Prevention Through Parenting (part 1) Flashcards
What is Nurse Family Partnership [NFP]?
Home visiting during pregnancy and through Childs second year
What are the benefits of an NFP?
- Improve parental health
- reduce child neglect and abuse
- reduce developmental/ behavioral dysregulation
- Enhance family functioning and parents’ self sufficiency
- decrease likelihood of violence behavior, criminality, and conduct disorder
What is the ecological theory guiding NFP?
-Ecological model: Parenting influenced by social networks,
neighborhoods, culture; Nurses attempt to enhance social environment
What is the Self-efficacy theory guiding NFP?
- Self-efficacy : Parents play a role in selecting and shaping environments and experiences; Nurses help with parents build capacities and confidence to set and achieve goals
What is the Attachment theory guiding NFP?
- Attachment theory: Attachment is key developmental milestone and is dependent on quality of early care; Nurses help enhance
parental sensitivity
Who is NFP for and why?
- For Low-income, first time-mothers often single, young mothers
- Higher rates of problems that NFP is designed to address
(poor birth outcomes, child maltreatment, risk for later
child anti-social behavior) - Receptive to services
- Likely to apply skills to subsequent children
Who are the visitors and what is the frequency of visits in an NFP design?
- Visitors- Nurses with training in women’s and children’s health
- Visitation Enrolled at end of second trimester
Frequency of visits:
- 6-10 visits during last trimester (up to 18)
- 24-30 visits in infancy until age 2 (up to 70)
- 75 to 90-minute visits
What are the goals of NFP?
- Improve outcomes of pregnancy by improving prenatal health
- Improve children’s subsequent health and development by helping parents provide mode competent care
- Improve parents’ life-course by helping them develop goals and make smart choices
What are the content of each NFP session?
- Detailed visit-by-visit guidelines targeting challenges of specific stages of pregnancy and first two years of life
- Assessment tools help guide activities
- Flexible and tailored to needs of family
What are some Sample topics/activities during pregnancy?
- Track diet and weight gains
-Behavior change strategies for risky health behaviors
(e.g., smoking)
-Education about signs of pregnancy complications
-Coordination of care with physicians
- Planning for delivery
What are some Sample topics/activities during infancy
- Observe and access help for child health
- Facilitate sensitive parent-child interactions
- Education about young children’s signals
- Activities to support parents ’engagement with children
What were some randomized clinical trials regarding NFP?
- Elmira, NY beginning in1977
- Memphis, TN beginning in 1990
- Denver, CO beginning in 1994
What were some of the findings of the NFP research?
- Reduced rates of child abuse and neglect
- Maintained differences in perpetrator abuse rates between 4- to 15-year follow-up
- Seen 32% fewer times in emergency rooms
- 56% reduction in injuries and ingestions
What does the NFP research say regarding Prenatal health behaviors?
- Reduction in smoking
- Greater social support, better use of community services
What does the NFP research say regarding Pregnancy and birth outcomes?
- Fewer pre-term deliveries
- Heavier babies
What does the NFP research say regarding Quality of parental care?
- Less punishment, more appropriate play, greater safety
What does the NFP research say regarding Child outcomes?
- 6 months: Less irritable and fussy
- Higher intellectual functioning
- Fewer behavior problems
- 15 year follow-up: Fewer arrests, fewer sexual partners
What does the NFP research say regarding Parent life-course?
- Fewer subsequent pregnancies
- Fewer months on welfare
- Fewer problems related to substance abuse
- Fewer arrests
What was the economic analysis regarding NFP?
- Costs $11,000 per family (for 2.5 years of services)
- Saves $17,000 per family
- Unlike Triple P, NFP recommends specifically targeting the most vulnerable families
- Results show that these families benefit the most
- More intensive program, so may not be practical to disseminate services as broadly as Triple P (and may actually dilute effects to try!)
Who authored the Attachment and Bio-behavioral catch-up?
Developer: Mary Dozier, University of Delaware
What are the 3 key challenges of ABC?
- Children are at risk for disorganized attachment when the
parent is the source of fear - Children who experience early adversity are at risk for problems regulating behavior and psychopathology
- Due to their own histories of trauma and current stress, parents are more likely to react in harsh and negative ways
What is ABC?
- Attachment and Bio-behavioral Catch-up (Dozier & Infant Caregiver Project Lab)
- Preventative intervention for infants and toddlers exposed to early adversity
- Target behaviors:
- Increase following the lead
-Increase nurturance to distress - Decrease frightening behavior
Why is ABC kept brief?
- Meta-analytic evidence shows that shorter-term
interventions are MORE effective than longer-term
interventions for changing parenting - Even for multi-risk families
Why is ABC conducted at home?
- Meet families where they are
- Reducing barriers to access
- Increase real-world nature, there by increasing
generalizability of skills
What do sessions 1 and 2 focus on? ABC
- providing nurturance
What do sessions 3 and 4 focus on? ABC
- Following the child’s lead
What do sessions 5 and 6 focus on? ABC
- reducing frightening behavior
What do sessions 7 and 8 focus on? ABC
- recognizing issues that get in the way
What do sessions 9 and 1O focus on? ABC
- consolidation and celebration
How does behavior change in video feedback?
- Review of parent-child interactions
-Opportunity to praise and support successes, as well as
gently challenge weaknesses
How does behavior change in, in the moment feedback?
- Coaching parents by providing feedback on moment-to-moment interactions
- Seems to be the key to success, data are showing that this is the mechanism for changing behavior
