Estimated Costs of Implementation

Average Cost per Family

No information is available about the average cost per family. However, cost considerations include the salaries of the home visitors and home visit travel costs. Additional costs include a laptop and cellphone for each home visitor, weigh scales for children, devices to measure head circumference and length, printed educational materials for caregivers, assessment materials, and a web-based data management system.
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Labor Costs

Labor costs vary based on local factors, such as the number of families served and the cost of living.

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Purchase of Model or Operating License

No information is available about the costs associated with operating the model.

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Materials and Forms

No information is available about the costs of materials and forms.

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Training and Technical Assistance

No information is available about the costs associated with training and technical assistance.

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Infrastructure

Home visitors need a laptop and cell phone. Infrastructure costs vary, depending on the local or regional implementing agency.

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Recruitment and Retention

Recruitment materials include a brochure individualized to the site’s needs and target audience, as well as other promotional materials. The cost of these materials varies depending on the location of the implementing agency.

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Implementation Notes

The information contained on this page was last updated in May 2020. Recommended Further Reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by Following Baby Back Home on April 10, 2020. HomVEE reserves the right to edit the profile for clarity and consistency.

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Training to Support Implementation

Requirements for Program Certification

There is no program certification process. Organizations interested in replicating FBBH should contact the FBBH program director. The developer recommends, but does not require, that interested organizations conduct a community needs assessment to determine the need for home visiting and case management services for medically complex, high-risk infants and their families; develop a plan for financing services; and identify procedures for participant referrals.

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Pre-Service Staff Training

FBBH home visitors receive training on the FBBH curriculum and topics such as safe sleep, Period of PURPLE Crying®, administering medications, preparing formula, growth and development, preventing injury, and coordinating care. Training is also provided on the Ages & Stages Questionnaire®, Third Edition (ASQ-3), the Ages & Stages Questionnaire®: Social-Emotional (ASQ:SE-2), and the Family Map Inventory.

There is no staff certification process.

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In-Service Staff Training

At least quarterly, home visitors are required to participate in ongoing training and professional development opportunities, offered internally and through the Arkansas Home Visiting Network Training Institute. The training focuses on children’s health issues, home visiting strategies, case management, and other topics relevant to the FBBH program and participating families. FBBH home visitors must complete the required continuing education hours as specified by their licensing board. FBBH nurses must maintain Cardiopulmonary Resuscitation Basic Life Support certification.

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Training Materials

No information is available about training materials to support implementation.

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Qualified Trainers

FBBH faculty and staff provide the core FBBH training. Local ASQ-3 and ASQ:SE-2 trainers, the Family Map Inventory developers, and the Arkansas Home Visiting Network Training Institute provide additional training.

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Technical Assistance

No technical assistance from the developer is available.

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Implementation Notes

The information contained on this page was last updated in May 2020. Recommended Further Reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by Following Baby Back Home on April 10, 2020. HomVEE reserves the right to edit the profile for clarity and consistency.

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More Information about the Model

Where to Find Out More

Carmen Irby
Program Director
Department of Pediatrics
University of Arkansas for Medical Sciences
Phone: (501) 526-8732
Email: cirby@uams.edu
Website: http://www.arhomevisiting.org/modelname/following-baby-back-homehttp://kidsfirst.uams.edu/services/following-baby-back-home/

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Recommended Further Reading

The following references were sources for the implementation profile or were recommended by the developer for further reading.

Arkansas Home Visiting Network. Following Baby Back Home. (n.d.). Retrieved May 7, 2018, from http://www.arhomevisiting.org/modelname/following-baby-back-home/

Kids First. Following Baby Back Home. (n.d.). Retrieved March 19, 2018, from http://kidsfirst.uams.edu/services/following-baby-back-home/

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Implementation Experiences

Summary of Sources

Information on implementation experiences is only reported for models that meet the HHS criteria for an evidence-based model. Following Baby Back Home has not met the criteria. As a result, HomVEE does not report information in this section.

