Abstract
BackgroundThe Family Nurse Partnership (FNP) programme was introduced to support young first-time mothers. A randomised trial found FNP added little short-term benefit compared to usual care. The study included a comprehensive parallel process evaluation, including focus groups, conducted to aid understanding of the introduction of the programme into a new service and social context. The aim of the focus groups was to investigate views of key health professionals towards the integration and delivery of FNP programme in England.MethodsFocus groups were conducted separately with Family Nurses, Health Visitors and Midwives at trial sites during 2011–2012. Transcripts from audio-recordings were analysed thematically.ResultsA total of 122 professionals participated in one of 19 focus groups. Family Nurses were confident in the effectiveness of FNP, although they experienced practical difficulties meeting programme fidelity targets and considered that programme goals did not sufficiently reflect client or community priorities. Health Visitors and Midwives regarded FNP as well-resourced and beneficial to clients, describing their own services as undervalued and struggling. They wished to work closely with Family Nurses, but felt excluded from doing so by practical barriers and programme protection.ConclusionFNP was described as well-resourced and delivered by highly motivated and well supported Family Nurses. FNP eligibility, content and outcomes conflicted with individual client and community priorities. These factors may have restricted the potential effectiveness of a programme developed and previously tested in a different social milieu. Building Blocks ISRCTN23019866 Registered 20/04/2009.
Highlights
The Family Nurse Partnership (FNP) programme was introduced to support young first-time mothers
The Family Nurses working in the four FNP sites that opened in 2007 (FNP wave 1) all had two years FNP experience prior to the recruitment of women into the trial, whereas the Family Nurses working at the four wave 2 sites were new to the role, and enrolled up to five non-trial participants on the programme, prior to commencing the programme with trial participants
Four FNP supervisors and three FNP administrators participated in the Family Nurse focus groups, and a smoking cessation advisor and two student Midwives participated in the Midwifery discussion groups
Summary
The Family Nurse Partnership (FNP) programme was introduced to support young first-time mothers. A randomised trial found FNP added little short-term benefit compared to usual care. The US-developed Nurse-Family Partnership® (NFP) program, is an intensive, structured home visiting service aimed at improving the life chances of young parents and their children. NFP has developed a four stage model for international replication: adaptation to local need, piloting, evaluation and wider implementation. Following this model the renamed, UK-adapted Family Nurse Partnership (FNP) programme was introduced in 10 pilot sites in England in 2007. The Building Blocks trial recruited 1645 pregnant teenagers from 18 primary care sites across England [14] and found delivery of FNP yielded little short-term benefit above pre-existing care provision alone
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