Putting the pieces together.

HIGH-RISK FAMILIES . . . . . . . . . . . . . . . . . . . . . . . . .COMPREHENSIVE Purpose. Improve physical and emotional care of children and reduce risks posed by limited intellectual functioning, lack of mastery, and poor mental health Population Served. Elmira: primarily white (89%), first time pregnant women, the majority with at least one risk factor—poor (59%), single (62%), or adolescent (64%). Memphis: primarily African-American (92%), first time pregnant women with at least two risk factors—poor (85% at or below poverty level), single (98%), or less than 12 years of education (65% adolescent). Service Delivery. Home visits. The NHVP model, refined over the past 20 years, consists of the following elements: ■ Home visitors are nurses who receive clinical supervision. ■ Families are enrolled during pregnancy through end of second trimester. PUTTING THE PIECES TOGETHER ■ Brief Intervention with Irritable Infants-p. 7 ■ Building Strong Families-p. 7 ■ Comprehensive Child Development Program-p. 11 ■ Early Head Start-p. 11 ■ Healthy Families America-p.5 ■ Healthy Steps-p. 10 ■ Infant Mental Health Services-p. 3 ■ Interaction Guidance-p. 8 ■ Johns Hopkins Child and Youth Program-p. 8 ■ Montreal Home Visitationp. 9 ■ Nurse Home Visitation-p. 1 ■ Parents As Teachers-p. 6 ■ Steps Toward Effective Enjoyable Parenting-p. 4 ■ UCLA Family Development Program-p. 4