About
The EFry Voices project aimed to recognize and value the perspectives of mothers with young children who were accessing services at the Elizabeth Fry Society of Greater Vancouver, known as EFry. EFry is a community-based, non-profit organization that supports 15,000 women, girls and children annually, providing affordable housing units, shelters, mental health treatment and parenting programs. Led by Nicole Catherine in partnership with EFry, the project research team engaged 20 mothers who offered solutions to help address barriers to accessing services.
Methodology
- This community-engaged research study centred the voices of mothers with first-hand experience of marginalization, including socioeconomic disadvantage.
- From April to September 2022, the maternal participants generously took part in semi-structured interviews.
- A project advisory group provided their expertise. This group comprised an Indigenous Elder and members of the Fraser Health Authority and the BC Association of Pregnancy Outreach Programs.
Key Findings
Limitations to the provision of current services exist:
- Barriers: Lack of childcare and insufficient information and referrals to available services.
- What helped: Providing childcare services and resource lists online and in-person. Offering mothers access to peer groups.
Programs must focus on whole health:
- Barriers: Many mothers were not provided consistent supports for their mental health and housing needs. Some nutrition programs were inadequate and food options did not reflect cultural diversity.
- What helped: Programs that respected cultural diversity to support overall health. Programs that provided trauma-informed care across services, with clear program plans and offered in small groups.
Clients need to feel safe(er) when using services:
- Barriers: Some mothers felt that programs did not meet their expectations or felt that they experienced unfair treatment.
- What helped: When staff took steps to ensure fair treatment, mothers felt safer using the services.
What This Means
- Helping shape policies: This community partnership created important information to help improve inclusion policies for EFry and similar community groups and non-profits serving women, girls and children.
- Listening to mothers’ voices: Mothers who face marginalization are often left out of decisions on how health and social services are designed and provided. It’s important for researchers to honour the strengths and insights of mothers with lived experience.
- Fixing the bigger system: The study results show that making services easier to access is a system-wide issue. Big changes in how government and non-profit services work together are needed to provide better, more connected support.
Catherine, N.L.A., Zheng, Y., Xie, H., Boyle, M., Jack, S., MacMillan, H., & Waddell, C. Effectiveness of Nurse-Family Partnership on child outcomes by patterns of program intensity: Secondary evidence from a randomized controlled trial (British Columbia Healthy Connections Project). Child Abuse & Neglect. https://doi.org/10.1016/j.chiabu.2025.107600
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Catherine, N.L.A., Zheng, Y., Xie, H., Boyle, M., Jack, S., MacMillan, H., & Waddell, C. Effectiveness of Nurse-Family Partnership on child outcomes by patterns of program intensity: Secondary evidence from a randomized controlled trial (British Columbia Healthy Connections Project). Child Abuse & Neglect. https://doi.org/10.1016/j.chiabu.2025.107600
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.
Catherine, N.L.A., Zheng, Y., Xie, H., Boyle, M., Jack, S., MacMillan, H., & Waddell, C. Effectiveness of Nurse-Family Partnership on child outcomes by patterns of program intensity: Secondary evidence from a randomized controlled trial (British Columbia Healthy Connections Project). Child Abuse & Neglect. https://doi.org/10.1016/j.chiabu.2025.107600
Research Overview
This paper examines how program intensity influenced child outcomes in the Canadian scientific evaluation of the Nurse-Family Partnership (NFP) program. Led by Nicole Catherine, Associate Director of the Children’s Health Policy Centre, the research team found that when NFP was delivered as intended, with sustained intensity — meaning families received the majority of recommended nurse-home visits consistently throughout the program — children experienced greater benefits in language and mental health-problem behaviour by age two years.
Methodology
- The researchers conducted secondary analysis of data from the British Columbia Healthy Connections Project (BCHCP), a randomized controlled trial evaluation of NFP involving 739 maternal participants and their 737 children in British Columbia.
- Participants in the BCHCP were enrolled in early pregnancy and randomly assigned, like flipping a coin, to two different groups — NFP versus Comparison (the existing services on offer in BC) — to investigate whether NFP provided greater benefits for mothers and children by age two years.
- The BCHCP study team collected data at regular intervals across pregnancy and early childhood (2013 to 2019) including on child injuries, language, cognition and problem behaviour (mental health) at age two years.
Key Findings
- Delivering NFP as intended, with sustained intensity, led to greater benefits regarding maternal-reported child language and mental health-problem behaviour.
- Importantly, the research team also found benefits using a rigorous measure of child language development (Bayley Scales of Infant Development), where children were observed directly in the home. This method is considered less biased than mothers’ self report of their children’s language development.
Implications
- Benefits for kids: Sustaining long-term program engagement with young families experiencing disadvantage can make a difference for children. Improvements in language and mental health — as early as age two years — are associated with longer term benefits across childhood and the school years.
- Longitudinal research: It is important to follow the participating children across adolescence to assess long-term program effects on mental health and academic functioning.
- Funding priorities: Policymakers should fund evidence-informed prevention programs that commence early in pregnancy at adequate levels of intensity to maximize benefits for children in need and for society as a whole.
