View
399
Download
0
Embed Size (px)
DESCRIPTION
Nurse Family Partnership_"Partners" Community Presentation
Citation preview
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
2
"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
3
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.
4
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
Cover this gray area with one of the 8 provided filmstrip photo JPG files.
5
Nurse-Family Partnership is a growing, national program
521
77
52
40
1
1
1
1
1
1
1
11
10
7
1
4
5
3
17
9
9
11
14
173
19
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
Cover this gray area with one of the 8 provided filmstrip photo JPG files.
8
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
9Overview
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
Cover this gray area with one of the 8 provided filmstrip photo JPG files.
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)
11
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%)
12
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
Cover this gray area with one of the 8 provided filmstrip photo JPG files.
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
16
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
Cover this gray area with one of the 8 provided filmstrip photo JPG files.
18For More Information
Cynthia Farkas, RN, FNP, [email protected]
Michelle Neal RN, [email protected] x 101
www.nursefamilypartnership.org