Reducing Child Maltreatment

In 2019, 3.5 million children were subject to Child Protective Services (CPS). In addition, about 28 million children visit the emergency department each year. Children under three years old, and from minority and low-income families are at high risk for being suspected of maltreatment and referred to CPS.

Family Connects is a postpartum home nursing program designed to reduce child harm and improve health outcomes for families. Benefits include better parenting behavior, greater connections to community resources, and lower postpartum mental health symptoms. Public health nurses contact families shortly after birth, make one to three home visits, and follow up four weeks after home visits by telephone. The visiting nurses provide families with health education, assess unmet needs, provide connections to community resources. The program is low-cost, amounting to about $500 to $700 per birth.

Benjamin Goodman and team examined whether Family Connects lowered child maltreatment investigations and child emergency medical care. They followed children from 531 Durham, NC families who received Family Connects care from birth to age five. Seventy percent of families were from racial minority groups. The team looked at state records for the total number of investigations for suspected child maltreatment. Hospital billing records were also coded for total number of child emergency department visits and overnight stays in hospital.

Shown in the Figure above, Family Connects members had 39% fewer CPS investigations and a 33% decrease in emergency medical care use compared to control families who did not receive Family Connects care. Past studies on the benefits of Family Connects only considered effects after a child’s first two years of life. In demonstrating benefits up to five years, this study suggests that short-term, high-quality programs can have potentially long-term, positive influences on child health.

Databyte via Goodman WB, Dodge KA, Bai Y, Murphy RA, O’Donnell K. Effect of a Universal Postpartum Nurse Home Visiting Program on Child Maltreatment and Emergency Medical Care at 5 Years of Age: A Randomized Clinical Trial. JAMA Network Open. July 2021.