Research shows that nearly 3.5 million children were the subject of investigations by protective services in 2019, and children account for more than 28 million ED encounters each year. A community-wide postpartum nurse home visitation program has been shown to be beneficial for children and families through the first two years of life, yet it's known that the short-term benefits of many early childhood interventions aren't sustained over time. A new study was undertaken to evaluate the effects of a postpartum nurse home visiting program on child maltreatment and emergency care use through age five.

The families of all 4,777 resident births in a North Carolina community during an 18-month time period were randomly assigned to either the home visitation program or treatment as usual. A random subsample of 549 families were selected to participate in an impact evaluation study beginning when the infant was six months old. The majority of children in both the full sample and subsample were from racial and ethnic minority groups.

The home visitation program includes one to three home visits with a public health RN to provide education, identify family needs, and connect families with community resources. Families also receive telephone follow-up, and an electronic resource directory is created to facilitate family connections to the community.

Families assigned to the home visitation program had 39% fewer Child Protective Services investigations for suspected child maltreatment through age five and 33% less total child emergency medical care use. The program had positive effects on both minority and nonminority families, but the effects were greater for nonminority families.

The authors note that the study's results may not be generalizable to other communities, and the effects may not be as great in the context of lower-quality implementation. They conclude that a study of the benefits and costs of the program is needed.