Session: Improving the Nurse-Family Partnership in Community Practice (Society for Prevention Research 21st Annual Meeting)

Introduction.  Evidence-based preventive interventions are rarely final products.  They have reached a stage of development and testing that warrant public investment, but inevitably require additional research and development to strengthen their impacts.  The Nurse Family Partnership (NFP) is a program of home visiting by nurses for pregnant women and parents of young children, grounded in three decades of findings from randomized trials, that is being replicated in the US and internationally.  Today the NFP operates in over 400 counties in the US.  The NFP seeks to prevent a host of health and developmental problems throughout the life-course by improving fetal, infant, and toddler development with home visiting by nurses.  This symposium will discuss programs of research conducted in community practice aimed at improving the NFP and its implementation.  The papers will focus on: a) on how one maintains the evidentiary foundations of an evidence-based intervention while altering important features of it, b) results of the studies, and c) challenges of conducting practice-based research.

Development and Evaluation of an Intervention to Address Intimate Partner Violence (IPV).  Drawing on observations that the impact of the NFP on child abuse and neglect is attenuated in households in which there are moderate to high levels of IPV, investigators from the first program of research have formatively developed an intervention to help nurses address IPV in the context of NFP home visits.  They have tested this intervention in a 15-site cluster randomized controlled trial and will present preliminary results from that program of research.

Development and Evaluation of a Tool for Observing Parent-Child  Interaction.   Investigators from the second program of research discovered that NFP nurses in community practice settings were spending less time in supporting parents’ competent care of their children than nurses did in the original trials.  They will report on the collaborative development of a new observational system Dyadic Assessment of Naturalist Caregiver-Child Experiences (DANCE) and set of clinical pathways (DANCE STEPS) they have developed to address this issue.