News & Resources

What Matters

The enduring impact of home visiting for family health and well-being

Last November began the Center for Child & Family Health’s 25th anniversary year. What started in 1996 as a vision for cross-sector collaboration to meet the needs of abused children has since evolved into a three-part strategy to treat, prevent, and transform childhood trauma.

Over that time, CCFH’s therapists, social workers, nurses, and home visitors have walked alongside thousands of children and families experiencing what are often the greatest challenges of their lives – separation, isolation, grief, loss, violence, economic insecurity, and more.

With evidence-based, trauma-informed mental health services, CCFH helps families navigate the day-to-day difficulties of childhood trauma and adversity. At the same time, CCFH equips children and their caregivers with the tools and resources necessary for a healthy future.

Hope for a child’s healthy future drives CCFH forward to its next 25 years. Below, we dive into how CCFH’s long-term home-visiting programs work with families to create a healthy present and future where children and parents can thrive.


Even today, nine years later, Kaleigh can point to a myriad of ways that home visiting laid a foundation for her family’s well-being.

A mom of three, Kaleigh’s younger son was enrolled in CCFH’s Durham Early Head Start Home-Based Program in 2013, and her daughter was enrolled in 2014.

Over four years, weekly home visits from their home visitor Anna Pabón – who now serves as the program’s coordinator – covered a wide range of needs.

“We talked to Anna about everything – making sure the kids were meeting milestones, ways to manage stress, work placement. It really went above and beyond just the child and the home. It was irreplaceable.”

The Most Important Factor

CCFH provides long-term, in-home support focused on building parenting skills and supporting households with access to community resources via two programs: Healthy Families Durham and the Durham Early Head Start Home-Based Program.

“If we want children to grow up safe and healthy, then we need to make sure that parents have the resources they need to create safe, healthy homes – especially those resources that protect them from toxic stress,” says Dr. Karen Appleyard Carmody, Director of Early Childhood Prevention Programs at CCFH.

The relationship with parents or caregivers is the most important factor in a child’s health and well-being. A safe, stable, and nurturing relationship provides a foundation for healthy development – emotionally, socially, intellectually, and even physically. Such secure relationships are especially important during the first three years of life, a critical time of growth and formation for both child and parent.

Families can enroll in CCFH’s long-term home visiting programs before their child is born and stay in the program until their child is three years old. Home visitors use the evidence-based Parents as Teachers curriculum to support parenting, child development, health, and nutrition. During weekly home visits, activities are customized to the individual, developmental needs of each family and child. The long-term in-home approach allows home visitors to get to know families closely and build trust over the course of the program.

Support for the Unexpected

While she was pregnant with her daughter in 2014, Kaleigh’s family faced major life transitions. The contract for her job had ended, and they moved out of state to be near family and help care for her father, who died shortly after their move.

Two weeks after her daughter’s birth came the diagnosis of a tumor in Kaleigh’s leg. The family returned to Durham to be close to care at Duke and her fiancé’s family. They spent some time experiencing homelessness, living with her fiancé’s mother, and navigating this phase without transportation of their own.

Surgery and rehabilitation in a nursing facility meant a long separation from her children and being unable to continue breastfeeding her newborn daughter.

Kaleigh experienced anxiety and depression from so many challenges in such a short time, and felt the weight of worry over what could happen next.

Rebuilding Relationships

A lifeline came in the form of resumed home visits with CCFH’s Durham Early Head Start Home-Based Program.

“When we came back down here, it was like starting all over again. And it was so good to have the Early Head Start team already know us and already know what our plans were, what our goals were, how we took care of the kids. We knew we had a lot of challenges. It was good to have an outsider come in and say, ‘This is bad, but it’s not the end.'”

Caring full time for his family, Kaleigh’s fiancé continued weekly home visits with Early Head Start for their two youngest children, learning how to apply for assistance programs like WIC with Anna Pabón’s help.

For Kaleigh’s daughter, the impact of the long separation from her mother had become painfully clear. As a toddler, she would run away crying if her father left her with Kaleigh and would not come to Kaleigh for comfort if she fell down. Kaleigh was struck by the realization that her daughter didn’t know her.

A referral to one of CCFH’s parent coaches for Attachment and Biobehavioral Catch-up (ABC) helped Kaleigh and her daughter reconnect. Through ten one-hour sessions with a parent coach, ABC builds the connection between parents and children age 6 months to 4 years old while supporting healthy social and emotional development. Over four months, they worked together in sessions that included Kaleigh’s fiancé at first, then shifted to focus on bonding between mother and daughter.

Kaleigh remembers clearly what gave her hope over the course of their ABC sessions: the moment when her daughter brought her a toy – wanting Kaleigh to look at it, wanting Kaleigh’s interest – without dad being there.

“Slowly, I just knew that it was going to be fine as soon as she brought me that toy,” Kaleigh says. “Now she loves me!”

Equipped to Thrive

Over 25 years of working with children and caregivers navigating adversity and healing from trauma, the CCFH team knows what resources and support mean to a family.

“Early Head Start really helped us maintain through different ways and different connections on so many levels,” says Kaleigh. “It was just one thing after the other, and they were there through it all. They have a special place in our heart.”

Parents who are equipped with knowledge, guidance, resources, and basic household essentials, can be a safe, nurturing presence to their children – paving the next 5, 10, or 25 years with a stable foundation from which children can thrive.

Learning from Each Other

CCFH’s home visitors approach their role with humility, always staying open to learning from families. They work collaboratively with families to come up with next steps for challenges families are facing, asking questions, sharing feedback, and exploring options together. Below, Anna Pabón shares what Kaleigh’s family and others in the Early Head Start program have taught her; and Kaleigh shares what she hopes the Early Head Start team learned from her family.

“ It was an honor to be able to meet with Kaleigh and her family each week, to get to know them on a deeply personal level and to respect each situation they experienced. What I learned from Kaleigh’s family and many other families we’ve served is that parents love their children and want the best for them no matter what their situation may look like. Kaleigh mentioned once that her children gave her hope and that is what kept her and her fiancé fighting to provide stable housing and economic stability for their children, and they did it! ”
- Anna Pabón
“ I hope that they learned that it matters. That Anna was always being kind, and open, and caring. She loved these kids so much. It matters. All the work that they’re doing matters. Every visit matters. Every project. Everything matters and it goes a long way. ”
- Kaleigh
Posted on May 26, 2022