Advertisement

Prevention Science

, Volume 19, Issue 4, pp 516–527 | Cite as

Visit Attendance Patterns in Nurse-Family Partnership Community Sites

  • Margaret L. Holland
  • David L. Olds
  • Ann M. Dozier
  • Harriet J. Kitzman
Article

Abstract

We examined visit attendance patterns of mothers enrolled in the Nurse-Family Partnership (NFP) home visitation program and associations between these patterns and characteristics of the families and sites, with the goal of increasing participant engagement. We utilized repeated measures latent class analysis to identify attendance patterns among 66,967 mothers in NFP sites across the USA. Mothers enrolled from 1996 to 2010. Data were collected by home visitors and aggregated by the NFP National Service Office. Five visit attendance patterns were identified. Consistent attenders (22%) remained engaged for the full program and attended 51.3 visits on average. Inconsistent attenders (9%) remained engaged but missed many visits, with an average of 36.4 visits. The remaining patterns were characterized by when participants left the program: early (28%; 6.7 visits), gradually (27%; 19.4 visits), or late (15%; 35.3 visits). Consistent and inconsistent attenders were less likely to use English as their primary language than other participants (R = 0.12; p < .001). Participants with more nurse changes per visit attended were more likely to drop out early (R = 0.11; p < .001). Sites with a higher percent of missing data had smaller portions of mothers who remained consistently engaged in the program over time (b = − 0.032; p < .01) and greater portions in the late (b = 0.007; p < .04) and gradual attrition classes (b = 0.018; p < .01). The large number of participants who dropped out early is concerning. Further exploration of this group may optimize use of resources by improving either retention or targeting of potential participants.

Keywords

Home visiting Attrition Retention Dose 

Notes

Compliance with Ethical Standards

Funding

Dr. Holland acknowledges funding from the University of Rochester CTSA award number KL2 RR024136 from the National Center for Research Resources and the National Center for Advancing Translational Sciences of the National Institutes of Health. Dr. Olds and Dr. Kitzman report grants from the US National Institute of Mental Health and the US Office of Juvenile Justice and Delinquency Prevention, during the conduct of the study. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Conflict of Interest

The Prevention Research Center for Family and Child Health, directed by Dr. Olds at the University of Colorado School of Medicine, has a contract with the Nurse-Family Partnership (NFP) to conduct research to improve the NFP program and its implementation. Dr. Olds was employed by this center at the time the study was conducted. Dr. Olds is the founder of the NFP.

Ethical Approval

This study was approved by the University of Rochester Research Subjects Review Board. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

All program participants provide consent for their data to be used for purposes of program improvement.

Supplementary material

11121_2017_829_MOESM1_ESM.docx (26 kb)
Supplementary Table 1 (DOCX 26 kb).
11121_2017_829_MOESM2_ESM.docx (28 kb)
Supplementary Table 2 (DOCX 27 kb).

