Nurse-Family Partnership is an evidence-based early childhood program that partners low-income first-time mothers with registered nurses. Through home visits from early pregnancy until the child turns two years old, nurses work with mothers to improve health, social and economic outcomes. Research shows the program improves prenatal health, child development and economic self-sufficiency while saving up to $5.70 for every $1 invested through reduced healthcare, justice system and welfare costs.
Learn Valuable Information for Getting Paid to Take Care of Your Family Membe...BestHomeCare
The need for home care is constantly growing and, as a result, providing care for a family member or friend has become much more common than it was just a few years ago. Most family caregivers are unaware of the opportunity they have to get paid for taking care of a family member or friend. The state of Minnesota and Federal Government sponsor programs designed to compensate caregivers for their services. This paper outlines these programs to help friend and family caregivers find the appropriate method for getting paid to take care of a loved one.
In Ohio, youth who are incarcerated are more likely to reoffend and have less success in education and employment. Speaker Erin Davies from the Ohio Juvenile Justice Coalition shared how Ohio reduced the number of kids facing jail time and the latest numbers on Ohio kids in the juvenile justice system.
Learn Valuable Information for Getting Paid to Take Care of Your Family Membe...BestHomeCare
The need for home care is constantly growing and, as a result, providing care for a family member or friend has become much more common than it was just a few years ago. Most family caregivers are unaware of the opportunity they have to get paid for taking care of a family member or friend. The state of Minnesota and Federal Government sponsor programs designed to compensate caregivers for their services. This paper outlines these programs to help friend and family caregivers find the appropriate method for getting paid to take care of a loved one.
In Ohio, youth who are incarcerated are more likely to reoffend and have less success in education and employment. Speaker Erin Davies from the Ohio Juvenile Justice Coalition shared how Ohio reduced the number of kids facing jail time and the latest numbers on Ohio kids in the juvenile justice system.
Georgia Voices for Medicaid Powerpoint - Fulton countyAlyssa Green, MPA
This presentation explains what Medicaid program is, who it protects, the creation of the coverage gap and what Medicaid advocacy looks like in the state of Georgia.
This was the result of a group project completed for the Family Policy (6130) Course at UGA. The assignment instructions were to choose a topic and create a policy brief using research, data, and the family impact analysis to present the selected issue. Three of my fellow classmates and I completed this project and presented it to the class. The sections I singly developed include: "What's the Issue?," "Background," and "References."
This presentation explains what Medicaid program is, who it protects, the creation of the coverage gap and what Medicaid advocacy looks like in the state of Georgia.
Providing Support To Employers And Working Caregivers 6 14 2010 2Elderplanner
Our “Elder Life Planning for Organizations” program allows non-profit and small eldercare enterprises
to offer a comprehensive eldercare program to employers, banks, membership organizations and faith based communities without the significant capital outlay that would otherwise be required.
1.6 Improving Outcomes for Youth Aging Out of Foster Care
Speaker: Brenda Fonseca
Nearly 28,000 youth emancipated from foster care in 2010, and it is imperative that they have access to services, affordable housing options, education, and employment to prepare them to live independently. Communities that have extended foster care to older youth under the Fostering Connections Act and that are creatively using resources to increase housing opportunities will discuss their successes and lessons learned.
Understanding the vocabulary of health insurance helps in selecting and using coverage effectively. eHealthInsurance commissioned a national study to determine public awareness of select health insurance terminology and the specifics of health insurance coverage. Americans admit to a health insurance vocabulary deficit.
Only a fourth (23%) feel they are very sure of what the terminology used in their health insurance policy actually means.
A third are somewhat sure of what the terminology actually means (32%).
One-fourth are not very sure (13%) or have no idea (10%) what the terminology used in their health insurance policy means.
One-fifth report they don’t have health insurance (21%).
The public demonstrates its lack of familiarity with health insurance terminology by not knowing what some of the key abbreviations stand for.
