EIF PROGRAMME REPORT FAMILY NURSE PARTNERSHIP

Transcription

1 EIF PROGRAMME REPORT FAMILY NURSE PARTNERSHIP JULY 2016

2 2 How to read an EIF Programme Report This Programme Report should be read in conjunction with our guidance on How to read an EIF Programme Report, which provides an explanation of the contents of the summary material. This can be found on the EIF website. Scope This assessment is based on information gathered through the EIF s review of What Works to support parentchild interaction in the period from conception to age 5 years in order to improve child development. The child outcomes reviewed were limited to impacts on attachment and/or parent sensitivity; behaviour and social and emotional skills; and cognitive development, in particular early literacy and use of language. The rating included represents an assessment in relation to these outcomes only. Disclaimer The information in this report and the rating of impact is designed to provide information for those developing early intervention programmes and systems. The evidence can be used to inform and assist professional judgement, but it is not a substitute for it. This Report does not purport to contain all the information that may be required by third parties in order to exercise their judgement. Evidence about what has worked in the past offers no guarantee that an approach will work in all circumstances. Every effort has been made to ensure the accuracy of the information, but no legal responsibility is accepted for (i) any errors or omissions (negligent or otherwise); and (ii) any consequences resulting from the use of or reliance on this Report. The Report includes reference to research and publications of third parties: the Early Intervention Foundation is not responsible for, and does not guarantee the accuracy, completeness, timeliness or availability of, those third party materials or any related material. The Early Intervention Foundation does not perform an audit and undertakes no duty of due diligence or independent verification of any information (including, but expressly not limited to, information about costs of the programmes) it receives from third parties including the programme providers. The rating is an independent judgement based on the facts reported to EIF as of the date expressed. It is not a recommendation or a statement of fact. This Report is provided on an as is basis without warranty of any kind, either express or implied.

3 3 Summary: Family Nurse Partnership Programme Description Brief Description Based on the version of the programme evaluated in its best evidence. Primary Outcome Domain: Attachment Delivery Model: Home Visiting Child Age: Perinatal Level of Need: Targeted Selective Full Description Based on information agreed with the programme developer, this section describes the programme more generally in terms of recommended or typical implementation. Family Nurse Partnership (FNP) is a home-visiting programme for young mothers expecting their first child. The programme is delivered by highly trained and supervised nurses or midwives. The FNP programme has three goals: 1) to improve pregnancy health and behaviours; 2) to improve child health and development by helping parents provide responsible and competent care; and 3) to improve economic selfsufficiency by helping parents plan for their own and their baby s future. Mothers enrol in the programme early in their pregnancy and receive visits from a family nurse on a weekly basis before, and for the first six weeks after, the birth of their child. Visits then continue fortnightly until three months before the child s second birthday when visits become monthly in preparation for the programme ending. 64 visits in total are scheduled. During these visits, mothers learn about their young child s health and development, and receive support for their own wellbeing. Ratings Summary Strength of Evidence of Child Outcomes 4+ Family Nurse Partnership has evidence from more than three rigorously conducted RCTs, with at least one study demonstrating long-term impact, and impact on assessment measures independent of study participants (not self-reports). At least one study has been conducted independently of the programme developer. These studies identified statistically significant positive impact on a number of child and parent outcomes. Programme Costs On the basis of information about resource requirements submitted by the provider, EIF has estimated the relative cost of programmes per family or child. The specific resource requirements are described in the next pages of this report. The cost scale runs from 1 to 5, with 1 being the least costly to set up and deliver, and 5 being the most costly. Family Nurse Partnership has a cost score of 5, meaning that this programme is estimated to be high cost to set up and deliver compared to other interventions reviewed by EIF. Impact Family Nurse Partnership has evidence demonstrating impact on a number of child and parent outcomes. Some key examples of statistically significant impacts include: Child attachment outcomes. Responsiveness expert observation measure (child age 6 months) Reduced maltreatment child protection records (child age 3) The programme also identified: Child behaviour outcomes. 5

4 4 Internalizing disorder scores on the Leiter International Performance Scale child self-report (at age 12) odds ratio = 0.63 Lifetime arrests youth self-report (at age 19) risk ratio = 0.57 Lifetime convictions youth self-report (at age 19) risk ratio = 0.42 Child cognitive outcomes. Improved cognitive development scores on the Schedule of Growing Skills tool maternal report (at child age 2) Implementation Summary Based on information provided by the programme developer, this section describes the programme more generally in terms of recommended or typical implementation. FNP is delivered to individual mothers in approximately 64 sessions of one-hour duration each. It is delivered by one family nurse, who receives 242 hours of programme training, and is qualified to QCF-6 level. Supervision is provided by the host agency, with one FNP supervisor who receives 300 hours of programme training and is qualified to QCF-7/8 level. Booster training of practitioners is required. There is a licensing requirement to run this programme. In Detail Level of need Low need X Moderate need High need Classification Universal X Targeted: Selective X Programme requirements Targeted: Indicated Specialist Highly Specialist X X X Format Sessions Number of practitioners required to deliver it Delivered to individuals Approximately 64 sessions of 1-hour duration 1 Practitioner requirements Job Title or Profession of Practitioner Family Nurse Qualification Level Recommended QCF 6 Hours of programme training 242 hours

