# Community Prevention of Child Maltreatment

> **NIH NIH R37** · DUKE UNIVERSITY · 2024 · $785,240

## Abstract

ABSTRACT
The aim of this project is to evaluate the impact of a novel comprehensive approach to improving population
outcomes and reducing disparities in early child development, called Community Navigation (CN). CN is based
on the MIECHV-approved Family Connects (FC), a universal newborn nurse home visiting program combining
alignment of community resources with engagement of families through short-term nurse home visiting to
identify family-specific needs, intervene briefly, and match families with tailored community resources. Two
randomized controlled trials (RCTs) have shown assignment to FC improves maternal mental health and
reduces population rates of child abuse investigations but does not have long-term impact on child behavior.
To improve and equalize population outcomes in parenting and child well-being, CN has been developed
through piloting as a universal psychosocial system of primary care across early life. Trained navigators reach
women during pregnancy, continue with FC at birth, and complete well-family visits at 12, 24, and 36 months
of child age to provide support, assess family-specific needs, deliver brief interventions, and connect families
with community resources for ongoing needs. With philanthropic support, CN is now being delivered through
an RCT with a community sample of 800 families in Durham, NC. 400 families have been assigned to receive
CN across the period from pregnancy through kindergarten, and 400 families have been assigned as care-as-
usual controls. Data analyses will test four hypotheses: (1) intervention efficacy: compared to controls, CN-
assigned families will demonstrate lower rates of child maltreatment, less child emergency medical care
utilization, better parent mental health, more positive parenting behaviors, and better child cognitive and
behavioral development through age 5; (2) disparity reduction: random assignment to CN will be
associated with reduction of race and income disparities, operationalized as positive impact of CN assignment
on each group with even stronger impact on low-income families and families of color; (3) intervention
mediation: improved parent mental health, parent self-advocacy, and parenting behaviors will account for
population impact (mediation) and disparity reduction (mediated moderation) in children’s behavioral
outcomes; and (4) how disparities develop: race and income disparities in access to community resources
in early life will account for race and income disparities in child outcomes at kindergarten. This proposal offers
an urgent, cost-shared opportunity to evaluate the population impact, disparity reduction, and mechanisms of
a novel system of primary care for birthing families. The project will contribute to public health by providing
empirical knowledge about an affordable, innovative, universal system of primary psychosocial care that aims
to improve population outcomes and reduce population disparities in parent mental health, positive parenting
behavi...

## Key facts

- **NIH application ID:** 10754962
- **Project number:** 5R37HD069981-12
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** KENNETH A DODGE
- **Activity code:** R37 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $785,240
- **Award type:** 5
- **Project period:** 2012-04-01 → 2028-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10754962

## Citation

> US National Institutes of Health, RePORTER application 10754962, Community Prevention of Child Maltreatment (5R37HD069981-12). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10754962. Licensed CC0.

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