[image_caption]Joan Patterson[/image_caption]
One of the early intervention programs with the strongest evidence for social impact is the Nurse Family Partnership, a voluntary home visiting program that serves low-income women pregnant with their first child. Each vulnerable mom is partnered with a registered nurse early in her pregnancy and receives ongoing home visits until the child’s second birthday. Mothers receive support for their own life course development as well as parenting education to provide the care and nurturance her child needs. This two-generation approach is key to the program’s success. Healthy children need healthy, well functioning parents.
Four decades of research in long-term controlled studies of the NFP home visiting program show remarkable outcomes, including family economic self-sufficiency and positive parenting practices leading to healthy child development and school readiness. There are significant reductions in child maltreatment, child injuries, emergency department visits, juvenile delinquency, family violence, and crime. A study by the RAND Corp. found that for every dollar invested in NFP, there was a savings of $5.70 in future costs for the highest risk families served.
Brain development begins in utero
Why start so early, even before the baby is born? A child’s brain development begins in utero with 80 percent of brain growth occurring prior to age 3. And this healthy brain is the foundation for continued learning, positive behavior, and health. The NFP nurses are trained to form a close relationship with the mother and advise her on prenatal health and child-rearing issues. They support the mother without judgment and are particularly successful in getting mothers to stop smoking and using alcohol and drugs, and to eat properly. Their babies are more likely to be full-term and to weigh more at birth.
Trust is the key ingredient. These women, who frequently have had no caring adult or support in their lives, develop a trusting relationship with their nurse who is able to support them to plan for their future – delaying another pregnancy, identifying ways to become self-sufficient, and coaching them in nurturing behaviors that help their infant develop a secure attachment, laying the foundation for successful future relationships.
Increased funding could reduce risks, improve outcomes
Today in Minnesota, more than 81,000 children ages 0-3 live in poverty. Annually, there are more than 10,000 births in the state to mothers on Medical Assistance. It’s estimated that only 15 percent of eligible families in our state receive home visiting services. That’s why we support increased funding for family home visiting programs as a successful strategy to reduce risks and improve outcomes for families and their children – and ultimately save taxpayers money.
The MN Coalition for Targeted Home Visiting is asking for $64.6 million over the biennium for targeted home visiting services to serve an additional 2,856 families. Please contact your state representatives and urge them to support this important legislation.
Joan Patterson and four others who contributed to this commentary — James Welch, Christine Andres, Stacy Walters and Regina Gleason — are members of the Minnesota Statewide Leadership Board for the Nurse-Family Partnership.
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They are indeed worthwhile programs. However research also shows for the programs to elicit long term effects, that parent/child interaction is key. The other issue for young parents who lack resources/skills is how to keep them engaged after the visitor leaves. Many hospitals have these early visiting programs. However I think also focusing on children when they get to the more challenging age is also key. Add to it, many counties, including Hennepin upped property taxes to pay for more child welfare interventions. My hope is that duplication is avoided and services streamlined. Another age group that benefits are preteens and teens with mental health issues.
You make excellent points Lisa. The need for good parenting continues throughout the life cycle. There is some belief (and a little evidence) that when children and parents get off to a good start, it is more likely that the positive developmental trajectory for both child and parent will continue — kind of like protecting our investment or “success breeds success.” It is more cost-effective to support and maintain what is working as opposed to trying to fix what is broken, which takes many more resources, including taxpayer dollars.