Findings from an RCT Investigating the Effectiveness of an IPV Prevention Component Inserted Into the Nurse Family Partnership Home Visitation Program (NFP): The Enhanced Nurse Family Partnership Study (ENFPS)

This paper presents results from an experimental study evaluating the addition of a preventive intervention for intimate partner violence (IPV) to the Nurse Family Partnership (NFP) home visitation program in Multnomah County, Oregon. NFP provides information, support and parent training to low-income first-time mothers-to-be to improve their pregnancy and parenting outcomes. The Enhanced Nurse Family Partnership Study (ENFPS) is testing the effectiveness of an experimental intervention that incorporates three additional components into NFP: 1) a curriculum aimed at improving relationship and conflict management skills, and at helping mothers make healthy relationship choices; 2) frequent assessment of IPV by their nurses (experimental nurses received additional training on IPV and the assessment); and 3) a secondary intervention for IPV that helped women who disclosed IPV and their nurses assess the level of danger and develop a safety plan, including referrals.  Women who were referred to the NFP program in Multnomah were randomly assigned to receive either the enhanced version of NFP (NFP+) or NFP as usual (NFP). Women who consented to the NFP program were then informed of and offered the opportunity to consent to the ENFP Study; 240 participants consented to the study and completed assessments. Assessments were completed by research assistants at baseline, 1-year, and 2-year follow up.  Logistic regression analyses indicate that women in the experimental group (NFP+) were less likely to engage in psychological violence perpetration than women in the comparison group (NFP) (1.23, p<.05). For physical aggression, results depended on prior violence experience.  That is, among women who report perpetration at baseline, experimental women are more likely than comparison women to report perpetration at the final assessment, with predicted probabilities of 0.56 and 0.38 respectively.   However, among women who reported no abuse at baseline, the experimental group fared significantly better than comparison women, with predicted probabilities of perpetration of 0.133 (experimental) and 0.264 (comparison).  The same was true for reports of physical victimization, in that for those reporting no victimization at baseline, the women in the experimental group were less likely to report victimization at 2-year follow-up. However, for women reporting victimization at baseline, women in the control group fared better.  Thus, the program seems to work as intended as a primary prevention approach but does not seem to work for those already experiencing or engaged in IPV. Possible explanations for these findings will be explored and implications for dissemination of this preventive component in the NFP program will be discussed.