Aug 08, 2018

The Nurse-Family Partnership: Health Equity for Mothers and Babies

On June 15, the Wisconsin Action Coalition hosted the eighth annual Wisconsin Center for Nursing Conference. 

The Wisconsin Action Coalition’s “Dealing With Disparity: Making a Difference in Practice & Leadership” conference on June 15 featured a workshop that brought to life the application of cultural care and health equity in practice.

In a presentation called “Clinical Knowledge for Strengthening Care for Low Birth Weight Babies,” Gwen Perry-Brye, DNP, RN-BC, APNP, and Jennifer Weitzel, MS, RN, with the Nurse-Family Partnership (NFP), described NFP’s powerful home visitation program and the evidence and framework for health equity that guides it.

The program promotes parents as teachers to strengthen care for low birthweight babies and their families in Wisconsin. Since 2017, the NFP in Kenosha County has resulted in a 25 percent reduction in cigarette smoking and 84 percent initiation of breastfeeding among NFP mothers. There is now a 94 percent immunization rates for infants compared to approximately 68 percent for the prior three years. Furthermore, 98 percent of infants and toddlers have met objectives for language and developmental progress versus the national average of 85 percent.

The Nurse-Family Partnership Health Equity Goals

The NFP is a great example of how nurses can help lead change in practice to promote health equity.

The RN home visitors change the future for the most vulnerable babies born into poverty by equipping the best person for the job—the mother—to become a competent, confident parent. A specially trained RN home visitor delivers NFP’s intensive and scientifically proven program at the most critical time for mom and baby. Over the first 1,000 days, from early pregnancy to baby’s second birthday, the RN home visitors seek to deliver a self-assured, capable first-time mother, a thriving baby poised for a bright future, and hundreds of thousands of dollars in societal benefits.

The goals are to improve pregnancy outcomes, child health and development, and economic self-sufficiency of the family.

Perry-Brye and Weitzel explained how the program is built on health equity, a framework that helps us understand that impactful change is possible. If we realize how a person’s risk factors relate to her health care access, health status and social factors, that gives us a greater understanding of how to strengthen care for moms and children in our care.

The medical model approach takes an individual and often disease-specific view, typically without the benefit of evidence-based, prevention-focused interventions to identify and address the patient’s complex needs. The epidemiological approach in public health takes a community-level view of health care condition and contributing factors, including social and environmental influences.

The convergence of these two approaches provides an opportunity for positive impact in prevention, treatment, and outcomes at its best: With an increased understanding of the social determinants, individuals and the public can be better positioned to manage their health.

Presentation slides can be viewed on the conference website and you can learn more about the NFP at http://www.nursefamilypartnership.org/.

Perry-Brye is the clinical services director/assistant health officer, Kenosha County, Wisc. 

Perez is an assistant professor of nursing at the University of Pennsylvania School of Nursing and is an advisor on diversity issues to the Future of Nursing: Campaign for Action.

The true measure of a nation’s standing is how well it attends to its children – their health and safety, their material security, their education and socialization, and their sense of being loved, valued, and included in the families and societies into which they are born (WHO, 2007).