Marcellus, L., Tonmyr, L., Jack, S.M., Gonzalez, A., Sheehan, D., Varcoe, C., Kurtz Landy, C., Campbell, K., Catherine, N., MacMillan, H., & Waddell, C. (2022). Public health nurses’ perceptions of their interactions with child protection services when supporting socioeconomically disadvantaged young mothers in British Columbia, Canada. Child Abuse & Neglect, 124, 105426. https://doi.org/10.1016/j.chiabu.2021.105426

Abstract

Background

Children of girls and young women experiencing socioeconomic disadvantage are at risk of maltreatment and associated health and developmental problems. Nurse-Family Partnership (NFP) is an early intervention program designed to improve child and maternal health outcomes. The effectiveness of NFP is being evaluated in British Columbia (BC) through a randomized controlled trial, augmented by a process evaluation to identify influences on how NFP was implemented.

Objective

To describe how public health nurses providing NFP perceived their interactions with child protection professionals.

Participants and setting

Forty-seven public health nurses across BC.

Methods

The principles of interpretive description informed the qualitative component of the process evaluation. Data from interviews and focus groups were analyzed using the framework analysis approach. A thematic framework was generated through processes of coding, charting and mapping, with a focus on organizational and systems influences.

Results

Nurses’ practice in supporting families often involved engagement with child protection services. Four themes about the nature of this work were identified: 1) developing a deeper understanding of the disciplinary perspectives of child protection, 2) striving for strengthened collaboration, 3) navigating change and uncertainty, and 4) responding to family and community complexity.

Conclusions

Participants valued the contribution of child protection professionals and expressed willingness to collaborate to support families. However, collaboration was constrained by multiple structural barriers. Collaborative models offer possibilities for integrated practice, although can be difficult to implement within current health and child protection systems and child protection regulatory contexts.