Jack Susan M, Sheehan Debbie, Gonzalez Andrea, MacMillan Harriet L, Catherine Nicole, Waddell Charlotte
School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON Canada L8S 4K1.
Children's Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, Room 2400, 515 West Hastings Street, Vancouver, BC V6B 5K3 Canada.
BMC Nurs. 2015 Sep 17;14:47. doi: 10.1186/s12912-015-0097-3. eCollection 2015.
The Nurse-Family Partnership is a home visitation program for first-time, socially and economically disadvantaged mothers. The effectiveness of this public health intervention has been well established in the United States; however, whether the same beneficial outcomes will be obtained within the Canadian context is unknown. As part of the British Columbia Healthy Connections Project, which includes a trial comparing Nurse-Family Partnership's effectiveness with existing services in British Columbia, we are conducting a process evaluation to describe and explain how the intervention is implemented and delivered across five regional Health Authorities.
A convergent parallel mixed methods research design will be used to address the process evaluation objectives. The principles of interpretive description will guide all sampling, data collection and analytic decisions in the qualitative component of the study. The full population of public health nurses and supervisors (n = 71) will discuss their experiences of implementing and delivering the program in interviews (or focus groups). Managers (n = 5-15) responsible for this portfolio will also be interviewed annually. Fidelity reports with quantitative data on the reach and the dose of the intervention will be collected and analyzed. Summaries of team meetings and supervisory sessions will be analyzed. Data will be used to compare, corroborate and explain results and variances across the five regional Health Authorities.
The process evaluation results will be of immediate instrumental use to the program implementers to inform intervention delivery. Findings will contribute to the emerging body of evidence surrounding: 1) professional nurse home visitation practice issues; 2) best practices for meeting the needs of families living in rural and remote communities; 3) a deeper understanding of how health and social issues such as mental health problems including substance misuse and exposure to intimate partner violence affect a young mother's capacity to parent; and 4) strategies to support professionals from the primary care, public health and child welfare sectors to work collaboratively to meet the needs of children and families who are at risk or experiencing maltreatment.
护士-家庭伙伴关系项目是一项针对首次生育、社会经济地位不利的母亲的家访计划。这种公共卫生干预措施在美国的有效性已得到充分证实；然而，在加拿大背景下是否会取得同样有益的结果尚不清楚。作为不列颠哥伦比亚省健康联系项目的一部分，该项目包括一项比较护士-家庭伙伴关系与不列颠哥伦比亚省现有服务有效性的试验，我们正在进行一项过程评估，以描述和解释该干预措施如何在五个地区卫生当局实施和提供。
将采用收敛平行混合方法研究设计来实现过程评估目标。解释性描述原则将指导研究定性部分的所有抽样、数据收集和分析决策。全体公共卫生护士和主管（n = 71）将在访谈（或焦点小组）中讨论他们实施和提供该项目的经验。负责该项目组合的管理人员（n = 5 - 15）也将每年接受访谈。将收集和分析包含干预措施覆盖范围和剂量定量数据的保真度报告。将分析团队会议和监督会议的总结。这些数据将用于比较、证实和解释五个地区卫生当局的结果和差异。
过程评估结果将对项目实施者立即产生实际作用，为干预措施的实施提供信息。研究结果将有助于丰富围绕以下方面的证据体系：1）专业护士家访实践问题；2）满足农村和偏远社区家庭需求的最佳实践；3）更深入了解诸如包括药物滥用和遭受亲密伴侣暴力在内的心理健康问题等健康和社会问题如何影响年轻母亲的育儿能力；4）支持初级保健、公共卫生和儿童福利部门的专业人员合作以满足处于风险或遭受虐待的儿童和家庭需求的策略。
