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Table 1 Canadian NFP model elements

From: British Columbia Healthy Connections Project process evaluation: a mixed methods protocol to describe the implementation and delivery of the Nurse-Family Partnership in Canada

Element Description
1 Client participates voluntarily in the NFP.
2 Client is a first-time mother.
3 Client meets socioeconomic disadvantage criteria at intake.
4 Client is enrolled in the program early in her pregnancy and receives her first home visit no later than the end of week 28 of pregnancy.
5 Client is visited one-to-one, one public health nursea to one first-time mother or family.
6 Client is visited in her home.
7 Client is visited throughout her pregnancy and the first two years of her child’s life in accordance with the current NFP guidelines.
8 Public health nurses and nurse supervisors are registered professional nurses with a minimum of a baccalaureate degree in nursing.
9 Public health nurses and nurse supervisors complete core educational sessions required by the NFP National Service Office and deliver the intervention with fidelity to the NFP model.
10 Public health nurses, using professional knowledge, judgment, and skill, apply the NFP visit guidelines, individualizing them to the strengths and challenges of each family and apportioning time across defined program domains.
11 Public health nurses apply the theoretical framework that underpins the program, emphasizing self-efficacy, human ecology, and attachment theories, through current clinical methods.
12 A full-time public health nurse carries a caseload of no more than 20b active clients.
13 A full-time nurse supervisor provides supervision to no more than eight public health nurses.
14 Nurse supervisors provide public health nurses clinical supervision with reflection, demonstrate integration of the theories, and facilitate professional development essential to the nurse home visitor role through specific supervisory activities including one-to-one clinical supervision, case conferences, team meetings, and field supervision.
15 Public health nurses and nurse supervisors collect data as specified by the NFP National Service Office (or provincial equivalents) and use NFP reports to guide their practice, assess and guide program implementation, inform clinical supervision, enhance program quality, and demonstrate program fidelity.
16 A NFP implementing agency is located in and operated by a public health agency known in the community for being a successful provider of prevention services to low-income families.
17 A NFP implementing agency convenes a long-term community advisory board that meets at least quarterly to promote a community support system to the program and to promote program quality and sustainability.
18 Adequate support and structure shall be in place to support public health nurses and supervisors to implement the program. Adequate administrative support should also be in place to assure that data are accurately entered into the database in a timely manner.
  1. Adapted from Nurse-Family Partnership [5] aIn the Canadian NFP model elements, the term public health nurse replaces the US term of nurse home visitor
  2. bBased on results of the Canadian NFP acceptability/feasibility study [8], the standard caseload in Canada was reduced to 20 clients, compared to 25 clients in the US based on differences in annual allowable vacation, length of work-week and client risk levels