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Nurse-Family Partnership (NFP)

Health Factors: Family & Social Support
Decision Makers: Local Government State Government Healthcare Professionals & Advocates Nonprofit Leaders Public Health Professionals & Advocates
Evidence Rating: Scientifically Supported
Population Reach: 1-9% of WI's population
Impact on Disparities: Likely to decrease disparities

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Description

The Nurse-Family Partnership (NFP) is a voluntary home-visiting program that supports low income, first-time mothers and their babies. Home visits by registered nurses begin during pregnancy and continue through a child’s second birthday. The program aims to improve prenatal, birth, and early childhood outcomes.

Expected Beneficial Outcomes

Improved well-being
Improved family functioning
Reduced risky health behaviors
Reduced child maltreatment
Improved economic security
Reduced rapid repeat pregnancies
Reduced hospital utilization
Reduced mortality
Improved social emotional skills
Increased academic achievement
Reduced delinquent behavior

Evidence of Effectiveness

There is strong evidence that NFP improves outcomes and provides ongoing benefits to mothers and their children in a cost-effective manner (Blueprints, Brookings-Isaacs 2007, Eckenrode 2010, OJJDP Model Programs, US DOJ-Olds 2011, Olds 2010, Olds 2007, PPN, RAND-Karoly 2005, RAND-Karoly 1998, UW Madison-Small 2005, SPTW, US DHHS-NFP, WSIPP-Aos 2004).

NFP improves family outcomes, with increased time between births and fewer children (Olds 2007, UW Madison-Small 2005). Mothers have more stable partner relationships (Olds 2010, Olds 2007), a greater sense of mastery, and are less reliant on welfare (UW Madison-Small 2005). Participants engage in fewer risky behaviors, with less substance abuse during pregnancy (UW Madison-Small 2005) and reduced role impairment due to substance abuse (Olds 2010). Their children are less likely to be maltreated or abused (UW Madison-Small 2005, RAND-Karoly 2005). The program leads to reductions in emergency room visits, hospital days (RAND-Karoly 2005), and reduced childhood mortality (Olds 2007).

Nurse-visited children have fewer emotional disorders at age nine (US DOJ-Olds 2011) and do better academically (Olds 2007, RAND-Karoly 2005). They demonstrate more positive behaviors, with fewer arrests (RAND-Karoly 2005), sex partners, and reduced use of alcohol and tobacco during adolescence (UW Madison-Small 2005). Program effects persist for daughters of NFP participants: they are less likely to be arrested and convicted of a crime, have fewer children, and use less Medicaid support (Eckenrode 2010). There appear to be no such effects for sons of NFP participants (Eckenrode 2010).

The Nurse-Family Partnership is cost-effective. It reduces government costs (Brookings-Isaacs 2007, Eckenrode 2010) while producing positive net benefits (Brookings-Isaacs 2007, US DOJ-Olds 2011, RAND-Karoly 2005, RAND-Karoly 1998, WSIPP-Aos 2004), except for families that were low-risk before participating in the program (Brookings-Isaacs 2007).

Implementation

United States

As of May 2015, NFP is implemented in 44 states and 7 countries (NFP).

Wisconsin

NFP has been in place in Milwaukee since 2007 and, as of June 2014, has served 788 families in Adams, Dane, Juneau, Kenosha, and Sauk counties and the city of Milwaukee (NFP-WI 2014). 

Implementation Resources

NFP - Nurse-Family Partnership (NFP). Helping first-time parents succeed. Accessed on February 29, 2016

Citations - Evidence

Blueprints - Center for the Study and Prevention of Violence (CSPV). Blueprints for healthy youth development. Accessed on June 6, 2016
Brookings-Isaacs 2007 - Isaacs JB. Cost-effective investments in children. Washington, DC: Brookings Institution; 2007. Accessed on December 1, 2015
Eckenrode 2010 - Eckenrode J, Campa M, Luckey DW, et al. 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. 2010;164(1):9-15. Accessed on December 15, 2015
OJJDP Model Programs - Office of Juvenile Justice and Delinquency Prevention (OJJDP). OJJDP model programs guide. Accessed on May 20, 2016
Olds 2007 - Olds DL, Kitzman H, Hanks C, et al. Effects of nurse home visiting on maternal and child functioning: Age-9 follow-up of a randomized trial. Pediatrics. 2007;120(4):e832-45. Accessed on May 20, 2016
Olds 2010 - Olds DL, Kitzman HJ, Cole RE, et al. 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. 2010;164(5):419-24. Accessed on November 9, 2015
PPN - Promising Practices Network (PPN). On children, families and communities. Accessed on June 6, 2016
RAND-Karoly 1998 - Karoly LA, Greenwood PW, Everingham SS, et al. Investing in our children: What we know and don’t know about the costs and benefits of early childhood interventions. Santa Monica: RAND Corporation; 1998: Monograph Report 898. Accessed on May 24, 2016
RAND-Karoly 2005 - Karoly LA, Kilburn MR, Cannon JS. Early childhood interventions: Proven results, future promise. Santa Monica: RAND Corporation; 2005: Monograph Report 341. Accessed on June 6, 2016
SPTW - Social Programs That Work (SPTW). Full list of programs. Accessed on June 2, 2016
US DHHS-NFP - US Department of Health and Human Services (US DHHS). Nurse-Family Partnership (NFP). Accessed on November 10, 2015
US DOJ-Olds 2011 - Olds D, Miller TR, Knudtson M, et al. Impact of the Nurse-Family Partnership on neighborhood context, government expenditures, and children’s school functioning. Washington, DC: US Department of Justice (US DOJ); 2011: Grant No.2005-MU-MU-0001. Accessed on May 24, 2016
UW Madison-Small 2005 - Small SA, Reynolds AJ, O’Connor C, Cooney SM. What works, Wisconsin: What science tells us about cost-effective programs for juvenile delinquency prevention: A report to the Wisconsin governor’s juvenile commission and the Wisconsin Office of Justice Assistance. Madison: University of Wisconsin-Madison; 2005. Accessed on December 12, 2015
WSIPP-Aos 2004 - Aos S, Lieb R, Mayfield J, Miller M, Pennucci A. Benefits and costs of prevention and early intervention programs for youth. Olympia: Washington State Institute for Public Policy (WSIPP); 2004. Accessed on November 24, 2015

Citations - Implementation

NFP - Nurse-Family Partnership (NFP). Helping first-time parents succeed. Accessed on February 29, 2016
NFP-WI 2014 - Pearsall C. Nurse-Family Partnership in Wisconsin. Denver: Nurse-Family Partnership (NFP); 2014. Accessed on February 16, 2016

Page Last Updated

June 1, 2015