Only one-third of Americans (36%) can volunteer that HMO stands for health maintenance organization.
Only one-fifth (20%) recall that PPO stands for Preferred Provider Organization.
Only one out of nine (11%) recalls that HSA stands for Health Savings Account.
When asked how sure they were with some of the specifics of their health insurance policy, most people said they were very sure of the amount of their co-payment (61%), but half or fewer were very sure they knew the amounts of other basic elements of their coverage:
Half said they were very sure of what they paid for their health insurance premiums (50%).
45% were very sure of their annual deductible.
41% were very sure of the level of their plan’s co-insurance.
35% were very sure of their maximum annual out-of-pocket costs.
For each of these items, one-fifth indicated that the questions were not relevant since they did not have health insurance (21%).
We know that one of the biggest factors that move Ohioans up and out of poverty is a job, but a job doesn’t always mean a living. Ohio’s public policies have the potential to create good jobs, increase opportunity for all Ohioans, and make Ohio’s economy stronger.
Speakers discussed how state policy decisions and budget proposals can potentially influence Ohio’s employment and direct care workforce. They covered programs in place to support working Ohioans – including person-centered work programs, the direct care workforce, and work supports – and how you can advocate for working Ohioans in the Senate.
Speakers included:
* Joel Potts, Executive Director, Ohio Job and Family Services Directors’ Association
* Beth Kowalczyk, Chief Policy Officer, Ohio Association of Area Agencies on Aging
* Wendy Patton, Senior Project Director, Policy Matters Ohio
The pending Healthy Ohio 1115 Medicaid waiver would require nearly all non-disabled adults on Ohio Medicaid to pay premiums. If approved by the federal government, the waiver would result in a greater number of uninsured Ohioans as well as increased Medicaid administrative costs and complexity.
Speakers include:
* Tara Britton, Public Policy Fellow, The Center for Community Solutions
* Nita Carter, Project Director, UHCAN Ohio
Georgia Voices for Medicaid Powerpoint - Fulton countyAlyssa Green, MPA
This presentation explains what Medicaid program is, who it protects, the creation of the coverage gap and what Medicaid advocacy looks like in the state of Georgia.
This was the result of a group project completed for the Family Policy (6130) Course at UGA. The assignment instructions were to choose a topic and create a policy brief using research, data, and the family impact analysis to present the selected issue. Three of my fellow classmates and I completed this project and presented it to the class. The sections I singly developed include: "What's the Issue?," "Background," and "References."
This presentation explains what Medicaid program is, who it protects, the creation of the coverage gap and what Medicaid advocacy looks like in the state of Georgia.
Providing Support To Employers And Working Caregivers 6 14 2010 2Elderplanner
Our “Elder Life Planning for Organizations” program allows non-profit and small eldercare enterprises
to offer a comprehensive eldercare program to employers, banks, membership organizations and faith based communities without the significant capital outlay that would otherwise be required.
1.6 Improving Outcomes for Youth Aging Out of Foster Care
Speaker: Brenda Fonseca
Nearly 28,000 youth emancipated from foster care in 2010, and it is imperative that they have access to services, affordable housing options, education, and employment to prepare them to live independently. Communities that have extended foster care to older youth under the Fostering Connections Act and that are creatively using resources to increase housing opportunities will discuss their successes and lessons learned.
Understanding the vocabulary of health insurance helps in selecting and using coverage effectively. eHealthInsurance commissioned a national study to determine public awareness of select health insurance terminology and the specifics of health insurance coverage. Americans admit to a health insurance vocabulary deficit.
Only a fourth (23%) feel they are very sure of what the terminology used in their health insurance policy actually means.
A third are somewhat sure of what the terminology actually means (32%).
One-fourth are not very sure (13%) or have no idea (10%) what the terminology used in their health insurance policy means.
One-fifth report they don’t have health insurance (21%).
The public demonstrates its lack of familiarity with health insurance terminology by not knowing what some of the key abbreviations stand for.
