The Family Nurse Partnership (FNP) programme in has been developed from over 35 years of extensive US research, including three large-scale randomised control trials (RCTs), the most rigorous way of determining whether a cause-effect relationship exists.

These trials have tested the US programme, the Nurse-Family Partnership (NFP) with diverse populations in different contexts in Elmira, New York (1977), Memphis, Tennessee (1988) and Denver, Colorado (1994). All three studies tracked families from pregnancy through to adulthood, and in the case of Elmira, observed how children benefitted up to the age of 28. This research has shown consistent improvements to the lives of children and mothers. It has:

  • Improved pregnancy health and behaviours
  • Reduced child abuse and neglect
  • Improved school readiness
  • Increased maternal employment and economic self sufficiency
  • Reduced closely spaced subsequent pregnancies.

US research has also shown significant returns on investment to Government and to wider society.

Better outcomes for mothers

FNP aims to improve pregnancy outcomes by supporting mothers-to-be to make informed choices about healthy pregnancy behaviours, as well as improving the future life course of young mothers, by supporting them to make changes to their lives and providing them and their babies with a better future.

Better pregnancy outcomes

Improved outcomes during pregnancy observed in the US trials include:

  • Decreases in cigarette smoking during pregnancy [1, 2]
  • Fewer hypertensive disorders of pregnancy and fewer pregnancy related infections [1]
  • Improvements in prenatal diets. [3]

Improved life course

Specific benefits to mother’s life course observed in the US trials include:

  • Fewer subsequent pregnancies and births and greater intervals between first and second babies [2,3,4]
  • Greater maternal employment [5]
  • Reductions in use of welfare and other government assistance [4, 6, 7]
  • 61% fewer arrests and 72% fewer convictions of mothers by the time their child is aged 15 [4]
  • More stable relationships with partners and with their child’s father. [7]

Reduced domestic abuse

Evidence the US and the Netherlands suggests FNP is effective in helping prevent and reduce domestic abuse, both for the mother as a victim and perpetrator. [8] This includes psychological, physical assault and sexual abuse during pregnancy, and physical assault by the time the child is two years old. [9]

 

Better outcomes for children

Reduced child neglect and abuse

Reduced child abuse, neglect, and resultant child injuries are the most consistent benefits of the NFP programme. The programme is frequently cited as one of the most effective programmes for preventing child abuse and neglect [16] as evidenced by reductions in both verified child abuse and neglect and in health care encounters for child injuries. More specifically, the US RCTs of NFP found:

  • 48% reduction in verified cases of child abuse and neglect by the time the children were aged 15 [4]
  • 56% reduction in A&E attendances for injuries and ingestions during child’s second year of life [10]
  • 28% relative reduction in all types of health care encounters during child’s first two years of life [3]
  • 79% relative reduction in the number of days that children were hospitalised with injuries or ingestions in child’s first two years of life. [3]

Improved school readiness

The US research trials show that the NFP improves children’s readiness for school, notably those from at risk backgrounds. Children of families who benefitted from NFP had better early language and cognitive development, and scored higher on school achievement tests than similar children who do not receive the programme. These important early outcomes are associated with improved school performance and increased earnings in adulthood.

Specifically, NFP children had:

  • 50% reduction in language delay at 21 months [2]
  • Better academic achievement in the first six years of elementary school (low resource mothers) [11]
  • Better language and emotional development at age 4 (low resource mothers) [12].

Improved emotional and behavioural development

Research from the US shows that NFP children had better emotional and behavioural development, including less early risk taking behaviours (such as substance abuse), than their control group counterparts. More specifically, NFP children had:

  • 67% reduction in behaviour and emotional problems at age six [1]
  • 28% reduction in 12 year olds mental health (anxiety and depression) problems [2]
  • 67% reduction in 12 year olds use of cigarettes, alcohol and marijuana [3]
  • 59% reduction in child arrests at age 15.