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Nurse-Family Partnership® in Canada

The Nurse-Family Partnership (NFP) Program is currently being implemented or evaluated in many different countries, including in Canada. More information about the different phases of program testing and expansion of NFP can be found on the NFP International website.

Given the robust evidence in support of the effectiveness of the NFP program in positively improving a range of maternal and child health outcomes in the United States, efforts began more than two decades ago to bring NFP to Canada as a public health strategy to promote healthy behaviours in pregnancy, prevent child maltreatment, improve children’s health and development, and to improve the lives of mothers and their children living in disadvantaged circumstances.

Because baseline health and social services differ in the United States compared to other countries, the Prevention Research Center for Family and Child Health at the University of Colorado Anschutz Medical Campus requires that countries with a long-term goal of implementing NFP agree to follow a 4-step protocol for international evaluation of the intervention.

Model for Adapting and Testing the Nurse-Family Partnership in International Contexts (click on any of the phases to read more):

Phase One: Adaptation. Examine the adaptations needed to deliver the NFP program in local contexts while ensuring fidelity to the NFP model. 

Phase Two: 
Feasibility and acceptability through pilot testing and evaluation. Conduct a pilot test of the adapted NFP program to inform what additional adaptations may be needed to ensure the feasibility and acceptability of the adapted NFP program. 

Phase Three:
 Randomized controlled trial (RCT). Consider expansion of the testing and evaluation work by conducting a RCT. 

Phase Four:
 Continued refinement and expansion. Once the evaluation of the RCT has been completed and the outcomes found to be of public health significance, the implementing agency may decide to further refine and expand the adapted NFP in their society. 

For further detail 
about the approach taken in Canada to work through this four-phase process, please refer to the following journal article:

Jack, S.M., Catherine, N., Gonzalez, A., MacMillan, H.L, Sheehan, D., Waddell, C. for the British Columbia Healthy Connections Project Scientific Team. Adapting, piloting and evaluating complex public health interventions: Lessons learned from the Nurse-Family Partnership in Canadian public health settings. Health Promotion and Chronic Disease Prevention in Canada, 35(8/9), 151-159.

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