Improving interagency service integration of the Australian Nurse Family Partnership Program for First Nations women and babies: a qualitative study

Abstract Background The Australian Nurse Family Partnership Program (ANFPP) is an evidence-based, home visiting program that offers health education, guidance, social and emotional support to first-time mothers having Aboriginal and/or Torres Strait Islander (First Nations) babies. The community-controlled sector identified the need for specialised support for first time mothers due to the inequalities in birthing and early childhood outcomes between First Nations’ and other babies in Australia. The program is based on the United States’ Nurse Family Partnership program which has improved long-term health outcomes and life trajectories for mothers and children. International implementation of the Nurse Family Partnership program has identified interagency service integration as key to program recruitment, retention, and efficacy. How the ANFPP integrates with other services in an Australian urban setting and how to improve this is not yet known. Our research explores the barriers and enablers to interagency service integration for the Australian Nurse Family Partnership Program ANFPP in an urban setting. Methods A qualitative study using individual and group interviews. Purposive and snowball sampling was used to recruit clients, staff (internal and external to the program), Elders and family members. Interviews were conducted using a culturally appropriate ‘yarning’ method with clients, families and Elders and semi-structured interview guide for staff. Interviews were audio-recorded and transcribed prior to reflexive thematic analysis. Results Seventy-six participants were interviewed: 26 clients, 47 staff and 3 Elders/family members. Three themes were identified as barriers and three as enablers. Barriers: 1) confusion around program scope, 2) duplication of care, and 3) tensions over ‘ownership’ of clients. Enablers (existing and potential): 1) knowledge and promotion of the program; 2) cultural safety; and 3) case coordination, co-location and partnership forums. Conclusion Effective service integration is essential to maximise access and acceptability of the ANFPP; we provide practical recommendations to improve service integration in this context.

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Expressing breastmilk while on break and in private: a qualitative study of Malaysian first-time mothers

Community Work & Family ◽

10.1080/13668803.2020.1787349 ◽

2020 ◽

pp. 1-16

Author(s):

Sh Fatimah AlZahrah Syed Hussien Al-Attas ◽

Rhonda M. Shaw

Keyword(s):

Qualitative Study ◽

First Time Mothers ◽

First Time

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A qualitative study on the breastfeeding experiences of first-time mothers in Vientiane, Lao PDR

BMC Pregnancy and Childbirth ◽

10.1186/1471-2393-13-223 ◽

2013 ◽

Vol 13 (1) ◽

Cited By ~ 9

Author(s):

Hope Mei Hong Lee ◽

Jo Durham ◽

Jenny Booth ◽

Vanphanom Sychareun

Keyword(s):

Qualitative Study ◽

Lao Pdr ◽

First Time Mothers ◽

First Time

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The health-seeking behaviours of first-time mothers with persistent pelvic girdle pain after childbirth in Ireland: A descriptive qualitative study

Midwifery ◽

10.1016/j.midw.2015.07.009 ◽

2015 ◽

Vol 31 (11) ◽

pp. 1104-1109 ◽

Cited By ~ 15

Author(s):

Francesca Wuytack ◽

Elizabeth Curtis ◽

Cecily Begley

Keyword(s):

Qualitative Study ◽

Pelvic Girdle ◽

Pelvic Girdle Pain ◽

Health Seeking ◽

First Time Mothers ◽

First Time ◽

Descriptive Qualitative

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Estimated State and Local Fiscal Effects of the Nurse Family Partnership Program

10.17848/wp09-152 ◽

2009 ◽

Author(s):

Timothy J. Bartik

Keyword(s):

Nurse Family Partnership ◽

Family Partnership ◽

State And Local ◽

Partnership Program

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Adapting, piloting and evaluating complex public health interventions: lessons learned from the Nurse–Family Partnership in Canadian public health settings

Health Promotion and Chronic Disease Prevention in Canada ◽

10.24095/hpcdp.35.8/9.07 ◽

2015 ◽

Vol 35 (8/9) ◽

pp. 151-159 ◽

Cited By ~ 5

Author(s):

S. M. Jack ◽

N. Catherine ◽

A. Gonzalez ◽

H. L. MacMillan ◽

D. Sheehan ◽

...

Keyword(s):

Public Health ◽

Process Evaluation ◽

Health Care Providers ◽

Home Visit ◽

Small Scale ◽

Care Providers ◽

Nurse Family Partnership ◽

Health And Social Care ◽

Family Partnership ◽

First Time

Introduction The Nurse–Family Partnership (NFP) is a home-visit program for young and first-time, socially and economically disadvantaged mothers. Evidence from three United States randomized controlled trials (RCTs) on the effectiveness of this intervention at improving pregnancy outcomes, improving child health and development, and increasing maternal economic self-sufficiency is robust. However, the effectiveness of the NFP in Canada, with its different health and social care context, needs to be determined. The purpose of this article is to describe the complex process for moving the NFP from the research arena to full implementation in Canada. Methods This process of evaluation in Canada includes (1) adapting the intervention; (2) piloting the intervention in small-scale feasibility and acceptability studies; and (3) conducting an RCT and process evaluation through a study called the British Columbia Healthy Connections Project (BCHCP). This large-scale evaluation also creates an opportunity to expand the NFP evidence base by conducting an additional study to examine potential biological mechanisms linking intervention and behavioural outcomes in children. Results Adaptation of the NFP home-visit materials is a continuous process. A pilot project determined that it was feasible to enrol eligible women into the NFP. This pilot also determined that, in Canada, it was most appropriate for public health agencies to implement the NFP and for public health nurses to deliver the intervention. Finally, the pilot showed that this intensive home-visit program was acceptable to clients, their family members and health care providers. Through the BCHCP, the next steps—the RCT and process evaluation—are currently underway. The BCHCP will also set the foundation for long-term evaluation of key public health outcomes in a highly vulnerable population of families. The function of home-visit programs should not be viewed in isolation. Rather, their potential can be maximized when they collaborate and share information with other agencies to provide better services for first-time mothers.

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