References

  1. Andersen, R. M. (1995). Revisiting the behavioral-model and access to medical-care—Does it matter. Journal of Health and Social Behavior, 36, 1–10.CrossRefPubMedGoogle Scholar
  2. Baker, C., Arnold, D., & Meagher, S. (2011). Enrollment and attendance in a parent training prevention program for conduct problems. Prevention Science, 12, 126–138. doi: 10.1007/s11121-010-0187-0.CrossRefPubMedGoogle Scholar
  3. Barlow, A., Mullany, B., Neault, N., Goklish, N., Billy, T., Hastings, R., et al. (2015). Paraprofessional-delivered home-visiting intervention for American Indian teen mothers and children: 3-year outcomes from a randomized controlled trial. American Journal of Psychiatry, 172, 154–162.CrossRefPubMedGoogle Scholar
  4. Brand, T., & Jungmann, T. (2014). Participant characteristics and process variables predict attrition from a home-based early intervention program. Early Childhood Research Quarterly, 29(2), 155–167.CrossRefGoogle Scholar
  5. Bumbarger, B., & Perkins, D. (2008). After randomised trials: Issues related to dissemination of evidence-based interventions. Journal of Children’s Services, 3, 55–64.CrossRefGoogle Scholar
  6. Coatsworth, J., Duncan, L., Pantin, H., & Szapocznik, J. (2006). Patterns of retention in a preventive intervention with ethnic minority families. Journal of Primary Prevention, 27, 171–193. doi: 10.1007/s10935-005-0028-2.CrossRefPubMedPubMedCentralGoogle Scholar
  7. Collins, L. M., & Lanza, S. T. (2010). Chapter 7: RMLCA and LTA latent class and latent transition analysis with applications in the social, behavioral, and health sciences (pp. 181–224). Hoboken: Wiley.Google Scholar
  8. Foulon, S., Greacen, T., Pasquet, B., Dugravier, R., Saias, T., Guedeney, N., et al., CAPEDP Study Group. (2015). Predictors of study attrition in a randomized controlled trial evaluating a perinatal home-visiting program with mothers with psychosocial vulnerabilities. PLoS One, 10(11), e0142495.Google Scholar
  9. Goldberg, J., Bumgarner, E., & Jacobs, F. (2016). Measuring program- and individual-level fidelity in a home visiting program for adolescent parents. Evaluation and Program Planning, 55, 163–173.CrossRefPubMedGoogle Scholar
  10. Haskins, R., Paxson, C., & Brooks-Gunn, J. (2009). Social science rising: A tale of evidence shaping public policy. The Future of Children, 19(2), 1–7.Google Scholar
  11. Holland, M. L., Christensen, J. J., Shone, L. P., Kearney, M. H., & Kitzman, H. J. (2014a). Women’s reasons for attrition from a nurse home visiting program. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 43, 61–70. doi: 10.1111/1552-6909.12263.CrossRefPubMedGoogle Scholar
  12. Holland, M. L., Xia, Y., Kitzman, H. J., Dozier, A. M., & Olds, D. L. (2014b). Patterns of visit attendance in the Nurse–Family Partnership program. American Journal of Public Health, 104, e58–e65. doi: 10.2105/AJPH.2014.302115.
  13. Ingoldsby, E. M., Baca, P., McClatchey, M. W., Luckey, D. W., Ramsey, M. O., Loch, J. M., et al. (2013). Quasi-experimental pilot study of intervention to increase participant retention and completed home visits in the Nurse-Family Partnership. Prevention Science, 14, 525–534. doi: 10.1007/s11121-013-0410-x.
  14. Kitzman, H., Olds, D. L., Henderson Jr., C. R., Hanks, C., Cole, R., Tatelbaum, R., et al. (1997). Effect of prenatal and infancy home visitation by nurses on pregnancy outcomes, childhood injuries, and repeated childbearing. A randomized controlled trial. JAMA, 278, 644–652.CrossRefPubMedGoogle Scholar
  15. Korfmacher, J., O’Brien, R., Hiatt, S., & Olds, D. (1999). Differences in program implementation between nurses and paraprofessionals providing visits during pregnancy and infancy: A randomized trial. American Journal of Public Health., 89, 1847–1851.CrossRefPubMedPubMedCentralGoogle Scholar