5 5 Accreditation/certificati on required? Yes Booster training? Yes Supervision requirements Number of supervisors 1 Type of supervisor 1st Host-agency supervisor providing clinical, skills and case-management supervision Qualification level 1st Recommended QCF 7/8 Training 1st 300 hours Host agency requirements Licensing fee Yes Evidence Details FNP has evidence from five rigorously conducted RCTs taking place since the 1980s. Summary of impact evaluation informing the EIF evidence assessment Study Design Country of Origin Sample Child Outcomes Parent Outcomes 1. Elmira trial RCT USA 400 highly disadvantaged first-time teen mothers ( 19 years) living in the Elmira, New York community Reduced A&E visits (child age 2) Reduced poisonings and accidents (child age 2) Reduced child behavioural problems (between child age 2 and 6) Fewer arrests in adolescence (child age 15) Fewer convictions in adolescence (child age 15) Reduced child abuse and neglect (child age 15) Reduced smoking (at Increased social support during pregnancy and delivery (at Increased access to community services (at Improved diet (at Reduced kidney infections (at Improved maternal involvement (between child age 2 and 6) Reduced use of punishment (between child age 2 and 6) 2. Memphis trial RCT USA 1139 first-time teen mothers living in African- American communities in Memphis, Tennessee Reduced A&E visits (child age 2) Reduced poisonings and accidents (child age 2) Improved intellectual functioning (between child age 2 and 6) Improved child receptive language (between child age 2 and 6) Increased access to community services (at Increased attempted breastfeeding (between childbirth and child age 2) Improved home environment (child age 2)

6 6 3. Denver trial RCT USA 735 single, firsttime teenage mothers living in disadvantaged communities in the Denver, Colorado metropolitan area 4. Dutch trial RCT Netherlands 460 young ( 25 years), first-time Dutch mothers who had low educational attainment and at least one other risk factor 5. UK trial RCT UK 1645 first-time teen mothers ( 19) living in disadvantaged communities throughout England Improved reading achievement (between child age 2 and 6) Reduced use of substances (child age 12) Reduced child externalising behaviour problems (child age 12) Reduced preventablecause child mortality Improved infant responsiveness (child age 6 months) Higher developmental quotients (child age 2) Reduced child abuse and neglect (child age 3) Higher developmental quotients (child age 2) Improved beliefs about abuse and neglect (child age 2) Improved self-efficacy (child age 2) Reduced smoking (at Reduced domestic violence (between child age 2 and 6) Reduced domestic violence (at Reduced smoking (at Increased attempted breastfeeding (between childbirth and child age 2) Increased breastfeeding duration (between childbirth and child age 2) Improved home environment (child age 2) Improved self-efficacy (child age 2) References References of main studies informing the EIF evidence assessment Study 1: Elmira Trial Olds, D. L., Henderson, C. R., Tatelbaum, R., & Chamberlin, R. (1986a). Improving the delivery of prenatal care and outcomes of pregnancy: A randomized trial of nurse home visitation. Pediatrics, 77, Olds, D. L., Henderson, C. R., Chamberlin, R., & Tatelbaum, R. (1986b). Preventing child abuse and neglect: A randomized trial of nurse home visitation. Pediatrics, 78, Olds, D., Henderson Jr, C. R., Cole, R., Eckenrode, J., Kitzman, H., Luckey, D., Pettitt, L., Sidora, K., Morris, P., & Powers, J. (1998). Long-term effects of nurse home visitation on children's criminal and antisocial behaviour: 15-year follow-up of a randomized controlled trial. Journal of the American Medical Association, 280,

