August 2008

1. August 2008

2. The 3 Guiding Goals of the NFP Model & Programs are: 1. Improve pregnancy outcomes 2. Improve child health and development 3. Improve parents’ economic self-sufficiency

3. NFP has Strong Theoretical Underpinning • Self-Efficacy Theory - mother’s ability to change certain behaviors by learning to draw upon her own strengths and successes. (Albert Bandura, 1977) • Human Ecology Theory - the mother’s and child’s social context are profound influences on the mother’s life. (Urie Bronfenbrener, 1979) • Attachment Theory - sensitive parental caregiving is a major influence on the child’s growing sense of security in the world. (John Bowlby & Mary Ainsworth, 1991)

4. NFP Services, Competencies, Education, & Guidelines are focused on: The Families most at risk and needing to be Served were: • Often teens • Usually unmarried Outcomes proven to assist in helping families achieve health, self-sufficiency, and early attachment & bonding: • Improving parental health • Starting early in pregnancy to achieve healthy births (16-20 weeks) • Improving infant and toddler development, health, & safety • Assisting Families in moving to Self-Sufficiency • And, creating parental prenatal & infant attachment & bonding

5. Key Program Components: • Serves low-income, first-time parents and their children • Nurse Home Visitors are highly educated, ususally BSN, registered nurses • Visits begin early in pregnancy and continue through the first two years of the child’s life • Nurses follow developmentally appropriate guidelines • Clinical Information System (CIS) monitors program implementation • Powerful relationship fosters client strengths, oriented around client’s goals

6. NFP Referrals • Eligibility: • First-time pregnant, low-income women, no later than the 28th week of gestation realistically by the 25th week. Preferred 16-20 weeks • Likely referral partners: • WIC clinics • Family planning / pregnancy testing centers • Obstetricians and Pediatricians serving low-income/ Medicaid clients • Prenatal care providers: clinics, community based organizations, hospitals • Schools/School Health Nurses • Churches • Self-Referrals

7. Client Enrollment / Caseload Building • 1 RN = 25 clients • 50% enrollment means 1 RN needs 50 referrals • Critical to take into account client attrition over time • Bottom line: Agency needs 58 referrals, per nurse, over nine months to meet caseload expectations • A four NHV team will need 232 referrals over first nine months of program replication

8. What does an NFP Program Look Like? A typical NFP Program consists of: • 1 Nurse Supervisor – MSN preferred • 4 Nurse Home Visitors – BSN preferred • 1 Administrative Clerical Support Staff

9. Elements of the Nurse-Family Partnership:Assuring Model Fidelity • Services offered make sense to eligible women. Services are flexible and guidelines support the unique needs and wants of the families. • Mothers enroll voluntarily early in pregnancy. NFP encourages ideal enrollment between 16-20 weeks. This allows time for establishing a relationship that allows for healthy behavior changes in smoking, diet, substance use, and adequate prenatal health care that impact positive birth outcomes. The earlier services begin the better. • Frequent home visits by nurses for 2½ years. Typically home visits occur weekly for the first 4-6 weeks of a participant entering the program, then every other week until the birth of the baby, then weekly for 4-6 weeks, then bi-weekly until the baby is 2 years old. Home Visitors and families decide on the visiting schedule that best meets their needs. • Powerful relationship fosters client strengths, oriented around client’s goals. Nurse Home Visitors with their clinical and nursing education background are trained in cultural sensitivity, health, clinical assessment, and partnering with individuals to improve health outcomes. • In addition to the nursing education that comes with an RN, NFP provides specialized nursing education in the areas of reflective practice, reflective supervision, and practice coaching. • NFP has Visit-by-visit guidelines that keep intervention focused while addressing the uniqueness of each family. • NFP uses a CIS Reporting System that allows for evaluation tied to achieving fidelity to the model and comparable outcomes. NFP uses this system to assure that the NFP Services are in keeping with evidenced based practices.

10. Educational Domains and Sub-domains Shared During Nurse Home Visits

11. What does the National Service Office of Nurse Family Partnership Do? • NFP provides specialized nursing education in Denver for all home visiting staff • NFP provides technical assistance by nurse consultants, program managers, and program developers throughout the life of the program • NFP provides a data specialist to assist in all data training and collection needs • NFP provides ongoing support at state and federal levels to assure funding for home visiting programs • NFP works in close collaboration with your state to assure that all data and program information is shared so that you receive the necessary to implement a quality evidenced based NFP program

12. Nurse Family Partnership In Close Collaboration with IDHS! We can look at how We Might Work Together To Assist Illinois Families in Reaching Their Dreams