Implementation of the Family Nurse Partnership programme in England: experiences of key health professionals explored through trial parallel process evaluation.

Authors:
J Sanders
J Sanders
The Netherlands Cancer Institute
Netherlands
Sue Channon
Sue Channon
Cardiff University
United Kingdom
Nina Gobat
Nina Gobat
Cochrane Institute of Primary Care and Public Health
Kristina Bennert
Kristina Bennert
Cardiff University
United Kingdom
Katy Addison
Katy Addison
School of Medicine
Mike Robling
Mike Robling
Cardiff University
United Kingdom

BMC Nurs 2019 2;18:13. Epub 2019 Apr 2.

2Centre for Trials Research, Cardiff University, Cardiff, CF14 4YS UK.

Background: The Family Nurse Partnership (FNP) programme was introduced to support young first-time mothers. A randomised trial found FNP added little short-term benefit compared to usual care. The study included a comprehensive parallel process evaluation, including focus groups, conducted to aid understanding of the introduction of the programme into a new service and social context. The aim of the focus groups was to investigate views of key health professionals towards the integration and delivery of FNP programme in England.

Methods: Focus groups were conducted separately with Family Nurses, Health Visitors and Midwives at trial sites during 2011-2012. Transcripts from audio-recordings were analysed thematically.

Results: A total of 122 professionals participated in one of 19 focus groups. Family Nurses were confident in the effectiveness of FNP, although they experienced practical difficulties meeting programme fidelity targets and considered that programme goals did not sufficiently reflect client or community priorities. Health Visitors and Midwives regarded FNP as well-resourced and beneficial to clients, describing their own services as undervalued and struggling. They wished to work closely with Family Nurses, but felt excluded from doing so by practical barriers and programme protection.

Conclusion: FNP was described as well-resourced and delivered by highly motivated and well supported Family Nurses. FNP eligibility, content and outcomes conflicted with individual client and community priorities. These factors may have restricted the potential effectiveness of a programme developed and previously tested in a different social milieu. Building Blocks ISRCTN23019866 Registered 20/04/2009.

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Source
http://dx.doi.org/10.1186/s12912-019-0338-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6444391PMC
April 2019
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