Building Blocks 2-6

Evaluating the medium-term effectiveness, and the cost and consequences of the Family Nurse Partnership parenting support programme in reducing maltreatment in young children.

https://youtu.be/1Bw3Iurocfg

This study was designed to evaluate the medium-term effectiveness of the Family Nurse Partnership (FNP) programme. The FNP programme aims to support teenagers expecting their first child and has been shown to reduce child abuse and neglect in the longer term in US studies. There has previously been one evaluation of the FNP programme in England called Building Blocks Trial, but this only looked at the short term effectiveness, this followed mothers and their children until the child’s second birthday. The current study will follow up the same mothers and their children for a further five years until the child is 7 years old.

This study has used routine data to follow up mothers and children and has accessed the medical, education and social care records of the mothers and their children. All mothers were given the opportunity to opt-out of this study.

Members of the public were involved in the study in various ways. The main involvement came come from three groups:

• CASCADE Voices: a group of care-experienced young people
• ‘Our Place’ group: a network of young parents with young children
• ALPHA: a group of young people who advise researchers organised by Cardiff University.

These three groups represent broadly the participants who took part in the study, for example they are similar in age. These groups advised on a broad range of topics from study design to dissemination of the results. There is also an independent lay representative on the study steering committee (SSC).

Key outputs from these activities:

• input on the letters that were sent out to participants about this study
• animations about what routine data is and how it can be used for research
• highlighting the key concerns and benefits of using routine data for public health research.

Results

Key findings

When comparing families in receipt of specialist home visiting and those who did not:

• There were no differences in rates of children referred to social services, being registered as in need of additional support, receiving a child protection plan or entering care.
• There were no differences in rates of children attending or being admitted to hospital for injuries or having swallowed something, nor in how long they stayed in hospital if admitted.
• Children from families visited by a Family Nurse were more likely to achieve a good level of development at reception age. This effect was strengthened when we accounted for child’s month of birth.
• There were no statistically significant differences on educational measures at Key Stage 1. However, when we adjusted for a child’s month of birth, families visited by a Family Nurse were more likely to reach the expected standard in reading.

Report recommendations

• Where FNP remains locally commissioned, these new study results may inform client prioritisation.
• Why the programme appears to address some but not all of its intended outcomes needs to be further explored. This should take into account how its implementation in a UK setting has differed from its US origin and also recent adaptations introduced in England.
• Whether the benefits observed for children in their school life extend to their later school years should be assessed and the existing cohort of families remains well placed to achieve this.