Only one-third of Americans (36%) can volunteer that HMO stands for health maintenance organization.
Only one-fifth (20%) recall that PPO stands for Preferred Provider Organization.
Only one out of nine (11%) recalls that HSA stands for Health Savings Account.
When asked how sure they were with some of the specifics of their health insurance policy, most people said they were very sure of the amount of their co-payment (61%), but half or fewer were very sure they knew the amounts of other basic elements of their coverage:
Half said they were very sure of what they paid for their health insurance premiums (50%).
45% were very sure of their annual deductible.
41% were very sure of the level of their plan’s co-insurance.
35% were very sure of their maximum annual out-of-pocket costs.
For each of these items, one-fifth indicated that the questions were not relevant since they did not have health insurance (21%).
We know that one of the biggest factors that move Ohioans up and out of poverty is a job, but a job doesn’t always mean a living. Ohio’s public policies have the potential to create good jobs, increase opportunity for all Ohioans, and make Ohio’s economy stronger.
Speakers discussed how state policy decisions and budget proposals can potentially influence Ohio’s employment and direct care workforce. They covered programs in place to support working Ohioans – including person-centered work programs, the direct care workforce, and work supports – and how you can advocate for working Ohioans in the Senate.
Speakers included:
* Joel Potts, Executive Director, Ohio Job and Family Services Directors’ Association
* Beth Kowalczyk, Chief Policy Officer, Ohio Association of Area Agencies on Aging
* Wendy Patton, Senior Project Director, Policy Matters Ohio
The pending Healthy Ohio 1115 Medicaid waiver would require nearly all non-disabled adults on Ohio Medicaid to pay premiums. If approved by the federal government, the waiver would result in a greater number of uninsured Ohioans as well as increased Medicaid administrative costs and complexity.
Speakers include:
* Tara Britton, Public Policy Fellow, The Center for Community Solutions
* Nita Carter, Project Director, UHCAN Ohio
Are we there yet?: Five years on the road to addressing child poverty – a pre...McGuinness Institute
Are we there yet?: Five years on the road to addressing child poverty – a presentation on 31 May 2016 by Dr Russell Wills – Children’s Commissioner
To learn more go to www.occ.org.nz or www.childpoverty.co.nz
To learn more about TacklingPovertyNZ go to http://tacklingpovertynz.org
Maternal & Child Health Among Detroit Michigan’s Lower Socio.docxandreecapon
Maternal & Child Health Among Detroit Michigan’s Lower Socioeconomic Group
Delroy Barnett
Christina Bergman
Maria Victoria Blanton
Veverly Brooks
Jennifer Castro
Ashford University
HCA415- Public and Community Health
Instructor: Tynan Mara
April 6, 2015
1
Target Population
Detroit Michigan Population:688,701
Percent of White American: 10.6%
Percent of Black American: 82.7%
Percentage of Women: 52.7%
Pregnancy Related Deaths 36.6 per 100,000 births.
Pregnancy Associates Deaths 75 pre 100,000 births.
Pregnancy Related deaths - 50.8 per 100,000 births in African Americans.
-3rd highest in nation
As of 2010, Detroit Michigan has a total population of 688,701 people. Of the 688,701 people, 10.6 % are White American and 82.7% are Black American. The community of Detroit is dealing with a rising concern with maternal health and pregnancy related mortality rates. Of the total population, 52.7% (or 362,945) are women. The cause of mortality among maternal mothers is obstetric causes, medical, accidents, suicide, assaults, and other causes. Per year on average, 6 women die from pregnancy issues, this amount is three times higher than that of the national average. These high mortality rates are more common in African American women than other races. Pregnancy related deaths among African Americans is 50.8 per 100,000 live births. This makes Detroit Michigan the third highest city of pregnancy related mortality in the nation. The high mortality rates in Detroit are due to health conditions, poverty, and proper health care. These numbers show that it is dangerous for a pregnant women to live and give birth in Detroit.
