Sharing the excitement of a ‘unique’ study

November 10, 2014

Nurse-Family PartnershipA scientist by training, Nicole Catherine speaks from the heart when it comes to the Nurse-Family Partnership (NFP). As scientific director and co-principal investigator of the BC Healthy Connections Project, she’s eager to test NFP.

“It reflects everything that appeals to me,” she says. “It’s consistent with my training. And it speaks to my heart because it’s an intervention for young, first-time mothers.”

Growing up poor, near Dundee — the fourth largest city in Scotland — Dr. Catherine saw her younger sister become pregnant at the age of 16 and witnessed, first-hand, the struggles she faced. At the time, the Dundee area had the highest teenage pregnancy rate in the United Kingdom. “My sister didn’t have the help she needed,” Dr. Catherine says, “and she struggles to this day.”

An intensive child and maternal health program, Nurse-Family Partnership gives disadvantaged women — who are preparing to parent for the first time — one-on-one home visits with public health nurses throughout the pregnancy, continuing until children reach their second birthday.

And the BC Healthy Connections Project is the first-ever scientific evaluation of NFP in Canada. Before leading this study, Dr. Catherine spent more than 10 years running randomized controlled trials on a wide variety of interventions, including another BC project promoting child health. She earned her PhD from UBC with a dissertation on children’s behaviour and biological responses to stress.

From there, she became a post-doctoral fellow in psychology at SFU — funded by the Canadian Institutes of Health Research — studying adolescent development.

But even then, she was familiar with NFP. “Anyone in the field of prevention science knows about it because it’s so ground-breaking,” she says. Although she’s studied newborns, children and adolescents, she welcomed the chance to work with pregnant women. “I’ve always known that intervening earlier is better,” she says.

Despite her rich experience with other scientific studies, Dr. Catherine describes the size and scope of this current project to be unique. To have the policy partners — the BC Ministry of Health, the BC Ministry of Children and Family Development and five Health Authorities — collaborating so closely with researchers is both unusual and invaluable, she says. “I’ve never experienced such a rigorous research-policy approach to an evaluation and it’s wonderful.”

Another aspect that makes the project unusual is its goal of recruiting more than a thousand women who are socially disadvantaged, young and pregnant. Doctors, midwives and other community professionals are being asked to refer pregnant women to their local public health unit as early in pregnancy as possible. Public health nurses then screen the young women, offering them existing services and assessing them for eligibility to the BC Healthy Connections Project.

As well, evaluating NFP is a huge endeavour. (Some 50% of participants are randomly allocated to receive existing services, while the remaining 50% are randomly allocated to receive NFP plus existing services.) The SFU Study Team conducts six interviews with each participant — throughout her pregnancy until her child’s second birthday. That’s more than 6,000 interviews.

To achieve this, Dr. Catherine supervises and supports the recruitment and training of SFU Study Team members as well as field interviewers, who are responsible for conducting interviews with all participants either in their homes or over the telephone. “That involves a lot of training so they become really skilled researchers,” she says. “They demonstrate respect and rapport with these young mothers who are giving us their valuable time.”

Each interview may be as long as two hours — inviting women to share their experiences in depth on topics such as preparing for parenting, health needs and social supports. “That’s a lot of data we’re collecting that needs to be coded, validated and analyzed,” she says.

Ultimately, the aim is to learn more about helping socially disadvantaged, young pregnant women, new mothers and children in BC. “It’s extremely rich data. It’s longitudinal, it’s in-depth, and it’s worthwhile,” Dr. Catherine says.

“It’s also an honour to hear these young women’s voices.”

Note that NFP is available only through the BC Healthy Connections Project (BCHCP) for the duration of recruitment. Practitioners or young pregnant women can click here for details on how to reach public health and determine eligibility for the BCHCP.