20100602-health-0101Wednesday, June 4, 2010
Written by Lisa Hanchey

Nurse-Family Partnership turns lives around for low-income mothers and kids.

Back in 2005, Lutricia Davis was in dire straits. The New Iberia native had lost a baby two years prior, and was recently unemployed. Her live-in boyfriend had also lost his job. Then, she discovered that she was pregnant. “We were doing really horrible at the time,” she recalls. “It was very, very bad.”

Broke and despondent, the 38-year-old sought treatment at the local health unit. While there, she saw a poster about the Nurse-Family Partnership, a nurse home-visiting program that helps first-time, low-income families. After enrolling in NFP, Davis received regular visits from a nurse, who worked with her on pre- and post-natal care, her own health and personal goals.

Following an uneventful pregnancy, Davis delivered a healthy 8-pound, 2-ounce baby girl, Daria, on Oct. 20, 2005. Her relationship with Daria’s father had ended, and Davis found herself as a single mom on welfare. With assistance from NFP, Davis was determined to find a better way to support Daria and herself. In January 2006, she enrolled at Louisiana Technical College to pursue her degree, which she had abandoned earlier during her third year in college. She also found a job at Shoney’s as a waitress, then Food-N-Fun as a cashier/manager. She plans to graduate in accounting this July.

And, that’s only the beginning: Davis’ dream has always been to open her own clothing store for plus-sized women. She chose accounting as a way to get her business background, and now she has enrolled in an online fashion design class to get closer to that goal.

Davis credits NFP with getting her life back on track. Daughter Daria is now a feisty 4-year-old. Once she completes her fashion design degree in 18 months, she plans to open her dream store.

The NFP helps vulnerable, destitute mothers and at-risk kids realize better outcomes. NFP is a voluntary, structured, home-visitation program targeting first-time moms below 200 percent of the poverty level. Starting at the 28th week of pregnancy, nurses make regular visits with the mother until the child’s second birthday. During that time, nurses coach mothers on the fundamentals of parenting, pre-natal care and economic self-sufficiency.

NFP began more than 30 years ago when David Olds, Ph.D., professor of pediatrics, psychiatry and preventive medicine and current director of the Prevention Research Center for Family and Child Health at the University of Colorado Health Sciences Center, was working at an inner-city day care in Baltimore, Md. He noticed a young boy who was always restless at nap time. After doing some digging, he discovered that at home, the child would wet his bed during naps, and his mother would beat him as punishment. This abusive situation inspired him to develop an intervention impacting the lives of children before it was too late.

In 1977, Olds launched a nurse home-visitation model to help low-income, first-time mothers take better care of themselves and their children. Over the years, the prototype evolved into the current NFP, a nonprofit serving more than 20,000 moms in 20 states. Louisiana was one of the first sites to implement NFP on a large scale. Since 1999, this state has served 7,035 clients through 128,513 home visits. As of April 2010, Louisiana has 94 nurses and 15 supervisors involved in NFP.

Randomized, controlled trials prove that NFP works. National stats show a 20 percent reduction in welfare use, 83 percent increase in mothers’ labor force participation by the child’s fourth birthday, 59 percent decrease in juvenile arrests at age 15, 61 percent fewer mothers’ arrests, 48 percent reduction in child abuse/neglect and 79 percent reduction in pre-term births among smokers. In Louisiana, the program boasted a 19 percent increase in workforce participation, 23 percent reduction in violence during pregnancy and 93 percent of children scoring at or above normal on language development. “It’s extremely rare to find a social service program that’s gone through a randomized control trial,” says Melanie Bronfin, public policy analyst at Tulane University School of Medicine and project director for the Louisiana Home Visiting Campaign. Beginning with a pilot by Louisiana’s Office of Public Health in the Department of Health and Hospitals in Lafayette and Monroe, NFP slowly expanded to 52 parishes out of 64. While this speaks well for Louisiana, which has consistently ranked 49th or 50th in the U.S. for overall child well-being in the Annie E. Casey Foundation’s Kids Count Data Book, NFP currently serves only 15 percent of eligible mothers. “A lot of people are not even aware that the program is out there,” observes Kim Williams, NFP’s program developer for Louisiana, Mississippi and Arkansas.

To spread the word, Louisiana is joining the Pew Home Visiting Campaign, a project of the Pew Center of the States. Louisiana is one of only four states to partner with Pew, a nonprofit organization that “applies a rigorous, analytical approach to improve public policy, inform the public and stimulate civic life.” Through grants provided by the Doris Duke Charitable Foundation and the Children’s Services Council of Palm Beach County, Pew is leading the home visiting research agenda.

OPH is launching the Louisiana Home Visiting Campaign, with the goal of increasing the number of participating moms from 15 to 25 percent. Ultimately, Louisiana seeks to expand NFP’s capacity to 50 percent of eligible women. Supporting this state’s cause is a coalition of diverse organizations and partner, including the American Academy of Pediatrics, the United Way and Entergy. “Our campaign is centered around educating policy makers and then advocating for nurse-family partnership expansion,” Bronfin says.
Research shows that NFP  is cost-effective, yielding up to a $5.70 return for every $1 invested. “I think too often, governments tend to try to fix the problems once they happen, and that’s a very expensive approach,” Bronfin explains. “One reason that this program is so cost-effective is that you are able to work with the mother and child at a critical point in their lives, so you are able to stop the bad stuff from happening.”

Today, Davis is touting NFP to family and friends. During her pregnancy, she recommended the program to her godchild, and is now reaching out to others, particularly young mothers-to-be. “I loved it,” she said. “I know what it did for me. I had a lot of fear with the second pregnancy. So, just to have someone come over, and to hear them talk to you and let you know that everything was going OK was very helpful.”

For more information about the Nurse-Family Partnership, call (800) 251-2229 or visit Web sites LaHomeVisiting.org or NurseFamilyPartnership.org.

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