1. Family Nurse Partnership programme “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.

2. Changing the world one baby at a time

3. Why FNP in the UK? A child born into the most disadvantaged 5 per cent of families is 100 times more likely to have multiple problems at age 15 than a child from the 50 per cent best-off families Evidence base Advances in neuroscience and infant development The need for a powerful intervention to bring about change

4. Family Nurse Partnership Programme Preventive, intensive, structured home visiting programme Offered to first time mothers under 20 years from early pregnancy until child 2 years – universally offered to high risk group Licensed programme with fidelity measures to ensure replication of original research High degree of intensity and depth and skill Small scale testing in England since April 07, now 113 sites large scale RCT started April 09 with 18 sites – including Sunderland

5. FNP GOALS Connecting with families to: Improve pregnancy outcomes Improve child health and development and future school readiness and achievement Improve parents’ economic self- sufficiency

6. Programme ‘dosage’ From early pregnancy until the child is 2 years old Weekly – fortnightly – monthly home visits Each visit 60-90 minutes

7. Who should be offered the programme? All first time mothers age 19 at LMP Living in the agreed catchment area Eligible if previous pregnancies ended in miscarriage, termination, still-birth Multiple births included Excluded if plan to have baby adopted at birth, plan to leave area for an extended period of time (3 months or more) before baby reaches age 2.

8. What do parents receive? Voluntary programme Each visit has structure and planned content, covering 6 domains (personal and child health, parenting, personal goals, friends and family, environment, local services) Regularity and repeated structure of visits provides predictability, safety and role modelling Interactive materials and approaches to learn, develop skills and do things differently within a safe environment Close, therapeutic relationship with the nurse

9. The content of the visits cover 6 domains Personal health – women’s health practices and mental health Environmental health – home and neighbourhood Life course development – women’s future goals Maternal (and paternal) role – skills and knowledge to promote health and development of their child Family and friends – helping to deal with relationship issues and enhance social support Health and human services – linking to other services The relationship between the nurse and the family lies at the heart of the programme

10. Guidelines for nurses Pregnancy Infancy Toddlerhood Educational resources

11. Approach Therapeutic alliance – Focus on bonding, attachment and emotional availability of caregivers Utilises client’s primary motivation as expectant mother Strength based, positive and hopeful – Using motivational interviewing skills Respectful agenda matching Setting goals with small steps and positive feedback

12. Key points FNP is…. Licensed Structured Interactive Grounded in theory Strength based Research based Based on a therapeutic relationship

14. QUESTIONS