Prevention Research Center for Family & Child Health, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA.
University of South Florida, College of Public Health, Tampa, FL, 33612, USA.
Matern Child Health J. 2024 Feb;28(2):333-343. doi: 10.1007/s10995-023-03839-6. Epub 2023 Nov 21.
Evidence-based home visiting programs are designed to improve maternal child health. Nurse-Family Partnership (NFP) is a model evidence-based home visiting program, shown to improve pregnancy outcomes, child development, and economic self-sufficiency for first-time mothers and their families experiencing social and economic adversities, enrolling them early in pregnancy. Recently, NFP has expanded its services to multiparous women (previous live births) and enrolling women past 28 weeks gestation (late registrants) in selected agencies in Florida since 2021.
To study the process and impacts of expanding NFP to expanded populations (multiparous and/or late registrants), we convened a diverse Advisory Committee to guide the NFP expansion evaluation in Florida.
This study employed a modified e-Delphi method with three rounds of data collection, to engage diverse partners to identify process and impact outcomes for the NFP expansion evaluation.
Child maltreatment was identified as the highest priority outcome. Process outcomes included program reach, client enrollment, and client engagement, while impact outcomes included maternal physical health, maternal mental health and substance use, birth outcomes, and breastfeeding practices. The Advisory Committee further identified potential data sources to measure these outcomes.
Identifying and selecting key process and impact outcomes using a community-engaged process is necessary to ensure equal buy-in from all partners and to inform rigorous program evaluation. This study showed that using methods such as e-Delphi is feasible and effective for achieving thoughtful and rigorous decision-making, even in times of uncertainty like the COVID-19 pandemic.
循证家庭访视项目旨在改善母婴健康。 护士家庭伙伴关系（NFP）是一种循证家庭访视模式，已被证明可以改善初次生育的母亲及其家庭的妊娠结局、儿童发育和经济自给自足能力，使她们在妊娠早期就能获得服务。 最近，自 2021 年以来，NFP 将其服务扩展到多胎妇女（以前有过活产）和在佛罗里达州的一些机构招募怀孕 28 周以上的妇女（晚期注册者）。
为了研究将 NFP 扩展到扩大的人群（多胎和/或晚期注册者）的过程和影响，我们召集了一个多元化的顾问委员会，指导佛罗里达州的 NFP 扩展评估。
本研究采用改良的电子德尔菲法进行三轮数据收集，以吸引多元化的合作伙伴，为 NFP 扩展评估确定过程和影响结果。
儿童虐待被确定为最高优先结果。 过程结果包括项目覆盖范围、客户注册和客户参与度，而影响结果包括产妇身体健康、产妇心理健康和物质使用、分娩结果和母乳喂养实践。 顾问委员会进一步确定了潜在的数据源来衡量这些结果。
使用社区参与的过程确定和选择关键的过程和影响结果对于确保所有合作伙伴的平等参与以及为严格的项目评估提供信息是必要的。 本研究表明，即使在像 COVID-19 大流行这样的不确定时期，使用电子德尔菲等方法也是可行且有效的，可以实现深思熟虑和严格的决策。
