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In the absence of intervention, the duration and magnitude of mental health symptoms can have an adverse impact on parent and caregiver well-being, parenting practices, and subsequent children\u2019s development. Although home visiting is hypothesized to impact parent mental health, most studies do not demonstrate sustained benefits over time. Family Connects (FC) is a short-term, universal postnatal nurse home-visiting program designed to support children and families. Evaluations of FC demonstrate 6-month impacts on parent mental health, but longer-term (5-years post intervention) benefits have not been investigated, nor the potential mechanisms of the sustained effect. Every resident birthing family in Durham, NC, over an 18-month period (total <jats:italic>n<\/jats:italic>\u2009=\u20094777) was randomly assigned by birth date to FC or control condition. Implementation was strong, allowing an intent-to-treat evaluation of the model on maternal mental health. At infant age 60\u00a0months, a random, representative sample of parents (FC <jats:italic>n<\/jats:italic>\u2009=\u2009201; control <jats:italic>n<\/jats:italic>\u2009=\u2009200) was interviewed by condition-blind researchers with two screening instruments, the Center for Epidemiological Studies Depression Scale (CES-D) and the Mental Health Continuum scale (MHC \u2013 SF). Regression analyses with relevant covariates tested hypothesized (one-tailed) effects on these self-report scales. Parents randomly assigned to FC were significantly (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.02) less likely to receive a depression score in the clinical range, reported a lower number of depressive symptoms (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.04), and received better scores for social well-being (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.04). Quality of the home environment (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.10) was a significant mediator of intervention impact on later parent mental health.<\/jats:p>","DOI":"10.1007\/s11121-025-01827-6","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T03:59:10Z","timestamp":1754020750000},"page":"921-931","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Promoting Long-Term Parent and Caregiver Mental Health Through Universal Postnatal Nurse Home Visiting: Intervention Effects and Mechanisms of Action"],"prefix":"10.1007","volume":"26","author":[{"given":"Gayane A.","family":"Baziyants","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth A.","family":"Dodge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W. 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