Improving interagency service integration of the Australian Nurse Family Partnership Program for First Nations women and babies: a qualitative study

Abstract

Background The Australian Nurse Family Partnership Program (ANFPP) is an evidence-based, home visiting program that offers health education, guidance, social and emotional support to first-time mothers having Aboriginal and/or Torres Strait Islander (First Nations) babies. The community-controlled sector identified the need for specialised support for first time mothers due to the inequalities in birthing and early childhood outcomes between First Nations’ and other babies in Australia. The program is based on the United States’ Nurse Family Partnership program which has improved long-term health outcomes and life trajectories for mothers and children. International implementation of the Nurse Family Partnership program has identified interagency service integration as key to program recruitment, retention, and efficacy. How the ANFPP integrates with other services in an Australian urban setting and how to improve this is not yet known. Our research explores the barriers and enablers to interagency service integration for the Australian Nurse Family Partnership Program ANFPP in an urban setting. Methods A qualitative study using individual and group interviews. Purposive and snowball sampling was used to recruit clients, staff (internal and external to the program), Elders and family members. Interviews were conducted using a culturally appropriate ‘yarning’ method with clients, families and Elders and semi-structured interview guide for staff. Interviews were audio-recorded and transcribed prior to reflexive thematic analysis. Results Seventy-six participants were interviewed: 26 clients, 47 staff and 3 Elders/family members. Three themes were identified as barriers and three as enablers. Barriers: 1) confusion around program scope, 2) duplication of care, and 3) tensions over ‘ownership’ of clients. Enablers (existing and potential): 1) knowledge and promotion of the program; 2) cultural safety; and 3) case coordination, co-location and partnership forums. Conclusion Effective service integration is essential to maximise access and acceptability of the ANFPP; we provide practical recommendations to improve service integration in this context.

Family Nursing Care during the Transition to Parenthood: A Scoping Review

“…Their study focused on various aspects, including the environment, communication, education, counseling, and support provided to families by nurses. The findings indicated that an FCC approach has a positive impact on the health and well-being of children, parents, and their families [ 27 , 33 , 37 , 38 , 42 , 44 ].…”

“…The articles referred to various programs and models focused on empowering parents, aiming to improve their self-efficacy and confidence, and consequently enhancing their caregiving practices [ 30 , 33 , 37 ]. For instance, the Australian Nurse-Family Partnership Program (ANFPP), based on theories of self-efficacy, attachment, and human ecology, aims to support women on their journey into motherhood, particularly those from disadvantaged backgrounds, to enhance child outcomes [ 37 ]. The assigned nurses play a pivotal role in this program, positively impacting parental abilities, pregnancy intervals, and instances of child abuse and neglect [ 37 ].…”

“…For instance, the Australian Nurse-Family Partnership Program (ANFPP), based on theories of self-efficacy, attachment, and human ecology, aims to support women on their journey into motherhood, particularly those from disadvantaged backgrounds, to enhance child outcomes [ 37 ]. The assigned nurses play a pivotal role in this program, positively impacting parental abilities, pregnancy intervals, and instances of child abuse and neglect [ 37 ]. Similarly, evidence-based parenting programs like the Parent and Infant program (PIN) contribute significantly to positive child development outcomes.…”

Syphilis in pregnancy: a qualitative investigation of healthcare provider perspectives on barriers to syphilis screening during pregnancy in south-east Queensland

“…[35][36][37][38][39][40][41] Continuity of care and caseload-midwifery models that involve outreach, home visits and culturally sensitive care from the same midwife through pregnancy, labour, and early postnatal period have also been successful in Aboriginal and Torres Strait Islander health services in Australia. 40,42,43 These models are shown to increase patient-HCP trust, patient satisfaction, and retention in ANC through open communication and increased support networks, and also allow for greater adherence to screening needs by offering care in flexible, culturally safe environments that are responsive to the individual's needs and lived experiences. [35][36][37][38][39][40][41][42][43] Such models could readily translate to other, higher risk communities but have not been widely promulgated to date.…”

“…40,42,43 These models are shown to increase patient-HCP trust, patient satisfaction, and retention in ANC through open communication and increased support networks, and also allow for greater adherence to screening needs by offering care in flexible, culturally safe environments that are responsive to the individual's needs and lived experiences. [35][36][37][38][39][40][41][42][43] Such models could readily translate to other, higher risk communities but have not been widely promulgated to date.…”