Evaluation of the effectiveness of the Family Nurse Partnership home visiting programme in first time young mothers in Scotland: a protocol for a natural experiment.

Fiona V Lugg-Widger,Mandy Lau,James White,Shantini Paranjothy,Jill Pell,Julia Sanders,Michael Robling,Rebecca Cannings-John

doi:10.23889/ijpds.v5i1.1154

Fiona V Lugg-Widger, Mandy Lau + Show 6 more

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https://doi.org/10.23889/ijpds.v5i1.1154

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Abstract

IntroductionIndividual, social and economic circumstances faced by young mothers (19 years or under) can challenge a successful start in life for their children. Intervening early might enhance life chances for both mother and child. The Family Nurse Partnership (FNP) is an intensive nurse-led home visiting programme developed in the US which aims to improve prenatal health behaviours, birth outcomes, child development and health outcomes, and maternal life course. Establishing evidence of effectiveness beyond the original US setting is important to understand where further adaptation is required within a country specific context.ObjectiveThis study will form one strand of the Scottish Government’s plan to evaluate the effectiveness of FNP as compared to usual care for mothers and their children in Scotland and will focus only on outcomes that can be identified using routine administrative data systems.MethodsThis study is a natural experiment with a case-cohort design using linked anonymised routine health, educational and social care data. Cases will be women enrolled as FNP Clients in ten NHS Health Boards in Scotland and Controls will be women who met FNP eligibility criteria but were pregnant at a time when the programme was not recruiting. Outcomes are mapped to the Scottish FNP logic model. All comparative analyses will be pre-specified, conducted on an intention to treat basis and will use multilevel regression models to compare outcomes between groups.DiscussionThe study protocol is based upon the specification of FNP commissioned by the Scottish Government. This study design is novel for the evaluation of the FNP/NFP programmes which are primarily evaluated with an RCT. Outcomes included within the study have been selected on the basis that they are outcomes FNP aims to influence and where there is routine data available to assess the outcome

Highlights

Individual, social and economic circumstances faced by young mothers (19 years or under) can challenge a successful start in life for their children
The aim of this study is to examine the association between the provision of Family Nurse Partnership (FNP), when added to existing services, and a range of outcomes covering maternal and child health, child development, and parental life course compared to existing services alone for first time teenage mothers
The study protocol is based upon the specification of FNP commissioned by the Scottish Government

Summary

Introduction

Individual, social and economic circumstances faced by young mothers (19 years or under) can challenge a successful start in life for their children. Intervening early might enhance life chances for both mother and child. The Family Nurse Partnership (FNP) is an intensive nurse-led home visiting programme developed in the US which aims to improve prenatal health behaviours, birth outcomes, child development and health outcomes, and maternal life course. The importance of early life experiences for child health and development. Young and economically disadvantaged mothers are more likely to smoke increasing the risk of adverse health outcomes for themselves and their children [5]. Intervening early in the lives of families with young mothers might enhance life chances for both mother and child. Open Access under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/deed.en)

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