Blueprints
Model Programs
Nurse-Family Partnership (NFP)
This program was part of a cost-benefit
analysis completed by the Washington
State Institute for Public Policy on several violence
prevention and reduction programs, including six Blueprints
programs:
Watching
the Bottom Line: Cost-Effective Interventions for Reducing
Crime in Washington.
Program Summary
Nurse-Family Partnership (Formerly
Prenatal and Infancy Home Visitation by Nurses), guided
by a strong theoretical orientation, consists of intensive
and comprehensive home visitation by nurses during
a woman’s pregnancy and the first two years
after birth of the woman’s first child. While
the primary mode of service delivery is home visitation,
the program depends upon a variety of other health
and human services in order to achieve its positive
effects.
Program Targets:
The program is designed to serve low-income, at-risk
pregnant women bearing their first child.
Program Content:
Nurse home visitors work with families in their homes
during pregnancy and the first two years of the child’s
life. The program is designed to help women improve
their prenatal health and the outcomes of pregnancy;
improve the care provided to infants and toddlers
in an effort to improve the children’s health
and development; and improve women’s own personal
development, giving particular attention to the planning
of future pregnancies, women’s educational achievement,
and parents’ participation in the work force.
Typically, a nurse visitor is assigned to a family
and works with that family through the duration of
the program.
Program Outcomes:
This program has been tested with both White and African
American families in rural and urban settings. Nurse-visited
women and children fared better than those assigned
to control groups in each of the outcome domains established
as goals for the program. In a 15-year follow-up study
of primarily White families in Elmira, New York, findings
showed that low-income and unmarried women and their
children provided a nurse home visitor had, in contrast
to those in a comparison group:
- 79% fewer verified reports of child abuse or
neglect;
- 31% fewer subsequent births;
- an average of over two years’ greater interval
between the birth of their first and second child;
- 30 months less receipt of Aid to Families with
Dependent Children;
- 44% fewer maternal behavioral problems due to
alcohol and drug abuse;
- 69% fewer maternal arrests;
- 60% fewer instances of running away on the part
of the 15-year-old children;
- 56% fewer arrests on the part of the 15-year-old
children; and
- 56% fewer days of alcohol consumption on the
part of the 15-year-old children.
Program Costs:
The cost of the program was recovered by the first
child’s fourth birthday. Substantial savings
to government and society were calculated over the
children’s lifetimes. In 1997, the two-and-a-half-year
program was estimated to cost $3,200 per year per
family during the start-up phase (the first three
years of program operation) and $2,800 per family
per year once the nurses are completely trained and
working at full capacity. Actual cost of the program
will vary depending primarily upon the salaries of
local community-health nurses. Communities have used
a variety of local, state, and federal funding sources
to support the program, including Medicaid, welfare-reform,
maternal and child health, and child abuse prevention
dollars.
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