Louisiana’s Nurse-Family Partnership Program
By Cynthia Suire, MSN, RNLouisiana Nurse-Family Partnership Program ManagerLouisiana Office of Public Health Maternal and Child Health Program
The Nurse-Family Partnership (NFP) program is an evidence-based, nurse home visitation program designed to serve low income, first-time pregnant mothers and their babies. The intervention begins in early pregnancy and continues until the first child reaches two years of age, providing frequent, intensive home visiting services. NFP uses experienced, highly trained registered nurses to guide and educate first time parents to achieve three important goals: (1) healthy pregnancy outcomes, (2) healthy infant/toddler growth and development, and (3) self-sufficient, healthy families. Experienced, registered nurses are critical to the successful delivery of NFP, as women have many questions and concerns about their health and the baby's health.
Three distinct randomized trials were performed by Dr. David Olds over the last 30 years that study the enduring effects of the NFP on maternal and child health outcomes. The trials occurred in three different areas with demographically different populations in Elmira, New York; Memphis, Tennessee; and Denver, Colorado. The published results of the randomized clinical trials showed that when the program is implemented with fidelity to the NFP model, several health and social improvements can be realized by the clients, families and communities. These improvements are realized through improvement in prenatal health, reduction in child abuse and neglect, reduction in juvenile delinquency and criminal activity, improvement in school readiness for the children and improvement in maternal employment.
The Office of Public Health (OPH) Maternal and Child Health (MCH) Program leadership, in the late 1990’s, recognized that behavioral and psychosocial issues were associated with Louisiana’s persisting poor maternal and child health outcomes. OPH-MCH began implementation of the evidence-based NFP program in 1999 to address those psychosocial issues and as a way to use experienced, skilled public health nurses as home visitors. NFP was chosen as the home visitation model because of its clear protocols, curriculum and intensive training, along with its promised results from rigorous randomized trials. NFP was appealing because it is “relationship based” and it was shown to be effective in nurturing parental competence and child development simultaneously. In addition, NFP National Service Office (NSO) monitored (and continues to monitor) program quality through the collection and distribution of program implementation and outcome information on the mothers enrolled in the program.
Since 1999, Louisiana NFP has grown from two sites to 16 sites in 52 of Louisiana’s 64 parishes and has served over 7,682 families with over 151,035 home visits. In addition, state MCH infrastructure has been formed to guide and support the teams of supervisors and nurses who provide the direct care in the home and areas that they serve. Though Louisiana’s NFP does enjoy diversified funding, Title V/MCH fiscal support is paramount. Families who partake of Louisiana’s NFP program have shown decreases in maternal smoking; increases in maternal workforce participation; decreases in experiences of maternal violence during pregnancy; above normal language development skills in the children and above average immunization rates in the children; clearly demonstrating the positive impact of using evidence-based models of home visiting.
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