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5 <br /> Increased Collaboration: In order to assess the need for and <br /> feasibility of a home visiting program for Orange County to <br /> supplement the Child Service Coordination Program, the planner will <br /> need to interface with individuals from many different agencies, <br /> organizations, day care providers, private providers and hospitals, <br /> as well as, consumers. In the event that a program is developed <br /> and implemented, collaboration with all of these constituencies <br /> will be essential to the success of the program and has the <br /> potential of substantially improving the network of health and <br /> human services available to Orange County families. <br /> Outcomes: Both references cited above speak to the benefits of <br /> home visiting programs. One of the strengths of" these programs is <br /> that a wide range of outcomes can be improved through a single <br /> intervention strategy. Recent evaluations of home visiting <br /> programs have demonstrated improvements in a broad variety of <br /> outcomes including reductions in low birth weight and prematurity <br /> rates, better use of prenatal care, improved health-related <br /> behaviors during pregnancy, improved weight gain by-- low birth <br /> weight babies-, 'decreased accidents and decreased child abuse. In <br /> addition, home visiting has been associated with improved cognitive <br /> development for at-risk infants and better school performance. <br /> Longitudinal studies have demonstrated that benefits of home <br /> visiting programs can persist over time for longer lasting <br /> improvements that can overall affect quality of life for <br /> participants. <br /> Plan: A planner will be hired on a contract basis to implement the <br /> planning grant. Possible options of people to fill this <br /> role include graduate student interns, faculty and independent <br /> contractors. <br /> Issues to be addressed during the planning period: <br /> -Is a generic home visiting program needed in Orange County? <br /> -Is this a good way to access every Orange County family and <br /> connect them with services they need? <br /> -If so, should the program be universal in nature so that every <br /> Orange County family is contacted and an assessment done, or <br /> should the service be targeted in some way? <br /> -Are there sufficient services in Orange County to which families <br /> can be referred? If not, what is needed? <br /> -Should visits begin prenatally or after birth? -How will the <br /> program interface with the CSC program and other services <br /> available to families and children? <br /> -What is the best way to interface with the three primary hospitals <br /> where Orange County children are born, UNC-H, Durham Regional and <br /> Duke? <br /> -What level of home visitor should be used in the program, <br /> professional or paraprofessional or combination? <br /> -Other issues to be determined in the process. <br /> The planner would also be expected to work with the <br /> collaborators to develop a program proposal should this be deemed <br /> appropriate as a result of the planning process. <br />