Nurse Family Partnership

Intended Outcomes:

1. Improve pregnancy outcomes by partnering with moms to engage in good preventive health practices, including thorough prenatal care from their healthcare providers, improving their diets and reducing any use of habit-forming substances.
2. Improve child health and development by assisting families provide responsible and competent care.
3. Improve the economic self-sufficiency of the family by supporting parents to develop a vision for their own future, plan additional pregnancies, continue their education and find work.Improve child health and development by assisting families provide responsible and competent care.

Continuum of Care:
Selective Prevention

Topic Areas:
Behavioral Health/Mental Health, Physical Health, Substance Use

Ages:
Adult (25+), Early Childhood (0-3), Young Adult (19-24)

Geographic Locations:
Rural, Urban

Delivery Settings:
Community-Based

Cultural Considerations:
Significant and well-articulated attention was given to disparities in outcomes

Audience:
Young, first-time moms-to-be, starting early in the pregnancy and continuing through the child’s second birthday.

Credentials:
Required credentials include: 1. Nurse home visitors: Registered Nurse with a Bachelor's Degree in nursing, as a minimum qualification. 2. Nurse Supervisor: Registered Nurse with a Bachelor's Degree in nursing, as a minimum qualification, and a Master's Degree in Nursing preferred.

Manuals:
No

Is Training Required?
Yes, see developer info

Who can provide the required training?
The Nursing Practice Team is vital to the success of Nurse-Family Partnership, providing specialized training, education and resources to nurses so that they provide the best care possible to young mothers. Through both in-person and distance learning opportunities, you will participate in the core education program designed to teach the skills needed to establish successful therapeutic relationships with clients. The program also includes instruction in the Visit-to-Visit guidelines to ensure that the Nurse-Family Partnership program is delivered with fidelity across the country so that the goals for each client are achieved. Your education will continue with regular team meetings with nursing supervisors and staff members from the National Service Office. These are structured to help you continually improve your skills in communications, problem-solving and building professional relationships. Through regular meetings and case conferences, you will have the opportunity to consult with other members of the team on addressing difficult personal and health-related crises among your clients. These meetings also provide a community of professional support with colleagues experiencing many of the same joys and challenges as you.

Program Costs (materials, training, etc.):
Yes, refer to program website

Program/Practice Website:
https://www.nursefamilypartnership.org/

Relevant Published, Peer-Reviewed Research:

Olds, D. L., Henderson, C. R., Jr, Chamberlin, R., & Tatelbaum, R. (1986). Preventing child abuse and neglect: a randomized trial of nurse home visitation. Pediatrics, 78(1), 65–78.

Kitzman, H., Olds, D. L., Knudtson, M. D., Cole, R., Anson, E., Smith, J. A., Fishbein, D., DiClemente, R., Wingood, G., Caliendo, A. M., Hopfer, C., Miller, T., & Conti, G. (2019). Prenatal and Infancy Nurse Home Visiting and 18-Year Outcomes of a Randomized Trial. Pediatrics, 144(6), e20183876. https://doi.org/10.1542/peds.2018-3876

Sidora-Arcoleo, K., Anson, E., Lorber, M., Cole, R., Olds, D., & Kitzman, H. (2010). Differential effects of a nurse home-visiting intervention on physically aggressive behavior in children. Journal of pediatric nursing, 25(1), 35–45. https://doi.org/10.1016/j.pedn.2008.07.011

Olds, D. L., Robinson, J., O’Brien, R., Luckey, D. W., Pettitt, L. M., Henderson, C. R., Jr, Ng, R. K., Sheff, K. L., Korfmacher, J., Hiatt, S., & Talmi, A. (2002). Home visiting by paraprofessionals and by nurses: a randomized, controlled trial. Pediatrics, 110(3), 486–496.

Robling, M., Bekkers, M., Bell, K., Butler, C. C., Cannings-John, R., Channon, S., Corbacho Martin, B., Gregory, J. W., Hood, K., Kemp, A., Kenkre, J., Montgomery, A. A., Moody, G., Owen-Jones, E., Pickett, K., Richardson, G., Roberts, Z. E. S., Ronaldson, S., Sanders, J., Stamuli, E., & Torgerson, D. (2016). Effectiveness of a nurse-led intensive home-visitation programme for first-time teenage mothers (building blocks): A pragmatic randomised controlled trial. The Lancet, 387(10014), 146-155. https://doi.org/10.1016/S0140-6736(15)00392-X

Additional Sources:

https://www.nursefamilypartnership.org/

WV Rating:
Supported by Research
»WV Ratings Info

Rationale for Rating:

NFP has a substantial history of study in RCTs, as well as longitudinal designs showing general positive outcomes for younger (often <18 years), lower-income, unmarried mothers in both urban and rural settings when compared to control groups. Primary positive outcomes relate to increased time between pregnancies and lower domestic partner violence, with less consistent findings related to lower welfare use, lower drug use, and higher academic achievement (e.g., high school graduation/GED). Despite positives, the program focuses primarily on mother factors (e.g., preventative strategies for health/mental health of themselves and subsequently child) and is not necessarily a direct intervention for children. Similarly, the program’s research often focuses on the mother with limited outcomes relative to the child themselves, with reviewed research showing mild to moderate improvements in child future externalizing behaviors. Despite some work related to externalizing behaviors, overall, very limited work has been completed on later child internalizing/externalizing challenges. Additionally, the research often is compared to a control or augmented NFP without a treatment-as-usual comparison (e.g., well-checks or programs fostering prenatal and postnatal physician visits vs in-home services). Training of the NFP and/or paraprofessional aren’t always detailed. Further, studies often show statistical significance, but it is unclear how relevant findings are for clinical significance (e.g., Olds et al. 1997 = 1.3 vs 1.6 subsequent pregnancies or .29 vs .54 fewer reports of child abuse). Cost of programs and benefit were also not discussed to showcase if programs were cost effective in terms of money, time, etc., especially compared to treatment-as-usual. Finally, much of the research seems to come from Olds and colleagues. While this may be a relic of studies selected, a brief ancestor review seems to identify the same authors in many of the papers. While not necessarily a limitation, it does suggest a larger sampling may be necessary to see how others implement the program (i.e., Olds likely has consistent protocols while others do not, which may influence outcomes).