Trends in demographics and needs for nurse-family partnership clients enrolled between 1997 and 2022

IF 3.4 2区心理学 Q1 FAMILY STUDIES

Child Abuse & Neglect Pub Date : 2025-03-27 DOI:10.1016/j.chiabu.2025.107358

Laura Etzel , Michael Knudtson , William Thorland

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引用次数: 0

Abstract

Background

Demographics and needs of nulliparous, Medicaid-eligible pregnant individuals, the target profile for Nurse-Family Partnership (NFP), have shifted over recent decades as teen pregnancy rates have dropped and Medicaid eligibility has expanded.

Objective

We examined trends in the proportion of NFP clients with demographic characteristics and needs impacting client and child outcomes.

Participants and setting

Participants were nulliparous, pregnant individuals (N = 349,935; 33 % Hispanic, 30 % non-Hispanic Black, 30 % non-Hispanic White) enrolled between 1997 and 2022 in NFP, a national public health intervention aimed at improving client and child outcomes through in-home nurse visitation.

Methods

Generalized linear models and time-varying models examined change over time.

Results

Later enrollment year predicted enrollment of: more racially/ethnically diverse clients with older age (β = 0.24 ± 0.002, P < .0001) more educated clients (college degree vs. high school diploma/GED OR 1.195, 95 % CI 1.194–1.195), more married/cohabiting clients (OR 1.131, 95 % CI 1.129–1.132), clients with higher mastery scores (β = 0.007 ± 0.0001, P < .0001), and increased client needs (pre-pregnancy mental/physical health diagnoses, substance use/addiction, IPV exposure, and homelessness; ORs 1.082 to 1.300, all P < .0001). The average summed needs of clients increased from 1.17 in 1997 to 1.36 in 2022. Non-Hispanic White clients had greater summed needs compared to Hispanic and non-Hispanic Black clients, driven by higher rates of health diagnoses and substance use.

Conclusion

The demographics and needs of NFP clients have shifted over time. Compared to the original trials and earlier program replication, recent clients are older and more educated but have greater needs in a variety of domains increasing risk of poor client and child outcomes.

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来源期刊

Child Abuse & Neglect Multiple-

CiteScore

7.40

自引率

10.40%

发文量

397

期刊介绍： Official Publication of the International Society for Prevention of Child Abuse and Neglect. Child Abuse & Neglect The International Journal, provides an international, multidisciplinary forum on all aspects of child abuse and neglect, with special emphasis on prevention and treatment; the scope extends further to all those aspects of life which either favor or hinder child development. While contributions will primarily be from the fields of psychology, psychiatry, social work, medicine, nursing, law enforcement, legislature, education, and anthropology, the Journal encourages the concerned lay individual and child-oriented advocate organizations to contribute.