NFP Community Presentation_2010

Working Together to Ensure Healthier Families

Presented by: Cynthia Farkas, RN, FNP, MSJCPH NFP Partners for Healthy Families Supervisor

February 2010

NFP Partners for Healthy Families

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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

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 and paraprofessionals

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

Research

Cover this gray area with one of the 8 provided filmstrip photo JPG files.

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Nurse-Family Partnership is…• An evidence-based, community health program

• Transforming lives of vulnerable first-time mothers living in poverty

• Improving prenatal care, quality of parenting and life prospects for mothers by partnering them with a registered nurse

Overview


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Nurse-Family Partnership is a growing, national program

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States that NFP serves

States where NFP is a state initiative

# Number of counties NFP is serving

Where we work

How It Works . . . NFP Colorado Coordination Team 6

The National Service Office

• Educates nurse home visitors and nurse supervisors in the NFP model• Advocates for national political support and long-term resources • Collects and evaluates data to ensure quality services and to guide

quality improvement

Invest in Kids:

• Nurse Consultation• Site development• Program Advocacy

How It Works . . . NFP Colorado Coordination Team

Colorado Department of Public Health and Environment:• Fiscal agency• Annual State Tobacco Appropriation• Annual Grant Application and Funding Selection• Annual Report

Prevention Research Center for Family and Child Health:• Longitudinal follow-ups of the three clinical trials• Conducting research aimed at improving NFP Program model • International work

How It Works . . . NFP Colorado Coordination Team


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Program Goals

• Improve pregnancy outcomes

• Improve child health and development

• Improve parents’ economic self-sufficiency

• First-time, low-income, at-risk mothers

• Registered nurses• Intensive services

(intensity, duration)

• Focus on behavior• Program fidelity

(Clinical Information System)

• Knowledge, judgment and skills

• High level of trust, low stigma

• Credibility and perceived authority

• Nursing theory and practice at core of original model

Overview

Key Program Components

Why Nurses?

Home Visit Overview . . . The 6 Domains

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Personal HealthHealth Maintenance PracticesNutrition and ExerciseSubstance Use Mental Health Functioning

Environmental HealthHomeWork, School, and Neighborhood

Life Course DevelopmentFamily PlanningEducation and Livelihood

Maternal Role Mothering RolePhysical CareBehavioral and Emotional Care

Family and FriendsPersonal network RelationshipsAssistance with Childcare

Health and Human ServicesService Utilization


10Nurse-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

•Savings also accrue to government from increased taxes paid by employed parents - $5.70 per dollar invested *(RAND Corporation 1998, 2005)

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NFP PFHF Client Demographics• 892 women enrolled in the program since inception in 2000 (CO

11,000)

• 667 infants have been born to NFP mothers (CO 7,342)

• Median age of clients is 20 years of age (CO 19)

• $17,500 is average annual household income (CO 13,500)

• 83% of clients were unmarried at program intake (CO 80%)

• 65% unemployed at program intake (CO 63% Unemployed)

• 53% non-Hispanic white; 34.3% Hispanic; 5.8% multiracial/other; 1.9% African American; 2.4% Native American; 2.6% Asian

(Colorado 41%; 47%; 5%; 3%; 2%; 1%)

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NFP Outcomes

NFP PFHF Colorado NFP National NFP

Reduction in domestic violence in pregnancy

-57% -46% -42%

Reduction in cigarette smoking during pregnancy

-20% -20% -15%

Immunization rates at 24 months

84% 91% 91%

Initiation of breast feeding

90% 87% 77%

Breast feeding at 6 months

31% 34% 27%

Low birth weight (<5 lbs 8 oz)

8.2% 9.1% 9.3%

Premature birth weight (< 37 wks)

8.2% 8.8% 9.7%

2010 . . . 10 Year Anniversary for Colorado NFP and NFP Partners for Healthy Families

2000 Implementation- 2 nurses

2001 2 more nurses

2002 Program expansion grant for 4 more nurses; Broomfield County added

FY2004-05 Medicaid reimbursement

National Recognition and NFP Emerging Practices:

• Survival Guide – Strategies to promote nursing excellence

• Annual Client Picnic• Integrating mental health and public health• Client success stories• Model site for NFP visitors (local, national,

international)

Other Successes:

• Collaboration with Jefferson County Criminal Justice Planning

• Continuous mental health case conference consultation

10 Years of NFP PFHF Success


Other Successes:

• Poster presentation at Colorado Public Health Association (2004)• PFHF Moms' Support Group (2000-2006)• Jeffco F.I.T. Coalition (Families, Infants, Toddlers)• Lactation Consultant on team• PFHF Representation in Colorado NFP Nurse Practice Council since

inception in 2006

10 Years of NFP PFHF Success

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Nurse-Family Partnership is Endorsed as a Model Program by

National Institute on early Education Research

World Health

Organization

Office of Juvenile Justice & Delinquency Prevention

"This program saves money. It raises healthy babies and creates better parents. It reduced childhood injuries and unintended pregnancies, increased father involvement and women's employment, reduced use of welfare and food stamps, and increased children's school readiness."

Barack Obama, U.S. President


18For More Information

Cynthia Farkas, RN, FNP, [email protected]

Michelle Neal RN, [email protected] x 101

www.nursefamilypartnership.org

NFP Community Presentation_2010

Education

Transcript of NFP Community Presentation_2010