The Family Nurse Partnership to reduce maltreatment and improve child health and development in young children: the BB:2 6 routine data-linkage follow-up to earlier RCT

Robling, Michael ORCID: https://orcid.org/0000-0002-1004-036X, Lugg-Widger, Fiona ORCID: https://orcid.org/0000-0003-0029-9703, Cannings-John, Rebecca ORCID: https://orcid.org/0000-0001-5235-6517, Sanders, Julia ORCID: https://orcid.org/0000-0001-5712-9989, Angel, Lianna, Channon, Sue ORCID: https://orcid.org/0000-0002-5394-1483, Fitzsimmons, Deborah, Hood, Kerenza ORCID: https://orcid.org/0000-0002-5268-8631, Kenkre, Joyce, Moody, Gwenllian ORCID: https://orcid.org/0000-0002-2000-4944, Owen-Jones, Eleri, Pockett, Rhys, Segrott, Jeremy ORCID: https://orcid.org/0000-0001-6215-0870, Slater, Thomas ORCID: https://orcid.org/0000-0003-3840-2454 and Jones, Eleri 2021. The Family Nurse Partnership to reduce maltreatment and improve child health and development in young children: the BB:2 6 routine data-linkage follow-up to earlier RCT. Public Health Research 9 , 2. 10.3310/phr09020

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Abstract

Background The short-term effectiveness (to 24 months post partum) of a preventative home-visiting intervention, the Family Nurse Partnership, was previously assessed in the Building Blocks trial (BB:0–2). Objectives The objectives were to establish the medium-term effectiveness of the Family Nurse Partnership in reducing maltreatment and improving maternal health (second pregnancies) and child health, developmental and educational outcomes (e.g. early educational attendance, school readiness); to explore effect moderators and mediators; and to describe the costs of enhancing usually provided health and social care with the Family Nurse Partnership. Design Children and their mothers from an existing trial cohort were followed up using routine data until the child was 7 years of age. Setting This study was set in 18 partnerships between local authorities and health-care organisations in England. Participants The participants were mothers [and their firstborn child(ren)] recruited as pregnant women aged ≤ 19 years, in local authority Family Nurse Partnership catchment areas, at < 25 weeks’ gestation, able to provide consent and able to converse in English. Participants mandatorily withdrawn (e.g. owing to miscarriage) from the BB:0–2 trial were excluded. Interventions The intervention comprised up to a maximum of 64 home visits by specially trained family nurses from early pregnancy until the firstborn child was 2 years of age, plus usually provided health and social care support. The comparator was usual care alone. Main outcome measures The primary outcome measure was child-in-need status recorded at any time during follow-up. The secondary outcomes were as follows: (1) referral to social services, child protection registration (plan), child-in-need categorisation, looked-after status, recorded injuries and ingestions at any time during follow-up; (2) early child care and educational attendance, school readiness (Early Years Foundation Stage Profile score) and attainment at Key Stage 1; and (3) health-care costs. Data sources The following data sources were used: maternally reported baseline and follow-up data (BB:0–2), Hospital Episode Statistics data (NHS Digital), social care and educational data (National Pupil Database) and abortions data (Department of Health and Social Care). Results There were no differences between study arms in the rates of referral to social services, being registered as a child in need, receiving child protection plans, entering care or timing of first referral for children subsequently assessed as in need. There were no differences between study arms in rates of hospital emergency attendance, admission for injuries or ingestions, or in duration of stay for admitted children. Children in the Family Nurse Partnership arm were more likely to achieve a good level of development at reception age (school readiness), an effect strengthened when adjusting for birth month. Differences at Key Stage 1 were not statistically different, but, after adjusting for birth month, children in the Family Nurse Partnership arm were more likely to reach the expected standard in reading. Programme effects were greater for boys (Key Stage 1: writing); children of younger mothers (Key Stage 1: writing, Key Stage 1: mathematics); and children of mothers not in employment, education or training at study baseline (Key Stage 1: writing). There were no differences between families who were part of the Family Nurse Partnership and those who were not for any other outcome. The differences between study arms in resource use and costs were negligible.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Social Sciences (Includes Criminology and Education) Healthcare Sciences Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer) Centre for Trials Research (CNTRR)
Publisher:	NIHR Journals Library
ISSN:	2050-4381
Date of First Compliant Deposit:	13 October 2021
Last Modified:	05 Jan 2024 03:34
URI:	https://orca.cardiff.ac.uk/id/eprint/144804

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