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Prerequisites for Implementation

Type of Implementing Agency

Implementing agencies can include organizations that provide services for children from birth to age 3 who have been discharged from a NICU or newborn nursery, and their families.

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Staffing Requirements

Two-person teams consisting of a registered nurse (RN) and a licensed social worker conduct home visits. A medical director provides medical consultation and a program director provides operational and clinical oversight. A part-time social work manager oversees the social work component of the model.

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Staff Education and Experience

The FBBH home visitors must maintain professional licensure in their respective fields. The FBBH nurses must be licensed as RNs by the state board of nursing. The FBBH social workers must be licensed by the Council on Social Work Education. Experience in maternal and child health is preferred.

The medical director must be licensed by the state medical board. The program director must have a minimum of a bachelor’s degree in nursing, social work, or a related field. The program director and social work manager must have clinical supervisory experience.

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Supervision Requirements

The program director and the social work manager must be available to the home visitors at all times for telephone consultation. In addition, the home visitors receive the following types of supervision:

  • Monthly reflective supervision focused on the home visitor’s professional development that includes caseload review, family engagement strategies, home visit planning, and staff development;
  • Monthly 1.5-hour team case conference presentations with the medical director that include evaluating the family’s needs and developing strategies to assist the family with health-related concerns and community resource needs; and
  • Monthly clinical supervision focused on supporting high quality service delivery that covers developing home visits, delivering the curriculum, identifying family strengths, and setting goals with the family.

The ratio of supervisor to home visitors is 1:12.

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Staff Ratio Requirements

FBBH home visiting teams have a caseload capacity of 45 infants.

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Data Systems/Technology Requirements

FBBH requires the use of a web-based data management system to enter clients’ data and document home visits.

Home visitors need a laptop and cell phone.

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Implementation Notes

The information contained on this page was last updated in May 2020. Recommended Further Reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by Following Baby Back Home on April 10, 2020. HomVEE reserves the right to edit the profile for clarity and consistency.

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Materials and Forms to Support Implementation

Operations Manuals

The FBBH manual describes the model’s objectives and curriculum guidelines, and includes a list of additional education resources.

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Service Delivery Forms

FBBH uses the following forms: participant referral, Health Information Portability and Accountability Act, program consent, consent to share information with physicians and community agencies, participant and family intake packet, participant demographic and medical information, immunization record, growth chart, ASQ-3 and ASQ:SE-2 introduction letter, and referrals for services.

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Assessment Tools

FBBH home visitors conduct the following assessments during enrollment:

  • Infant physical assessment;
  • Medication and formula preparation assessment, at intake and as needed;
  • Caregiver depression screening, at intake and every 6 months;
  • Food insecurity screening for infants, at intake and every 6 months;
  • ASQ-3 and ASQ:SE-2;
  • Intimate partner violence screening;
  • Infant vision screening, at and before age 3 months, and annually thereafter;
  • Infant and parent interaction observation assessment;
  • Psychosocial assessment;
  • Infant well-being assessment; and
  • Family Map Inventory.
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Curriculum

The FBBH curriculum addresses the medical, social, and emotional growth and development needs of the infant and the family and covers the following topics:

Health/General

  • Medical topics and procedures;
  • Management of medical concerns;
  • Strategies to reduce preventable emergency department visits and rehospitalizations;
  • Prevention of influenza and respiratory syncytial virus (RSV);
  • Immunizations;
  • Infection control and home hygiene;
  • Period of PURPLE Crying;
  • Infant feeding and food choices from ages 1 to 3;
  • Oral health and dental care;
  • Birth spacing;
  • Tax Equity and Fiscal Responsibility Act (TEFRA) option, Supplemental Security Income, and Medicaid; and
  • Medicaid transportation.

Physical/Social/Emotional Development

  • ASQ-3 learning activity handouts;
  • ASQ-3 activity pages;
  • ASQ:SE-2 Emotional Development Guide;
  • Healthy Minds: Nurturing Your Child’s Development handouts;
  • Act Early developmental checklists and booklet;
  • Bright Futures Family Tip Sheets;
  • Brain development; and
  • Infant and child pre-literacy skills.