2
Thesis Statement
Thesis
The health disparities among women and children in Detroit are some of the worst in the nation. “The maternal mortality rate for black mothers in 2002 was almost 25 deaths per 100,000 live births, compared to nearly 6 deaths per 100,000 live births among white mothers and more than 7 deaths…among Hispanic mothers” (National Institute of Health, 2006, p.x). That is nearly four times the national average. More focus needs to be placed on maternal and child health in low socio-economic areas of Detroit.
Factors & Causes
Over 40% of population is living in poverty
Chronic Diseases
Limited access/ quality of health care
Obstetric, Medical, Accidents leading cause
While normally a major health concern in less developed countries, maternal and child health in the United States has become a major concern. “Child mortality is highly preventable and can be reduced greatly through improvement of environmental conditions and hygiene levels, as well as increased parental compliance with immunizations for vaccine preventable diseases…Many of these deaths were caused by preventable or easily treatable condition or by malnutrition (WHO, 2012c; WHO, 2012a)” (Friis, Bell, & Philibert, 2013). Poverty is a detrimental impact on the maternal health of women in Detroit. With the me ...
Research published in February 2014 shows a growing number of local authorities across England are failing in their legal duties to families to provide outreach and childcare brokerage services.
Redefining Relationships between Citizens, Communities and Services and Diffe...Mentor
Our new Chief Executive Michael O'Toole made a presentation at the Capita Conference 'Managing Demand in Public Services' held in London on 21st October 2014.
O website da #SMAM2019 #WBW2019 já está disponível, contendo materiais, publicações relevantes para a campanha da Semana Mundial de Aleitamento Materno coordenada pela WABA.
Você encontrará informações gerais, objetivos, cartaz, infográficos, o fôlder de ação e seu complemento, perguntas frequentes (FAQs) e links para campanhas anteriores da WBW.
Fique atento aos nossos Kits de Mídia que contêm recursos de criativos, bem como links para registrar as atividades que estão sendo planejadas e relatórios das celebrações.
Por enquanto, tudo em inglês: www.worldbreastfeedingweek.org:
SROI national specialist family service 2013Minney org Ltd
Phoenix Futures (National Specialist Family Service - substance misuse rehabilitation) Social Return on Investment report. Demonstrates the value for money both in overall terms, and in direct cash flow to local authority social services / NHS / judiciary
Karen Minyard, GHPC Director, presented "Social Determinants of Health Equity and Levels of Potential Impact in the System: Opportunities for Leverage" at the Georgia Grantmakers Alliance in Macon, GA on August 25, 2011.
Creating Safe Environments For Students to Walk or Bike to School Can Increase Their Daily Physical Activity. How are kids getting to school? What are some of the barriers to walking, biking to school?
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
1. Working Together to Ensure Healthier Families
Nurse-Family Partnership Overview
2. 2
"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
4. 4
"They always say babies
don’t come with
instruction manuals, but
if there was one, the
Nurse-Family Partnership
would be it."
Andrea, Mom from
Pennsylvania
10. "The great thing about
Nurse-Family Partnership is
that it works. To put it
simply…it decreases
about everything you
want to decrease and
increases about
everything you’d want it
to increase."
Dr. Thomas R. Frieden, former New
York City Health Commissioner
(now Director, CDC, and
Administrator, Agency for Toxic
Substances and Disease Registry)
14. "If communities are truly
interested in making sound
investments that will yield
high public and private
gains in both the long and
short run, they would fare far
better by investing in
evidence-based, early child
development initiatives like
Nurse-Family Partnership
than in professional sports
stadiums or office towers."
Rob Grunewald,
Associate Economist, Federal
Reserve Bank of Minneapolis
19. "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."
Barack Obama, U.S. Senator
(now President)
26. 26
"The Nurse-Family
Partnership
empowers first-time
mothers with the
resources and
knowledge to
provide an
environment in
which children can
reach their full
potential."
