A Qualitative Evaluation of Engagement and Attrition in a Nurse Home Visiting Program: From the Participant and Provider Perspective

Lana O. Beasley
,
Leigh E. Ridings
,
Tyler Smith
,
Jennifer D. Shields
,
Jane F. Silovsky
,
William Beasley

University of Oklahoma
,
Medical University of South Carolina
,
University of Washington
,
Oklahoma State University

Research Output:

Contribution to journal

Article

Peer-review

Abstract

Beginning parenting programs in the prenatal and early postnatal periods have a large potential for impact on later child and maternal outcomes. Home-based parenting programs, such as the Nurse Family Partnership (NFP), have been established to help address this need. Program reach and impact is dependent on successful engagement of expecting mothers with significant risks; however, NFP attrition rates remain high. The current study qualitatively examined engagement and attrition from the perspectives of NFP nurses and mothers in order to identify mechanisms that enhance service engagement. Semi-structured interviews were conducted in focus groups composed of either engaged (27 total mothers) or unengaged (15 total mothers) mothers from the NFP program. NFP nurses (25 total nurses) were recruited for individual semi-structured interviews. Results suggest that understanding engagement in the NFP program requires addressing both initial and sustained engagement. Themes associated with enhanced initial engagement include nurse characteristics (e.g., flexible, supportive, caring) and establishment of a solid nurse-family relationship founded on these characteristics. Factors impacting sustained engagement include nurse characteristics, provision of educational materials on child development, individualized services for families, and available family support. Identified barriers to completing services include competing demands and lack of support. Findings of this study have direct relevance for workforce planning, including hiring and training through integrating results regarding effective nurse characteristics. Additional program supports to enhance parent engagement may be implemented across home-based parenting programs in light of the current study’s findings.

Access to documents

10.1007/s11121-017-0846-5

Bibliographic Information

Output type

Research Output:

Contribution to journal

Article

Peer-review

Original language

American English

Pages from-to (Number of pages)

Pages 528-537

Journal (Volume, Issue Number)

Prevention Science

Publication milestones

Published - 10/2017

Publication status

Published - 10/2017

ISSN

1389-4986

Publication IDs

Scopus: 85031107606