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Health Access Nurturing Development Services (HANDS)

Health Access Nurturing Development Services (HANDS)
By Kraig Humbaugh, MD, MPH, Lexington-Fayette County Health Department Commissioner

Adverse childhood experiences, known as ACEs, are critical indicators of a person’s potential health outcomes throughout their lifespan. According to the Centers for Disease Control and Prevention, ACEs include traumatic childhood experiences such as violence or abuse, witnessing violence, or having a family member attempt or die by suicide. Other ACEs concern aspects of a child’s environment that can disrupt a sense of safety, stability and bonding. Examples include substance misuse, mental health problems, and instability within the household, such as divorce or incarceration of a parent. ACEs are linked to chronic health problems, mental illness, and substance misuse in adulthood. The likelihood of negative health outcomes increases as the number of ACEs increase.

Fortunately, ACEs can be prevented by creating and sustaining safe, stable, nurturing relationships and environments for children. The Lexington-Fayette County Health Department’s (LFCHD) Health Access Nurturing Development Services (HANDS) program offers families evidence-based, best-practice parenting education in order to give children an optimal start in life. The program’s goals are to improve child safety, encourage nurturing environments, and support stable relationships that will have a positive impact on the health and development of children.

HANDS is a voluntary, free home visitation intervention for expectant mothers and new parents that uses an evidence-based curriculum called Growing Great Kids. The program has been shown to reduce ACEs and promote healthy behaviors by building parenting skills that lead to stronger families who are self-sufficient, and who provide an empathic, responsive childhood experience. According to a joint study by the University of Kentucky and the Kentucky Department for Public Health, which was published in the Maternal and Child Health Journal in 2017, families who participated in HANDS were less likely to experience child maltreatment and had lower rates of preterm delivery. An increase in positive outcomes correlated with an increase in home visits by trained HANDS staff.

How does HANDS work? Families may enroll in the program during pregnancy or before their baby turns 3 months of age. Services are not dependent on income or insurance type. To enroll, prospective participants complete an initial survey to assess if HANDS services are recommended. The survey assesses all potential ACEs. The survey helps identify the positive attributes and strengths the parent currently provides. If services are recommended, families are offered HANDS weekly home-visitation services by the health department, free of charge. Families are paired with a trained HANDS family support worker who provides routine home visitation services throughout the duration of the program. Most families are visited at least once a week at the beginning. The program concludes when the enrolled child turns 2 years of age.

HANDS staff are rigorously trained in the program’s curriculum and in home visitation services. In addition, staff are required to have ongoing continuing education in domestic violence, substance use, child abuse and neglect, mental health, boundaries, and ethics. Staff meet weekly to discuss each family’s positive experiences, as well as any issues or concerns.

HANDS is actively seeking new families interested in participating. Approximately 100 families are currently participating in the LFCHD HANDS program, but there is room for more. Though families do not have to be referred by a physician to receive services, referrals from a physician’s office are always appreciated. Simply contact the LFCHD HANDS program at 859-288-2338 or at If the family resides in another Kentucky county, LFCHD will help connect them with their local county health department for assistance. A simple referral can help give a new family and new baby the best possible start to life.