Bringing your baby home from the hospital is a time of joy. But it has also been shown to be a highly vulnerable time for families. Residents of Alamance County have expressed an interest in creating more robust ways of helping support local families. One way to do this is universal post-partum visits. Community partners including Jessica Johnson, with the Alamance County Health Department, have been exploring this idea.
Ensuring that every child in Alamance County has the best chance to succeed is at the heart of Alamance Achieves work to bring together our community and local organizations. Currently only Medicaid recipients in Alamance County receive a visit from one of Alamance County’s Health Department nurses after an infant is born.
A team at the Health Department has been studying a visitation model created by Family Connects International as a possible way of expanding the home visit program so all families in Alamance County would receive at least one newborn home visit. The visits would be conducted by a nurse, who would perform a physical assessment on the baby and the mother. The physical would include weighing the baby, checking the mother’s blood pressure and asking questions to screen for postpartum depression. Additionally, if the mother is breastfeeding or had a C-section the nurse would ask about both. Finally, the nurse could connect the family to any resources they may need.
According to a randomized controlled trial Family Connects International conducted in 2014, their model showed:
Families had 44% lower rates of Child Protective Services investigations for suspected child abuse or neglect through the second year of life.
Community connections increased by 13%.
Mothers were 30% less likely to experience possible postpartum depression or anxiety.
Families were more likely to use out-of-home childcare.
As the number of birth risks increased, infants experienced fewer emergency department visits but more hospital overnights.
Mothers were more likely to complete their 6-week postpartum health check, but also had more emergency department visits.
The Alamance County Health Department has been working alongside community partners like local prenatal providers and pediatricians, mental health providers and early educators to co-design how an effective universal home visiting program would work in Alamance County. Like other Alamance Achieves partners working on systems change, the process of creating and aligning toward shared goals is crucial.
Johnson said, “Alamance Achieves have been amazing thought partners, helping to push for a community voice piece to make sure this is a program the community wants.”
A successful home visiting program will connect families to the specific services that Alamance County families need and want during the perinatal period. To understand which services are needed, a collaborative team of partners from the Health Department, Elon University, Cone Health, Alamance Achieves backbone staff and Elon-Alamance Health Partners have been conducting listening sessions with families to learn about the experience of bringing home a newborn in Alamance County — and to find out how receptive the families would be to the idea of postpartum home visits. The study was funded by the North Carolina Early Education Coalition and supported by Alamance Partnership for Children.
The program would go beyond home visits, by including a community alignment specialist position. This person would focus on working to improve the systems within Alamance County, including collecting data to see what resources worked well for families, where any gaps existed and which agencies had the capacity to take referrals. Johnson added, “The goal of the data would also be to increase program awareness and buy-in, so we can continue to create a better system that increases our capacity and learn from families about what resources they need during that vulnerable time.”
