The Nurse Family Partnership Program Clarissa Igle, RN

1. The Nurse Family Partnership Program Clarissa Igle, RN Nurse Manager, Visiting Nurse Service of New York Nurse-Family Partnership March 26, 2009

2. Home Visit Overview Maternal Role Mothering Role Physical Care Behavioral and Emotional Care Family and Friends Personal network Relationships Assistance with Childcare Health and Human Services Service utilization Personal Health Health Maintenance Practices Nutrition and Exercise Substance Use Mental Health Functioning Environmental Health Home Work, School, and Neighborhood Life Course Development Family Planning Education and Livelihood March 2009

3. 3 “There is a magic window during pregnancy…it’s a time when the desire to be a good mother and raise a healthy, happy child creates motivation to overcome incredible obstacles including poverty, instability or abuse with the help of a well-trained nurse.” David Olds, PhD, Founder, Nurse-Family Partnership March 2009

4. Bronx Comparison to Other Boroughs: Key Indicators of Maternal/Infant Health On markers of Maternal Infant Health, the Bronx is the borough most at risk. Source: IMR and LBW: NYC Vital Statistics, DOHMH (2007) . PPD and IPV- NYC PRAMS (Pregnancy Risk Assessment Monitoring System, 2006)

5. VNSNY NFP – Impact on Women and Children in the Bronx • Reduced domestic violence • More women breastfeeding • High immunization rates • Lower rates of subsequent pregnancy March 2009

6. Domestic Abuse During Pregnancy: Bronx NFP Results There is a 41% decrease in reported physical abuse during pregnancy, and a 44% decrease in reported fear of partner. Source: NYC NFP: Nurse-Family Partnership Data through 12/30/2008 March 2009

7. Breastfeeding Initiation Rate: VNSNY NFP, NYC and US Source: NYC NFP: Nurse-Family Partnership Data through 12/30/2008 and NYC: First time births on Medicaid from PRAMS 2006. US: National Immunization Service (NIS), 2005 Healthy people 2010 goal = 75% Breastfeeding is optimal for the physical and cognitive development of the infant, and for maternal infant bonding. VNSNY NFP sites consistently exceed breastfeeding initiation rates when compared to New York City and the Healthy People 2010 goal. March 2009

8. Percentage of Children up to Date with Immunizations Source: NYC NFP: Nurse-Family Partnership Data through Dec 30 2008- NYC and US comparisons from Citizen’s Committee for Children Status Report 2008

9. Cumulative Percent of Women with Subsequent Pregnancy 6 Months & 18 Months Postpartum New York City NFP vs. US Subsequent pregnancies that occur shortly after the original pregnancy put both the mother and infant at higher risk for health complications and economic hardships. The rates of subsequent pregnancy in the Bronx NFP are lower than the national average. Decreasing this rate even further at 18 months is currently an area of focus. Source: Source: US: CDC 2006 Pregnancy Nutrition Surveillance System (PNSS); NFP data from Nurse-Family Partnership (NFP) Data through 12/30/2008

10. “This program saves money. It raises healthy babies and creates better parents. It reduced childhood injuries and unintended pregnancies, increased father involvement and women's employment, reduced use of welfare and food stamps, and increased children's school readiness. And it produced more than $28,000 in net savings for every high-risk family enrolled in the program.” • Barack Obama, • U.S. President March 2009