nurse-family partnership: working together for healthier families

Working Together for Healthier FamiliesNurse-Family Partnership Overview

© Copyright 2010 Nurse-Family Partnership. All rights reserved.

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“There is a magic window during pregnancy…it’s a time when the desire to be a good mother and raise a healthy, happy child creates motivation to overcome incredible obstacles including poverty, instability or abuse with the help of a well-trained nurse.”

David Olds, PhD, Founder, Nurse-Family Partnership


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Program Goals

• Improve pregnancy outcomes

• Improve child health and development

• Improve parents’ economic self-sufficiency

Key Program Components•First pregnancy, women living in poverty•Frequent home visits over 2 ½ years•Focus on behavior, skills, confidence•Flexible, structured intervention•Monitoring of implementation and outcomes

Nurses

•Knowledge, judgment and skills•High level of trust, low stigma•Credibility and perceived authority

Program Design


Home Visit Overview

4Program Design

Personal HealthHealth Maintenance PracticesNutrition and ExerciseSubstance Use Mental Health Functioning

Environmental HealthHomeWork, School, and Neighborhood

Life Course DevelopmentFamily PlanningEducation and Livelihood

Parental RoleIdentity: Mothering/Fathering Physical CareBehavioral and Emotional Care

Family and FriendsPersonal Network RelationshipsAssistance with Childcare

Health and Human ServicesService Utilization


Trials of the Program

1977

Elmira, NY

Participants: 400

Population: Low-income whites

Studied: Semi-rural area

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1988

Memphis, TN

Participants: 1,139

Population: Low-income blacks

Studied: Urban area

1994

Denver, CO

Participants: 735

Population: Large portion of Hispanics

Studied: Nurse versus

paraprofessional visitors

Dr. Olds’ research & development of NFP continues today…

Using Research to Test Program Effectiveness



Women’s Health and Development– Various improvements in pregnancy health and health behavior– 79% reduction in pre-term births among women who smoke– 32% fewer unintended subsequent pregnancies– 72% fewer criminal convictions of the mother

Children’s Health and Development– 56% reduction in emergency room visits for injuries/ingestions– 48% reduction in child abuse– 50% reduction in language delays at child age 21 months– 67% reduction in behavioral/cognitive problems at child age 6

Family Stability and Economic Self-Sufficiency– 20% reduction in months on welfare– 83% increase in labor force participation by child’s fourth birthday– 46% increase in father’s presence in the household


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Nurse-Family Partnership is Cost-Effective

•Nurse-Family Partnership returns more than $18,000 over and above program costs for each family enrolled

(Washington State Institute of Public Policy 2008)

•Savings accrue to government from decreased spending on:

health care criminal justicechild protection mental health education public assistance



July 2010 [select all, copy and paste]

Going to Scale

32 states

385 counties

21,494 families currently enrolled

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77

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40

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3

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11

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317

910

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112

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Going to Scale

•Consider the complexity of what you’re trying to reproduce, where, and with whom

•Outline the essentials clearly, so others can understand

•Scaffolding helps (planning, training, manuals, coaching)

•Money and its “strings” have power•Evaluation is essential


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The Nurse-Family Partnership National Service Office

Accountable for Quality and Results

• State and community planning: financing, implementation

• Contracts with agencies who conduct the program locally

• Nurse education in the model – home visitors and supervisors

• Quality monitoring and coaching for improvement• Advocacy support• Service-related revenue fosters our own sustainability

Going to Scale


Three Big Ideas….

1. Well-designed services that matter to those they serve…

2. Carefully evaluated…3. Taken to scale with necessary supports…

Improved health for families living in poverty


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For more Information

Peggy Hill, Chief Strategic Relations Officer Nurse-Family Partnership National Service Office 1900 Grant Street, Ste 400 Denver, Colorado 80203

[email protected]

Toll-free 866.864.5226

www.nursefamilypartnership.org

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