The Evaluation of the Family Nurse Partnership Programme in Scotland: Phase 1 Report – Intake and Early Pregnancy
The Family Nurse Partnershhip (FNP) is a preventative programme for first time teenage mothers and their babies. FNP is being tested in Scotland for the first time. This is the first interim evaluation report and focuses on the intake and early pregnancy phases of the programmes implementation.
Footnotes
1 The report includes monitoring data from the nine-month recruitment phase, when clients were engaged and enrolled in the programme, and data from in-depth qualitative interviews with clients during their pregnancies, which took place up to the 40th week of pregnancy.
2 The report includes monitoring data from the nine-month recruitment phase, when clients were engaged and enrolled in the programme, and data from in-depth qualitative interviews with clients during their pregnancies, which took place up to the 40th week of pregnancy.
3 'Postpartum' means after the birth
4 The implementation team included representatives of the Scottish Government, NHS Lothian, Edinburgh City Council among others.
5 The Core Model Elements require each full-time Family Nurse to have a caseload of no more than 25, while the fidelity 'stretch' goals required them to recruit a caseload of 25 per full-time nurse within 9 months of recruitment commencing. In Lothian, 3 nurses recruited 26 clients (as there were a small number of early drop outs from the programme), 2 recruited 25 and 1 part-time nurse recruited 18. The supervisor also had 2 clients, as required by the Core Model Elements (see Appendix E for full list of Core Model Elements). They also co-visited one of the Family Nurse's clients for a period. The requirement to recruit clients over a 9 month period was a fidelity 'stretch' goal for the programme.
6 Early on in the set-up of the Edinburgh FNP test site, it was realised that the data used in the planning stages to estimate the likely number of births to women under 20 in a nine month period had been based on numbers of teenage pregnancies in Edinburgh, rather than the number of births to teenage mothers. As a result, there was some concern that it might have overestimated the likely numbers of women who would be eligible for FNP (since not all would continue with their pregnancy). A further complication arose from a lack of clarity in the birth data over whether these were women's were first or subsequent births ( FNP is restricted to women expecting their first child).
7 A client may have conceived at age 19, but be 20 by the time they engage with the programme
8 The base for education data is 143, with the remaining respondents declining to give this information to their family Nurse.
9 Note - clients were not necessarily living with their current partner.
10 This is higher than the 79% of clients who had a current partner because it includes ex-husbands.
11 This is to save further pressure on Midwives explaining about a programme they may not be necessarily familiar with and a lesson learned from English FNP sites as being good practice.
12 A sixth programme domain is health and human services. This relates to linking families with other community services necessary to meet the needs identified across the other five domains, and for which family resources are not available.
13 An evidence based method for helping people engage with and maintain behavioural change. Originally developed to help people with substance misuse problems, motivational interviewing focuses on using an empathetic, person-centred style to elicit and strengthen people's own motivations to change (see Miller & Rose, 2009).
14 The data reported in this chapter were collected at either the first or the third or fourth client visits after enrolment.
15 This figure is lower than the 148 initially enrolled due to client disengagement before data collection and cancelled appointments, which meant that a small number of clients had not completed the relevant form at the time of data analysis. Data on domestic abuse was collected at the third or fourth visit post-enrolment.
16 Note: clients could be abused by people in more than one category.
17 Numbers in the last two categories are too small to report on. More than one type of injury could be reported. Base: Clients who were physically abused in the year prior to enrolment= 26.
18 The English figures are based on those reported in Barnes et al (2008). The difference in the 2 figures was tested using a standard z-test for testing the difference between 2 percentages from independent samples.
19 Gathered at the first pregnancy visit.
20 Note that the two figures are not completely comparable, however. GUS asks mothers retrospectively after their baby is born whether or not they had intended to breastfeed and does not distinguish between 'definite' and 'possible' intentions to breastfeed.
21 The jobs were advertised in the Scotsman and other newspapers and on the SHOW website and NHS intranet.
22 Since the interviews were conducted, it has been announced that FNP sites in NHS Tayside will be funded.
23 This arrangement between DHFNP National Unit and the Scottish Government was made a requirement of the license by UCD.
24 It should be noted that these are only early findings from the FNP pilot in Scotland, and full recommendations will not be available until the whole programme has been implemented.
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