A qualitative study of effective collaboration among nurse home visitors, healthcare providers and community support services in the United States

Abstract

Collaboration across sectors is needed to improve community health, but little is known about collaborative activities among public health prevention programs. Using the Nurse-Family Partnership® (NFP) home visiting program as context, this qualitative study aimed to describe effective collaboration among nurse home visitors, healthcare providers and community support services to serve families experiencing social and economic adversities. We used grounded theory to characterise collaboration with six purposively sampled NFP sites in the United States through in-depth interviews. We interviewed 73 participants between 2017 and 2019: 50 NFP staff, 18 healthcare providers and 5 other service providers. Interviews were recorded, transcribed, validated and analysed in NVivo 11. Validation steps included intercoder consistency checks and expert review. Thematic memos were synthesised across sites. Most participants perceived collaboration to be important when serving families with complex needs, but substantial variation existed in the degree to which NFP nurses collaborate with providers dependent on provider type and community context. Factors that contributed to effective collaboration were relational in nature, including leadership commitment and provider champions, shared perceptions of trust, respect and value, and referral partnerships and outreach; organisational in terms of mission congruence between providers; and structural such as policy and system integration that facilitated data sharing and communication channels. These findings provide greater insights into effective cross-sector collaboration and care coordination for families experiencing adversities. Collaboration across sectors to promote health among families experiencing adversities requires intentional efforts by all inter-professional providers and continued commitment among all levels of leadership to coordinate services.

Changes in cross‐sector collaboration between nurse home visitors and community providers in the United States: A panel survey analysis

“…We saw generally less collaboration between NFP and providers in housing resources and substance use treatment; though both sectors represent critical needs for some families. Our prior qualitative inquiries have found that NFP nurses rarely share client information with housing service providers 19 . Despite various housing resources available for their clients, the demand for affordable housing far exceeded what was available; limiting opportunities for NFP and housing providers to coordinate.…”

A qualitative study of public health nurses' experiences detecting and preventing child maltreatment in primary care settings

“…The common denominator for these PHNs was that they worked in smaller places or personally knew people who worked in the collaborating services. Having a contact person in partnering organizations is essential for effective collaboration among home‐visit nurses in public health prevention programmes (Williams et al, 2022). Collaboration with other professions has been emphasized as important and beneficial for detecting vulnerable children and supporting families (Tung et al, 2019).…”

A systematic review and qualitative meta‐synthesis of the roles of home‐visiting nurses working with women experiencing family violence

“…Strong working relationships between services contribute to effective support for families, with research identifying the need for collaborative communication and practice (Williams et al, 2021). Families with additional challenges often require services beyond the scope of an individual organization, and issues can arise with a lack of alignment in service goals (Tung et al, 2019).…”

“…Strong working relationships between services contribute to effective support for families, with research identifying the need for collaborative communication and practice (Williams et al, 2021).…”