MODELS FOR PRACTICE
FOCUS
AREA: MATERNAL, INFANT, AND CHILD HEALTH
Program Name: Nurse-Family Partnership
Location:
Healthy People 2010 Objective: 16-6, 16-17
Web Address: http://www.nccfc.org
Blueprint: The Nurse-Family
Partnership is a home visiting program using trained nurses as home visitors. The
program has been tested, refined, and found to be consistently effective over
the past 20 years in three scientifically controlled studies. Since 1996, the
program has been developed in over 250 counties in 23 states. The target
population is low-income women, first-time mothers, and their families through
the first-born child’s second birthday. The program is implemented at the state
and local levels. At the state level, support is provided through a partnership
between a state agency and the National Nurse-Family Partnership Office based
at the University of Colorado Health Science Center. The national office
provides assistance with community and organizational planning; provides
training for the nurse home visitors, their supervisors, and administrators
responsible for managing the program; and conducts evaluation services. Each
agency that operates the program hires nurses to serve as home visitors and
supervisors.
Women
are referred to local program staff from prenatal care providers in the community
served. The program is introduced to the prospective client, and if she chooses
to join, nurses begin visiting every one to two weeks. The nurses’ goal is to
improve health behaviors that can affect preterm delivery, low birth weight,
and infant development. After delivery, the focus turns to the enhancement of
family care of infants and toddlers. In addition, the program focuses on
preventing unintended subsequent pregnancies, failure to find work, and welfare
dependence¾factors that lead to chronic
poverty, higher risk for crime and delinquency, and suboptimal care for
children.
Making a Difference: The three randomized
controlled trials have been maintained over the past 25 years with longitudinal
follow-up of all program participants. In addition, program staff use the
Clinical Information System to keep track of family characteristics, needs,
services provided, progress toward accomplishing objectives, and to help nurses
and program staff continuously improve the implementation of the program.
Beginnings: In the 1970s, Dr. Olds, the
program founder, examined society’s most difficult health and social problems.
He concentrated on problems that could be impacted through preventive
intervention early in the life cycle. The Nurse-Family Partnership was designed
to improve health behavior during pregnancy, nurturing competent caregiving for
infants and toddlers, and promoting attainment of positive life goals that
resulted in family economic self-sufficiency. The program began in the 1970s
strictly in the research setting and since 1996 has been available to the
public.
Challenges and Solutions: Challenges vary
from site to site but include issues related to efficient program delivery, funding
sustainability, client retention, staff recruitment for significant expansion
of the program, and higher costs to deliver the program in rural areas. Funding
sustainability is addressed by not allowing sites to initiate the program
without solid funding (e.g., Medicaid, Temporary Assistance for Needy
Families). Client retention is being addressed through quality improvements
initiatives led by the national office, which includes bringing together staff
from sites that have successfully retained families. Nurse recruitment and
retention are addressed prior to the initiation of the program. Costs of the
program may be higher in rural areas due to the distances home visitors must
travel to visit families, with the result being that each nurse may not be able
to successfully serve a caseload as high as those carried by nurses in more
urban locations. National office site developers assist communities in
considering various implementation and management models, and to design program
management systems that are most likely to work in particular settings.
The national office provides written reports, presentations, and a
website to educate potential referral sources and community members about the
Nurse-Family Partnership.
The Nurse-Family Partnership has received numerous awards and
honors from national and international organizations dedicated to violence
prevention, child abuse prevention, substance abuse prevention, prevention
research, health, and juvenile justice.
Matt
Buhr-Vogl, Senior Site Developer
Nurse-Family
Partnership
Phone:
(866) 864-5226 (toll-free)