7 7 Olds, D. L., Eckenrode, J., Henderson, C. R., Kitzman, H., Powers, J., Cole, R., Sidora, K., Morris, P., Pettitt, L.M., & Luckey, D. (1997). Long-term effects of home visitation on maternal life course and child abuse and neglect: Fifteen-year follow-up of a randomized trial. Journal of the American Medical Association 278, Eckenrode, J., Campa, M., Luckey, D. W., Henderson, C. R., Cole, R., Kitzman, H., Anson, E., Sidora-Arcoleo, Powe, J., & Olds, D. (2010). Long-term effects of prenatal and infancy nurse home visitation on the life course of youths: 19-year follow-up of a randomized trial. Archives of Pediatrics & Adolescent Medicine, 164, Study 2: Memphis Trial Kitzman, H., Olds, D. L., Henderson, C. R., Hanks, C., Cole, R. Tatelbaum, R., McConnochie, K. M., Sidora, K., Luckey, D. W., Shaver, D., Englehardt, K., James, D., & Barnard, K. (1997). Effect of prenatal and infancy home visitation by nurses on pregnancy outcomes, childhood injuries, and repeated childbearing. Journal of the American Medical Association, 278(8), Olds, D. L., Kitzman, H., Cole, R., Robinson, J., Sidora, K., Luckey, D. W, Henderson, C. R., Hanks, C., Bondy, J., & Holmberg, J. (2004). Effects of nurse home-visiting on maternal life course and child development: Age- 6 follow-up results of a randomized trial. Pediatrics, 114(6), Olds, D. L., Kitzman, H., Hanks, C., Cole, R., Anson, E., Sidora-Arcoleo, K. Luckey, D. W., Henderson, C. R., Holmberg, J., Tutt, R.A., Stevenson, A.J., & Bondy, J. (2007). Effects of nurse home visiting on maternal and child functioning: age-9 follow-up of a randomized trial. Pediatrics, Kitzman, H., J., Olds, D, L., Cole, R.E., Hanks, C.A., Anson, E.A., Arcoleo, K.J., Luckey, D.W., Knudtson, M.D., Henderson, C.R., & Holmberg, J.R. (2010). Enduring effects of prenatal and infancy home visiting by nurses on children: follow-up of a randomized trial among children at age 12 years. Archives of Pediatrics & Adolescent Medicine, 164(5), Olds, D. L., Kitzman, H. J., Cole, R. E., Hanks, C. A., Arcoleo, K. J., Anson, E. A., Luckey, D.W., Knudston, M.D., Henderson, C.R., Bondy, J., & Stevenson, A.J (2010). Enduring effects of prenatal and infancy home visiting by nurses on maternal life course and government spending: follow-up of a randomized trial among children at age 12 years. Archives of Pediatrics & Adolescent Medicine, 164(5), Olds, D. L., Kitzman, H., Knudtson, M. D., Anson, E., Smith, J. A., & Cole, R. (2014). Effect of home visiting by nurses on maternal and child mortality: Results of a 2-decade follow-up of a randomized clinical trial. JAMA paediatrics, 168(9), Study 3: Denver Trial Olds, D. L., Robinson, J,, O'Brien, R., Luckey, D. W., Pettitt, L. M., Henderson, C. R., Ng, R. K., Sheff, K. L., Korfmacher, J., Hiatt, S., & Talmi, A. (2002). Home visiting by paraprofessionals and by nurses: A randomized, controlled trial. Pediatrics, 110, Olds, D. L., Robinson, J., Pettitt, L., Luckey, D. W., Holmberg, J., Ng, R. K., Isacks, K., Sheff, K., & Henderson, C. R. (2004). Effects of home visits by paraprofessionals and by nurses: age-4 follow-up results of a randomized trial. Pediatrics, 114, Olds, D. L., Holmberg, J. R., Donelan-McCall, N., Luckey, D. W., Knudtson, M. D., & Robinson, J. (2014). Effects of home visits by paraprofessionals and by nurses on children: follow-up of a randomized trial at ages 6 and 9 years. JAMA pediatrics, 168, Study 4: Dutch Trial

8 8 Mejdoubi, J., van den Heijkant, S., van Leerdam, F. J. M., Crone, M., Crijnen, A., & HiraSing, R. A. (2014). Effects of nurse home visitation on cigarette smoking, pregnancy outcomes and breastfeeding: A randomized controlled trial. Midwifery, 30, Mejdoubi, J., van den Heijkant, S. C. C. M., van Leerdam, F. K. M., Heymans, M. W., Hirasing, R. A., & Crijnen, A. A. M. (2013). Effect of nurse home visits vs. usual care on reducing intimate partner violence in young high-risk pregnant women: A randomized controlled trial. PLOS One, DOI: /journal.pone Mejdoubi, J., van den Heijkant, S. C. C. M., van Leerdam, F. J.M.,Heymans, M. W., Crijnen, A., & Hirasing, R.A. (2015). The effect of VoorZorg, the Dutch Nurse-family Partnership, on child maltreatment and development: A randomized controlled trial. Plos One, DOI:10, 1371/journal.pone Study 5: UK Trial Robling, M., Bekkers, M., Bell, K., Butler, C. Cannings-John, R., Channon, S., Corbacho Martin, B., Gregory, J., Hood, K., Kemp, A., Kenkre, J., Montgomery, A.A., Moody, G., Owen-Jones, E., Prof Pickett, K., Richardson, G., Roberts, Z.E.S., Ronaldson, S., Sanders, J., Stamuli, E., & Torgerson, D. (2015). Effectiveness of a nurse-led intensive home-visitation programme for first-time teenage mothers (Building Blocks): A pragmatic randomised controlled trial. The Lancet,