Former U.S. Senator
Arlen Specter (R-PA)
"The success of the
Nurse-Family
Partnership is
undeniable: this
program should be
expanded to every
community in this
country, not just a
select few."
Ken Salazar, former
U.S. Senator (now
Interior Secretary)
"I am very proud
that Milwaukee
was chosen to be
a Nurse-Family
Partnership site
because this is a
proven cost-
effective
investment in the
well-being of
children and
families."
Milwaukee Mayor
Tom Barrett
27. 2727
“If there is any hope that Congress' new
health care bill will put some restraints
around the growth in medical costs, it
rests in the part of the proposal that calls
for rewarding programs that reshape
how medicine gets practiced…the
Administration has the chance to invest
in one such program – the Nurse-Family
Partnership – when it starts giving out
$1.5 billion in home health care grants...”
5.25.10
Full coverage: www.nursefamilypartnership.org > About > News
“Infant development strategies, like
other forms of social capital, are
perversely distributed in America -
fetishized in places where babies are
fundamentally secure and likely to
prosper, undervalued in places
where babies are not. The NFP aims,
in a fashion, at equalization.”
Katherine Boo 2.6.06
“If you want to invest societal resources
where they will have the biggest benefit
for all of us, clearly the evidence is there
now that protecting children from the
worst kinds of deprivation in their
youngest years will result in more
functional, capable, prosocial citizens.”
Martha Farah, director of the Center for
Cognitive Neuroscience at the University of PA
3.2.09
“ We're all better off if we make the
investment upfront. I would rather see
us be involved early and have it be an
educational situation, as opposed to
no involvement and then become part
of the criminal justice system.”
Patrick Perez, sheriff of Kane County, IL and
member of Fight Crime: Invest in Kids 4.14.10
“ Working Together to Ensure Healthier Families.” [alternate title – “It Begins with Trust” Every year 500,000 children are born to first-time mothers who are from low-income households. [Presentation note: If applicable… Here in [state/community in which presentation is being made] that number is __________. I’m here today to talk with you about a unique community health program, Nurse-Family Partnership, that has been developed specifically to transform the lives of these first-time mothers and their children. These are tough times and we are all facing hard choices. As a result, we are all looking to invest in programs that work. I’m proud to say that Nurse-Family Partnership works - more than 30 years of randomized controlled clinical trials prove that it works, and a number of independent studies also show that the program can more than pay for itself.
Nurse-Family Partnership was developed over 30 years ago. Our founder, David Olds, was a young man who taught in an inner-city day-care center in the late 1970’s. That experience caused him to suspect that by age four or five some children who come from disadvantaged homes were already in trouble. He began to think hard about when to get involved to help these children and his investigation led him to develop a program for women like the one pictured here – first time mothers. I think you may have read the quote by now, which helps you to understand why Dr. Olds and our program are so committed to first-time mothers.
It’s important to know that this is a proven opportunity for you and your community. Before I go into the presentation, I want to start with four important points: We are an evidence-based community health program. This is important. We are in tough times and you need to know that with Nurse-Family Partnership you will invest in a program with more than 30 years of evidence that shows it WORKS! We transform the lives of our clients – first-time, low-income mothers. Mothers who work with their nurse will do better in school, improve their economic well-being and become an active and involved parent who is present for her child. We are unique in that each mother is partnered with a registered nurse who is trained in the exacting standards of NFP by the National Service Office. This unique relationship between nurse and mother begins early in her pregnancy and each mother receives ongoing visits that continue through her child’s second birthday. Finally, independent research shows that every dollar invested in Nurse-Family Partnership can yield as much as five dollars in return. (RAND corp. 2005)
This is a quote from an NFP in Pennsylvania. For those of us in the room who are mothers, and for any of us who are parents, I think this resonates. Having a first child is a remarkable experience, but it is not without anxiety. Women in the high-risk population we serve already face enormous challenges – including poverty, a dangerous physical environment, isolation, being young and lacking education. For them, the anxiety is even greater and the generational risk even more profound… What is remarkable about our nurses is that they establish a powerful relationship with each young mother that helps them transform their lives and connect with their children.
