After becoming pregnant unexpectedly, single mother-to-be Maegan Gomez thought long and hard about how her life was about to change. And despite her close relationship with her parents and extended family, she knew she didn't have all the answers. Gomez was also more than a little afraid.
“Until you have your own baby you just don’t know how it will be. That’s where Keisha and Nurse-Family Partnership really came through for me. I learned things I wouldn’t have learned from reading a book or watching TV,” said Gomez. “I learned what I needed to know, and I learned to trust myself as a mother."
Nurse-Family Partnership provides low-income first-time mothers with home visits from bachelor’s-prepared, registered nurses during pregnancy and until the child reaches two years of age, because decisions made during pregnancy and in the first few years of a child’s life have an immeasurable impact on their health and well-being.
Gomez first heard about Nurse-Family Partnership at the preschool where she works. She immediately contacted the program and signed up. Within two weeks she had met the nurse who would help guide her through her pregnancy and the first two years of her baby Poppy’s (born full term at seven pounds, eight ounces and 21 inches long) life—Keisha Lucas.
Having been a young mother herself, Lucas knows full well the benefit of regular visits with a health care professional to keep new moms on track and focused on raising a healthy child.
“Nurse-Family Partnership is an intensive home visitation program. We are in the home a couple of times a month and our visits can last up to an hour to an hour and a half. Every visit includes a health assessment of both mom and baby,” said Lucas. “We encourage healthy choices, but we aren't there to tell the mom what to do. We offer suggestions for having a healthy baby.”
The relationship a nurse forms with a mother is critically important to the success of Nurse-Family Partnership. “When I first enroll a mom I ask a lot of questions, but I also share a little bit about myself. I want mothers to feel comfortable with me and in the beginning they might not. I’m a stranger in their home. But because I’m there when I say I will be and share my knowledge about promoting health and the development of their baby, we build a relationship of mutual trust and respect over time,” said Lucas.
An evidence-based community health program, Nurse-Family Partnership has improved the health, education and economic self-sufficiency of thousands of participating families across in the country, in both the long and short term.
According to the Annie E. Casey Foundation, more than a quarter of North Carolina’s children live in poverty, a number that has grown since 2008. Research has shown that low family income can impede a child’s cognitive development and hinder their ability to learn. Poverty can also contribute to behavioral, social, and emotional problems, and cause and exacerbate poor health.
In North Carolina, Nurse-Family Partnership has served more than 2,400 mothers and welcomed more than 1,500 babies. The program currently serves mothers in 17 counties, including 69 mothers and 58 babies in Forsyth County alone. And that number is growing.
In Winston-Salem, where Maegan Gomez lives with her father, the Nurse-Family Partnership Program works with the Forsyth County Department of Public Health and is supported by a five-year grant from the Kate B. Reynolds Charitable Trust. The program was launched in December 2012, after years of effort on the part of community leaders and organizations that recognized the need to provide support for struggling low-income families. In other parts of the state, the Trust is partnering with The Duke Endowment and other funders, both private and public, to grow the number of mothers and children served by the program.
Nurse-Family Partnership sees a unique opportunity to grow its efforts in North Carolina, thanks to new collaborations among funders.
“I’m excited about the partnerships we’ve developed here. The phrase ‘public-private’ gets thrown around a lot, but the Kate B. Reynolds Charitable Trust and others have created very real partnerships with state and federal funders. Our work here will serve as a model for how other states can support Nurse-Family Partnership, especially in the current economic climate,” said Chris Bishop, state director for the Carolinas, Nurse-Family Partnership.
Nurse-Family Partnership was developed by David Olds, now a professor of pediatrics, psychiatry, and preventive medicine at the University of Colorado Denver. Early in his career, Dr. Olds recognized that his youngest patients, as well as their mothers, would benefit from the support and guidance of a professional nurse. He went on to develop a home visitation program for first-time, low-income mothers and their babies.
Dr. Olds tested the program over more than three decades in randomized controlled trials in Elmira, New York; Memphis, Tennessee; and Denver, Colorado. And the results were clear—Nurse-Family Partnership improved pregnancy outcomes, improved the health and development of children, and helped put new mothers on a positive path, both for themselves and their families.
The program now serves mothers and babies in 43 states, the U.S. Virgin Islands, and six tribal communities. From Denver, the Nurse-Family Partnership National Service Office ensures quality replication of the program and provides implementing agencies with support in nursing education and practice, quality assurance, public policy, and more.
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“The mothers participating in Nurse-Family Partnership frequently face obstacles as they move toward their goals. As nurses, we can see what we think might be a pathway out of poverty, but we can’t shortcut a mother’s journey. Sometimes a mother needs help, and we can walk alongside her. We can ask questions, but we don’t tell a mother what to do. Our practice is reflective and motivational. We help mom find the best way on her path,” said Christine Wanous, nurse supervisor for the Forsyth County Nurse-Family Partnership.
The Kate B. Reynolds Charitable Trust has supported Nurse-Family Partnership in North Carolina since 2008 because it’s a natural fit with the Trust’s mission to improve the health and well-being of North Carolina families. The Trust also recognizes Nurse-Family Partnership’s unsurpassed and well-documented achievements.
“As a funder we’re always looking for a sure thing, and from an investment perspective this is it. Properly implemented, Nurse-Family Partnership has guaranteed results. It has a documented transformational quality. The program’s benefits also extend beyond our traditional health-focused efforts. Nurse-Family Partnership impacts education, maternal success, and securing employment. The program has strengthened participating families and communities,” said Allen Smart, vice president of programs at the Kate B. Reynolds Charitable Trust. “But that’s not all. Nurse-Family Partnership is a unique opportunity for the Trust to join with other committed funders, such as The Duke Endowment. This is something we have not done before, and we are learning from the experience.”
As of 2012 in North Carolina, 89 percent of babies in the program were born full-term and at healthy weights. Seventy-two percent of participating mothers did not become pregnant again before completing the program. Forty-four percent of mothers earned a high school diploma or GED while in the program, and 26 percent are working to obtain a diploma.
“Investing in Nurse-Family Partnership gives the Trust surety of results, which in turn gives the Trust the unique opportunity to focus on making sure our support is where it needs to be. We leave the patient outcomes to Nurse-Family Partnership, because we know it’s working,” said Smart.
Across the country, Nurse-Family Partnership consistently reports health, education, and economic outcomes far beyond those of similar programs:
- Improved prenatal health
- Fewer childhood injuries
- Fewer subsequent pregnancies
- Increased intervals between births
- Increased maternal employment
- Improved school readiness
“Nurse-Family Partnership has put me in a better place. I’m grateful to be a part of it. When I look at the things I do with my daughter today, I wonder if I would have known that singing to her and reading to her help her grow and learn. Would I know that feeding her with a bowl and a spoon is better than putting her cereal in a bottle? I’m not sure. I just know that when we go to the doctor for her checkups I am proud of her weight and her growth. And I’m proud of the mother I’ve become,” said Gomez.
Maegan is currently working full-time while earning an Associate’s Degree in Early Childhood Education as a full-time student. She plans to attend a four-year college and become an elementary school teacher. Poppy is now ten months old.
NCNFP BY THE NUMBERS
Home Visits Completed 47,426
Total Clients Served 2,397
Total Babies Born 1,573