recruited

2,760,000+

The Pew Charitable Trusts

Collaborator

Trials

4

Recruited

3,100+

The Duke Endowment

Collaborator

Trials

17

Recruited

48,100+

Published Research Related to This Trial

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]

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]

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]

Citations

1. 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 ...

2. 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 ...

3. clinicaltrials.gov clinicaltrials.gov/study/NCT01843036

NCT01843036 | Durham Connects RCT Evaluation II The aim of this randomized controlled trial (RCT) is to conduct a second, independent evaluation the implementation and impact of the Durham Connects (DC) ...

4. 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 ...

5. sanford.duke.edu sanford.duke.edu/story/successful-durham-infant-home-visiting-program-goes-national/

Successful Durham Infant Home-Visiting Program Goes National The program sends a nurse to visit the family of every newborn, regardless of the family's income level. The nurse informs parents how to access community ...

6. overdeck.org overdeck.org/portfolios/spotlight/effect-of-family-connects-universal-postpartum-nurse-home-visiting-program-on-child-maltreatment-and-emergency-medical-care-at-5-years-of-age-a-randomized-clinical-trial/

Effect of Family Connects' Universal Postpartum Nurse ... This is a randomized controlled trial of Durham Connects (later renamed Family Connects), a universal home visitation program for families with a newborn child ...