But why start during the first trimester when the mother is still pregnant with her first child? As this chart shows, during the first 30 months of a child’s life – the period in which Nurse-Family Partnership works with our clients – basic functions related to vision, hearing, and language develop, and it is during this time period that trained registered nurses can have a huge impact on both mother and child. Women can enroll in Nurse-Family Partnership as early in their pregnancy as they wish, but no later than their 28th week. By starting early in pregnancy, the nurse has time to develop a strong relationship with the mother and has time to work on improving the mother’s own health, and therefore the health of the newborn. Our program is intense – with up to 64 visits over the course of 30 months. Planned visits include: 14 visits during pregnancy; 28 visits during infancy; and 22 visits during toddlerhood.
Nurse-Family Partnership is a disciplined program. Every nurse receives extensive training to ensure that they focus on three goals: 1. Improve pregnancy outcomes: Help women practice sound health-related behaviors, including: obtaining good prenatal care from their healthcare provider; improving their diet; and reducing personal health behaviors that can affect a child such as the use of cigarettes, alcohol and illegal drugs. 2. Improve the child’s health and development: Help parents provide responsible and competent care for their children. 3. Improve families’ economic self-sufficiency: Help parents develop a vision for their own future, plan future pregnancies, continue their education and find jobs. The program features five program components essential to the successful implementation of the program: It begins with the clients we serve – first-time, low-income mothers. We focus on families with limited resources because they are more likely to experience increased risk factors. As I have noted, nurses are a central component and the intensive services they provide helps women to learn skills as well as acquire knowledge. Why nurses? Pregnant women have many questions and concerns about their health and the baby's health, and highly value the expertise that nurses can bring to them during this critical life transition. One nurse who works with us noted that many times our clients don’t understand what’s going on and they can be intimidated by a doctor. Working with their nurse on a continual basis allows them the time they need to build trust and ask questions. This relationship is an important part of our program’s success. Nurse-Family Partnership is a rigorous program. During each visit, a nurse collects information which is fed into a database that our national office in Denver maintains. This enables your local agency to monitor the program, using the information to ensure the same results that we have seen during the first 30 years are realized in your community. Visit-by-visit guidelines are also provided to help our nurses structure each engagement so that it adheres to key components of our program but remains adaptable to each family’s needs.
Home visits focus on six core areas beginning with the mother’s personal health and the maternal role. Nurses also work with mothers on issues that can affect their development and their child including environmental health issues and the influence of family and friends. Life course development focuses on the mother’s future, and nurses also help their clients navigate the health and human services system to take advantage of resources that can benefit both mother and child.
You have heard me talk a lot about the importance of evidence, and I think it’s worth taking time to make clear why evidence-based community health programs are important. 30 years of evidence from randomized, controlled trials prove that Nurse-Family Partnership works. The process that our founder David Olds followed is the same process used in the field of medicine. Well-designed randomized, controlled trials are an accepted research practice in medicine and are essential in producing valid, actionable evidence about what does and does not work. Medical breakthroughs that are the result of randomized, controlled trials include vaccines for polio, measles, and hepatitis B, as well as cancer treatments that have dramatically improved survival rates from leukemia, Hodgkin’s disease and breast cancer. For public health programs, evidence from clinical trials often is not required. This is changing as policymakers, public health officials and the communities they serve increasingly demand proven approaches for addressing public health. I’m here to tell you that if you invest in Nurse-Family Partnership, you can be assured of the value of your investment. With results from three randomized, controlled trials over three decades with diverse groups in Elmira, NY, Memphis, TN, and Denver, CO, Nurse-Family Partnership has set itself apart as one of the leading evidence-based programs in the country. In fact, NFP was just named one of only two “Top Tier” early childhood programs identified by the nonprofit, nonpartisan Coalition for Evidence-Based Policy as meeting the highest standards of scientific evidence [in case asked, the other progam is Success for All for grades K-2 (a school-wide reform program, primarily for high-poverty elementary schools, with a strong emphasis on reading instruction).]
