Implementation of the Nurse Family Partnership Program in Pima County Rural Communities

Abstract

The Nurse Family Partnership (NFP) program is a home visitation program that targets low income parents expecting their first child. With the nurse delivering services, the program is designed to facilitate positive changes that improve health outcomes for the woman and her baby. Despite successful program implementation in mostly urban communities across the United States, obstacles exist to implement Nurse Family Partnership in rural communities. The purpose of this practice inquiry was to collaborate with Pima County Health Department and Nurse Family Partnership to evaluate the feasibility of implementing the Nurse Family Partnership program in Pima County rural communities. As part of this practice inquiry collaboration, the first aim completed a community assessment of Arivaca to identify rural community strengths and potential barriers to implementation and thus serve as an implementation prototype for Pima County Health Department. Descriptive statistics were utilized from the Arizona Department of Health Services Arizona Vital Statistics, U.S. Census Bureau, and Arizona Department of Health Services needs assessment data sets to assess population characteristics and the Nurse Family Partnership eligible population in Arivaca. Additionally, a windshield survey was conducted to assess community referral capacity and/or program champions, existing public/community health programs or services linkages, and issues due to rurality such as transportation challenges and driving time/distances. The second practice inquiry aim developed an implementation plan, including an evaluation component, alongside Pima County Health Department that expands Nurse Family Partnership into additional rural communities in Pima County. The Nurse Family Partnership implementation plan template was utilized to identify community need and population characteristics, Pima County Health Department mission and culture, organization capacity, nursing practice and support, community linkages, sustainability, and financing and fiscal policy support. Descriptive statistics were utilized from the Arizona Department of Health Services Arizona Vital Statistics, U.S. Census Bureau, and Arizona Department of Health Services needs assessment data sets to describe a community profile to complete the Nurse Family Partnership implementation plan template. This practice inquiry demonstrated that completion of a windshield survey and review of descriptive data sets in the proposed service areas helps to identify community referral capacity and/or program champions, existing public/community health programs or services linkages, and issues due to rurality. This process can be used as a prototype for Pima County Health Department prior to implementation in the entire proposed service area.