Tailored Nurse Support Program Promoting Positive Parenting and Family Preservation.
Samantha M Brown, Luke McConnell, Alicia Zelaya and 2 others
PMID 37104683WHAT IT FOUND
In matched low-income families, a nurse home-visiting program was not associated with fewer child protection referrals, open assessments, or confirmed assessments, but it was associated with fewer opened cases and fewer out-of-home placements.
Program families also improved on nurse-rated parenting.
Key findings
01Compared with matched comparison families, there were no significant differences in child protection referrals, open assessments, or founded assessments.
02Nurse Support Program families were significantly less likely than comparison families to have a child protection case opened or to have a child placed in out-of-home care.
03Within Nurse Support Program families, nurse-rated caretaking and parenting knowledge, behavior, and status improved from pre- to post-assessment.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was not randomized, so it cannot prove that the Nurse Support Program caused the differences. The program combined assessment, education, counseling, case management, care coordination, and family-focused practices, so the study cannot identify which part mattered. Only families who completed at least eight home visits were included, so results may not apply to families who drop out or attend fewer visits. Participation was voluntary, so families who stayed in the program may differ from families who did not. The sample was small and came from two counties in one U.S. region. Child protective services outcomes were followed for only 1 year. Families were matched only on child county, race/ethnicity, sex, and age, so other household or risk factors may differ. Parenting outcomes were measured before and after the program within the same families, with no matched comparison group. Caretaking and parenting outcomes were nurse-rated, and child protection outcomes came from administrative records, which may contain reporting biases.
Declared interests
The article is listed as NIH extramural research support, and the authors reported no conflicts of interest.
The easy way to misread this
Do not read the case-opening and placement findings as proof that the Nurse Support Program prevents child maltreatment or that any single program component caused the differences. Referrals, open assessments, and founded assessments did not differ, and the study was nonrandomized with only a 1-year follow-up.