This slide provides an overview of the three locations – Elmira, NY, Memphis, TN, and Denver, CO – where Dr. Olds conducted the randomized, controlled trials. The Elmira study was conducted through a community non-profit agency focused on promoting child development. This was a poor impoverished community with high rates of child abuse, and a mostly white population. The Memphis study was conducted through a county health department with African-American women. The Denver study included over 40% Hispanic women through a University outreach program in a highly fragmented health care system. Varied setting and populations were important to test the program carefully and assure replicability. Follow-up studies with participants from all three trials continue today - many of the children are now parents and grandparents themselves. Please see the website, Proven Results section for access to the published research.
We believe this slide helps to make clear why 30 years of evidence is important to you. Nurse-Family Partnership’s evidence and track record of successful replication of the program are why so many communities across the nation are confident that investing in NFP makes sense!
Let’s look at some specific outcomes from the trials: The first graph shows the results of children born to mothers in Memphis who had low psychological resources. The children had better reading and math achievement at age 9 than their counterparts who were not in the program. The graph on the right shows results from the Denver trial of children born to mothers who had low psychological resources – the children in the Denver trial who participated in the program showed better language development at age 4, making them better prepared to start school.
The children of mothers participating in the Memphis trial had fewer healthcare encounters for injuries and ingestions, including fewer days hospitalized in their first two years of life. The mothers also had greater intervals between births of first child and second child. The reduction in unplanned, closely-spaced pregnancies is extremely important in reducing risks for other negative outcomes such as child maltreatment and injuries, and enmeshment in poverty.
Nurse-visited mothers in the Memphis trial also spent fewer months using welfare and food stamps. Each study has been reevaluated and participants have undergone subsequent interviews and follow-ups to find out if the program effects seen while families were receiving home visits faded out once the program ended, or were sustained over time. The good news is that Nurse-Family Partnership is a program with lasting impact – the results of each follow-up study continue to show positive outcomes [Note to presenter: At the time of Memphis study, the assistance program was called “Aid to Families with Dependant Children” (AFDC); today it is known as TANF.]
These are indeed difficult times and we all need to make careful choices. As we consider how and where we should invest, I’d like to take some time to talk about the return on investment you can realize when you invest in Nurse-Family Partnership and bring the program to your community.
Nurse-Family Partnership benefits don’t end at the family-level. This slide shows the return on investment for communities that invest in NFP – and it shows why we serve the most vulnerable families. You can see that for lower risk families – those who are middle class, married and have other resources – NFP provides benefit. But look at the second group –higher risk families. An analysis conducted in 2005 by the Rand Corporation found a net benefit to society of $34,148 per higher-risk family served (high risk=low socioeconomic status and unmarried). That’s a return of $5.70 for each dollar spent on the program. For those higher-risk families, the analysis found that communities recovered the cost of the program by the time the child reached the age of four. And there were additional savings through the lives of both mother and child.
A study conducted by the Washington State Institute of Public Policy estimated a return on investment of more than $18,000 for each family enrolled, and a 1998 study by the Rand Corporation found that savings accrue in areas such as health care delivery, child protection, education, criminal justice, mental health and welfare and public assistance. In addition, communities also realize a benefit through increased taxes paid by employed parents. [Note to presenter: Various cost-benefit analyses have been conducted, and they often-times vary on the amount of total return estimated depending on which outcomes were monetized and included in the calculation.]
This information is from a 2008 report by the Pennsylvania State University that shows savings to Fayette County, as well as the entire state of Pennsylvania. The study estimates that the 25 Nurse-Family Partnership sites in operation in 2005 were collectively saving the state $119 million. The pie chart shows where those savings come from -- 74% from reductions in crime -- and another 24% of the savings come from the prevention of child abuse and neglect, and from education savings due to improvements in the children’s school readiness. It should be noted that this particular study focuses on criminal justice-related savings so it does not include savings from health care.