Injury Prevention

  • Home safety checklist;
  • Safe sleep fact sheet;
  • Child maltreatment fact sheet;
  • Crybaby fact sheet;
  • Crying plan;
  • Hot car safety fact sheet;
  • Burn prevention fact sheet;
  • Fire escape plan graph;
  • Home smoke alarm distribution; and
  • Intimate partner violence fact sheet.

Additional resources are available to the home visitors on topics to address the individual needs of the family.

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Available Languages

Most FBBH materials are available in English, Marshallese, and Spanish.

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Fidelity Measurement

At least quarterly, supervisors observe a visit conducted by each home visiting team. The supervisor completes a home visit observation form that assesses the planning and delivery of the home visit, the relationship between the home visiting team and the family, and the home visiting team’s flexibility and adherence to and competence with the curriculum. Supervisors discuss fidelity issues with the home visitors individually and as a team during quarterly meetings.

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Fidelity Standards

To deliver FBBH with fidelity, the following core components of the FBBH model must be implemented:

  • Home visits are provided by a registered nurse and licensed social worker;
  • Home visiting teams participate in monthly case conference presentations with the medical director;
  • Supervisors observe each home visiting team at least quarterly;
  • Home visiting teams participate in ongoing training (quarterly, at a minimum);
  • Referrals typically are received from Arkansas NICUs;
  • Home visiting teams use the FBBH curriculum to deliver home visiting and case management services;
  • Infants’ growth and development are monitored though growth charts and ASQ-3 and ASQ:SE-2 questionnaires, according to the recommended schedule; and
  • Home visiting teams use a web-based data management system to monitor cases and assess outcomes.
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Implementation Notes

The information contained on this page was last updated in May 2020. Recommended Further Reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by Following Baby Back Home on April 10, 2020. HomVEE reserves the right to edit the profile for clarity and consistency.

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Model Overview

Implementation Support

Following Baby Back Home (FBBH) is a home visiting model implemented in Arkansas that is administered by the Department of Pediatrics at the University of Arkansas for Medical Sciences and the Arkansas Home Visiting Network. The Arkansas Home Visiting Network offers training to FBBH staff.

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Theoretical Model

FBBH serves families of medically complex, high-risk infants as they transition home from the neonatal intensive care unit (NICU). FBBH aims to foster developmentally appropriate parenting and promote child health. The home visitor works with the family to set goals based on the family’s strengths and challenges. The goal development process incorporates family resilience, family stress and adaptation, attachment, and adult learning theories.

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Target Population

The model serves families residing in Arkansas with medically complex, high-risk infants discharged from the NICU. Families are enrolled immediately following the infant’s discharge from the NICU.

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Targeted Outcomes

FBBH aims to reduce morbidity and mortality rates among medically complex, high-risk infants by reducing preventable infant rehospitalizations, improving adherence to infants’ medical appointments and immunizations, and increasing families’ skills and self-efficacy in caring for their high-risk infants.

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Model Components

The model consists of home visits with a registered nurse and a licensed social worker. The home visiting team provides care coordination, helps families identify local resources to meet the service needs of the infant, and provides referrals to support families’ social functioning and overall well-being. The team also follows up with families by phone between visits.

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Model Intensity and Length

FBBH offers services immediately following discharge from the NICU until the child’s third birthday. The FBBH intervention includes two home visits per month for the first two months after enrollment, one home visit per month until the child is one year old, and one visit every other month until the child's third birthday. Home visits typically last 60 minutes.

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Location

The model is implemented in 57 of the 75 counties in Arkansas.

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Adaptations and Enhancements

FBBH allows local programs to adapt the curriculum or model to meet their program’s and families’ needs; however, it recommends that all programs adhere to the core elements of basic infant and toddler care.

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Implementation Notes

The information contained on this page was last updated in May 2020. Recommended Further Reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by Following Baby Back Home on April 10, 2020. HomVEE reserves the right to edit the profile for clarity and consistency.

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