Family Nurse Partnership BLACKPOOL FAMILY NURSE PARTNERSHIP PROGRAMME • A structured, intensive home visiting programme •A preventative programme •Benefits children and families who have the poorest outcomes i.e. mothers with low psychological resources, low educational achievement, limited family support and poor mental health •Licensed programme with fidelity measures to ensure replication of original research •High degree of intensity, depth and skill required to deliver the programme Structure of the visits From recruitment – weekly for 4 weeks 2 weekly until birth of the baby Weekly for 6 weeks 2 weekly until baby is 21 months Monthly until baby is 2 years Domains covered – Personal & environmental health, life course development, maternal (paternal) role, family and friends. The case for prevention and early intervention has never been stronger •Advances in neuroscience and our understanding of pregnancy show just how important early life is for the emotional and cognitive development of children •Pregnancy and early life is a sensitive period when adversities become biologically embedded – fetal programming “It is....also a parent's willingness to nurture a child, that finally decides our fate”(Obama2009) •Pregnancy and birth a key time – mothers have an instinctive drive to protect their young and first time parents in particular want their child to be healthy and happy and do well in life •Increasing evidence that effective health promotion and disease prevention interventions in early life can produce measurable benefits in health, later educational achievement, economic productivity and responsible citizenship “Like it or not, the most important mental and behavioural patterns, Once established, Are difficult to change once children enter school” Nobel Laureate, James Heckman (2005) Target Group • Young pregnant women, 19 years and under at LMP • First pregnancy, although having a previous miscarriage or stillbirth does not prevent recruitment • Up to 28 weeks pregnant but before 16 weeks if possible • Programme is completely voluntary • Young Fathers and other family members are very much included Family Nurse Partnership’s Goals 1. Improve pregnancy outcomes 2. Improve child health and development and future school readiness and achievement 3. Improve parents economic self-sufficiency Randomised Controlled Trials Elmira NY Memphis TN Denver CO 1977 1987 1994 N = 400 N = 1,138 N = 735 •Low income whites • Low income blacks •Large portion of Hispanics •Semi – rural •Urban •Nurse v paraprofessional Consistent Outcomes Improvements in women’s antenatal health Reduction in children’s injury (NAI/accidental) Increases fathers involvement Increases in employment Reduction in dependence on benefits Fewer subsequent pregnancies Greater intervals between births Improved school readiness and greater IQ age 6 Nurses= sustained outcomes over many years 1. Be Healthy 2. Stay Safe 3. Enjoy and Achieve 4. Make a Positive Contribution 5. Achieve Economic Wellbeing Cost savings Unscheduled antenatal admission = £1,000 per night To keep a child in residential care = £2,500 per week Support a child in need = £400 per week 90% reduction of PINS = (approx)£40k a year (Person In Need of Supervision- Equivalent to our ASBO) Healthy Child Programme Pregnancy and the first five years of life QUESTIONS??