In a 2004 report the New York City Department of Health and Mental Hygiene, examined the cost savings they could reasonably project if they were to implement Nurse-Family Partnership at large scale. Using local statistics on health indicator and local costs, they concluded the program would be highly cost-effective and are now in a multi-year effort to bring Nurse-Family Partnership to thousands of New York City women living in poverty.
While Nurse-Family Partnership remains focused on the mothers we serve and the communities and agencies that partner with us, we are gaining increased attention at the national level. We believe this interest is part of an ongoing trend to identify and invest in community health programs that work and we welcome the chance to talk with you about how we can work together to benefit mothers and our community. Or as some might say – Nurse-Family Partnership is real change.
It’s important to note that one of the primary reasons we are successful is because of the agencies we work with. They are exceptional and all of our agency partners across the country share eight common characteristics: They have a strong reputation for serving low-income families They have excellent working relationships with referral sources and early childhood programs They are committed to innovation and to evidence-based programs They are committed to growing and expanding the program They are effective at recruiting and retaining nurses They are flexible and focused on enabling nurses to succeed They are financially strong and stable Finally, we work together well and share a strong alignment with mission and priorities
During the past 15 years, Nurse-Family Partnership has successfully expanded to communities throughout the U.S. In doing so, our National Service Office staff work with agencies to identify funding sources. That’s because public funding is essential if we are to reach every eligible mother. As this slide shows, states rely on highly varied funding streams from public and private organizations. We can get funding from many sources because we are an innovative community health program with profound broad benefits. While our most common funding stream is Medicaid – Nurse-Family Partnership has so much potential for positive impacts as children grow older, that we can tap a variety of public funding sources to support the program. In 2010, the National Service Office successfully advocated for federal funding with the help of NFP champions across the country, resulting in the historic Federal Maternal, Infant and Early Childhood Home Visiting Program created by Congress.
Our local agencies benefit from a close relationship with the National Service Office of Nurse-Family Partnership and its partners. This is a unique element of our program. Because we are evidence-based and feature a program that require rigorous and disciplined training, Nurse-Family Partnership has an office in Denver, Colorado with full-time staff that work to train and educate nurses, provide ongoing clinical support, and also provide operations support to agency partners. Support from the national service office includes a national database that allows us to ensure that the results in your community match up with the results we have documented from 30 years of randomized, controlled trials. This is important in that it helps the communities we serve to make clear to residents the benefit of a Nurse-Family Partnership.
Nurse-Family Partnership has had tremendous growth since the National Service Office was founded in 2003 with a mission of replicating the program in communities across the country. As of February 2013, Nurse-Family Partnership programs are in 42 states, the U.S. Virgin Islands and in more than 500 counties. But we have much work to do – approximately 600,000 children are born to eligible mothers every year. And while we have accomplished a lot, we still have a long way to go to make this program available to all eligible mothers.
So, here in [NAME GOES HERE] we currently serve… enter data as needed. Characteristics of our population include: LIST AS NEEDED
We are seeing tremendous success here in [COMMUNITY NAME]… Outcomes we have observed to date include: LIST AS NEEDED
In closing, I wanted to provide you with examples of other voices that endorse Nurse-Family Partnership. These include U.S. Senators and mayors… [we will create several versions of this slide with people of interest in specific areas of the country…]
They also include national and local media that have covered our success across the country. Samples of these articles, and other stories, are included in the packet I will give to you today. Also, we provide a News Center on our Web site that lists media coverage from around the country.
Finally, many agencies, organizations and independent “think tanks” have strongly endorsed Nurse-Family Partnership in recent years. Each of these organizations recommends Nurse-Family-Partnership because of our strong scientific foundation and our published findings. In short – they endorse Nurse-Family Partnership because it works.
Thank you for your time today – I welcome the chance to answer any questions you may have.