  16. Nurse-Family Partnership. (2015). Nurse-family partnership snapshot. Retrieved Nov. 6, 2015, from http://www.nursefamilypartnership.org/getattachment/about/fact-sheets/NFP_October_2015_Snapshot.pdf.aspx.
  17. O’Brien, R. A., Moritz, P., Luckey, D. W., McClatchey, M. W., Ingoldsby, E. M., & Olds, D. L. (2012). Mixed methods analysis of participant attrition in the nurse-family partnership. Prevention Science, 13, 219–228. doi: 10.1007/s11121-012-0287-0.CrossRefPubMedPubMedCentralGoogle Scholar
  18. Olds, D. L., Eckenrode, J., Henderson, C. R., Kitzman, H., Powers, J., Cole, R., & Luckey, D. (1997). Longterm effects of home visitation on maternal life course and child abuse and neglect: Fifteen-year follow-up of a randomized trial. Journal of the American Medical Association, 278(8), 637–643.Google Scholar
  19. Olds, D. L., & Korfmacher, J. (1998). Maternal psychological characteristics as influences on home visitation contact. Journal of Community Psychology, 26, 23–36. doi: 10.1002/(Sici)1520-6629(199801)26:1<23::Aid-Jcop3>3.0.Co;2-2.CrossRefGoogle Scholar
  20. Olds, D. L., Henderson Jr., C. R., Tatelbaum, R., & Chamberlin, R. (1986). Improving the delivery of prenatal care and outcomes of pregnancy: A randomized trial of nurse home visitation. Pediatrics, 77, 16–28.PubMedGoogle Scholar
  21. Olds, D. L., Robinson, J., O’Brien, R., Luckey, D. W., Pettitt, L. M., Henderson Jr., C. R., et al. (2002). Home visiting by paraprofessionals and by nurses: A randomized, controlled trial. Pediatrics, 110, 486–496.CrossRefPubMedGoogle Scholar
  22. Olds, D. L., Hill, P. L., O’Brien, R., Racine, D., & Moritz, P. (2003). Taking preventive intervention to scale: The nurse-family partnership. Cognitive and Behavioral Practice, 10(4), 278–290.CrossRefGoogle Scholar
  23. Olds, D. L., Baca, P., McClatchey, M., Ingoldsby, E. M., Luckey, D. W., Knudtson, M. D., et al. (2015). Cluster randomized controlled trial of intervention to increase participant retention and completed home visits in the nurse-family partnership. Prevention Science, 16, 778–788.CrossRefPubMedGoogle Scholar
  24. Paulsell, D., Del Grosso, P., & Supplee, L. (2014). Supporting replication and scale-up of evidence-based home visiting programs: Assessing the implementation knowledge base. American Journal of Public Health, 104, 1624–1632. doi: 10.2105/AJPH.2014.301962.CrossRefPubMedPubMedCentralGoogle Scholar
  25. Pearlin, L. I., & Schooler, C. (1967). The structure of coping. Journal of Health and Social Behavior, 19, 2–21.CrossRefGoogle Scholar
  26. Raikes, H., Green, B. L., Atwater, J., Kisker, E., Constantine, J., & Chazan-Cohen, R. (2006). Involvement in early head start home visiting services: Demographic predictors and relations to child and parent outcomes. Early Childhood Research Quarterly, 21, 2–24. doi: 10.1016/j.ecresq.2006.01.006.CrossRefGoogle Scholar
  27. Rhodes, S. D., Simán, F. M., Mann, L., Song, E., Alono, J., Downs, M., et al. (2015). The impact of local immigration enforcement policies on the health of immigrant Hispanics/Latinos in the United States. American Journal of Public Health, 105, 329–337.CrossRefPubMedPubMedCentralGoogle Scholar
  28. Royston, P. (2005). Multiple imputation of missing values: Update of ice. The Stata Journal, 5, 527–536.Google Scholar
  29. Wagner, M., Spiker, D., Gerlach-Downie, S., & Hernandez, F. (2000). Parental engagement in home visiting programs—Findings from the Parents as Teachers multisite evaluation. Menlo Park: SRI International.Google Scholar

Copyright information

© Society for Prevention Research 2017

Authors and Affiliations

  • Margaret L. Holland
    • 1
  • David L. Olds
    • 2
  • Ann M. Dozier
    • 3
  • Harriet J. Kitzman
    • 4
  1. 1.School of NursingYale UniversityOrangeUSA
  2. 2.Department of PediatricsUniversity of Colorado DenverAuroraUSA
  3. 3.Department of Public Health SciencesUniversity of RochesterRochesterUSA
  4. 4.University of Rochester School of NursingRochesterUSA

Personalised recommendations