Family Nurse Partnership study
Research type
Research Study
Full title
Evaluating the real-world implementation of the Family Nurse Partnership in England: a data linkage study
IRAS ID
230351
Contact name
Katie Harron
Contact email
Sponsor organisation
UCL GOS ICH
Clinicaltrials.gov Identifier
Z6364106, UCL Data Protection Registration
Duration of Study in the UK
2 years, 5 months, 30 days
Research summary
More than 20,000 babies are born to teenage mothers in England each year (~4% of births). Teenage mothers face a number of challenges in pregnancy (including lower levels of education, less stable careers and lower income than older mothers), which can lead to worse outcomes for mothers and their children. Whilst teenage motherhood can be a positive experience for some, early pregnancy is also related to domestic violence, less engagement with education and employment, and rapid repeat pregnancies. Unhealthy behaviours during pregnancy and inadequate prenatal care can lead to adverse neonatal outcomes, and children born to teenage mothers are at greater risk of maltreatment and associated long-term consequences, including adverse physical, social, emotional and cognitive outcomes, and depression, anxiety and suicidal behaviour.
Pregnancy and the postnatal period therefore provide important opportunities for supporting teenage mothers and their children. In the US, a home visiting intervention was shown to benefit mothers and their children, notably through improved health during pregnancy, decreased child maltreatment and injuries, improved school readiness, and greater maternal workforce participation. In England, the Family Nurse Partnership (FNP) was introduced in 2007, aimed primarily at first time teenage mothers. A trial of 1600 families in England found no evidence of benefit from FNP on birth weight, maternal smoking, subsequent pregnancy or A&E attendances. However, the trial did find evidence of benefit on language and cognitive development up to age 2, and, as benefits are recognised locally, the programme is still delivered across the UK. By 2016, 25,000 mothers had been enrolled in FNP across 125 Local Authorities (covering around 25% of eligible mothers), and, learning from the trial, the service is evolving and adapting over time. Understanding the context in which the intervention is now delivered, and the factors that may influence how well it works (e.g. the local setting, and the types of families receiving FNP), is key to understanding its value.
This study aims to evaluate how the real-world implementation of FNP varies across England. The research will complement results from the trial, by providing a more detailed assessment of whether there are particular settings in which FNP works well. To do this, we will use electronic records that are routinely collected as part of health, education, and social care services to compare outcomes for FNP participants with similar families who did not take part in FNP. We discussed our proposal with mothers participating in FNP, and they were supportive of the study.
We will look at outcomes for children (e.g. emergency hospital admissions for possible neglect or abuse, development at school-age, referrals to social services) and mothers (e.g. continuing education after birth, subsequent pregnancies, hospital admissions due to violence or injuries). Exploring whether FNP works better for some families (e.g. the youngest teenagers) than others will help improve targeting of resources and highlight groups in need of alternative support. Findings from the study will help policy-makers decide whether FNP should be offered to families in their local setting. Evidence generated by this study will support commissioners in providing improved services for mothers and children who could benefit most, and lead to increased efficiency through more effective targeting of resources.
REC name
East Midlands - Nottingham 1 Research Ethics Committee
REC reference
18/EM/0014
Date of REC Opinion
22 Jan 2018
REC opinion
Favourable Opinion