Nurse Family Partnership improves child language and mental health, study shows

July 19, 2023

Findings from the Children’s Health Policy Centre’s scientific evaluation of the program Nurse-Family Partnership have shown that it improved maternal-reported child language and mental health (problem behaviour) at age two years.

Known as the BC Healthy Connections Project, or BCHCP, the study published its findings today in a paper in the Journal of Child Psychology and Psychiatry.

“We are thrilled to have these significant positive findings,” said Nicole Catherine, co-principal investigator for the BCHCP randomized-controlled trial. “We have shown that intervening very early in a child’s life —during pregnancy—can have enduring benefits.”

Co-principal investigator Charlotte Waddell added that the study represents millions of dollars and thousands of hours of work by hundreds of people over 13 years. “Our findings show the power of policy-practice-research collaboration in the service of common goals,” she said. “It’s the ideal way to address tough questions of public health importance.” The Children’s Health Policy Centre (CHPC) at Simon Fraser University led the trial, in collaboration with McMaster University and other organizations.

The study, which started in 2013, enrolled 739 pregnant girls and young women and their 737 children across the four participating regional Health Authorities (Fraser, Interior, Island and Vancouver Coastal Health. Northern Health was involved in an NFP nursing pilot and process evaluation).

Some 200 Indigenous (including First Nations, Métis or Inuit) girls and young women, or 27%,  generously agreed to participate in this long-term trial. Some 237 BCHCP children, or 32%, had an Indigenous mother or father.

The study was funded by the BC Ministry of Health, with support from the BC Ministries of Children and Family Development and Mental Health and Addictions. Participating regional health authorities funded direct nursing costs. The Mowafaghian and Stern Foundations provided addition generous supports.

Nurse-Family Partnership aims to improve the lives of children born to young, first-time mothers. Developed nearly 45 years ago by researcher David Olds and colleagues in the United States, the program starts early — in pregnancy, before children are even born. It involves intensive home visits by public health nurses continuing until children reach their second birthday. The program focuses on those who are coping with socioeconomic inequities.

Public health nurses provide the home visits — up to 64 in total over two-and-a-half years. Nurses delivering the program received extensive education. As well, they received resources to use in the visits, and ongoing supervision and support. “We acknowledge the participating young moms and children who shared their experiences via data collected during 4,000 research interviews,” co-principal investigator Catherine said. “They told us that they wanted to help make a difference for other young families like them.”

An earlier finding, published in the Canadian Medical Association Journal Open, had shown that NFP led to reduced prenatal cannabis use, and in smokers led to modest reductions in cigarette use. Further results will be published in the next year, for example, on NFP’s impact on reducing intimate-partner violence.

“All the findings show that longer term follow-up of our NFP cohort of children is warranted given that further benefits may emerge across childhood and adolescence,” Catherine said adding that the team is identifying new funding to follow the children over 10 years and beyond. “This kind of long-term follow-up is the best way to show the return on public investment in early childhood programs designed to prevent problems from occurring in the first place.”

Full text of the JCPP paper is available here.

Collaboration can help advance children’s wellbeing

June 25, 2023

Canada needs to substantially increase public investments in effective interventions to improve the mental health of children.

That was one of the key messages from a June 19/23 talk by Christine Schwartz, psychologist, SFU adjunct professor and Children’s Health Policy Centre scientific writer.

She was speaking to policy-makers, practitioners and researchers at a talk sponsored by the Children’s Healthcare Canada network.

The 30-minute Zoom presentation, followed by a Q&A session, was part of the SPARK program, designed to showcase knowledge, evidence and expertise to spark conversations, ideas and action.

“Effective collaborations between researchers and policy-makers can play a tremendous role in advancing the wellbeing of children,” Schwartz told the group. Audience members were especially interested in learning how CHPC team members have been able to conduct research that is both academically rigorous and responsive to the needs of policy-makers.

Go here to see a recording of the presentation.

CHPC associate director celebrates new appointment

June 16, 2023

Children’s Health Policy Centre Associate Director Nicole Catherine has just been named an affiliate faulty member of The Human Early Learning Partnership (HELP) at the University of British Columbia.

Catherine also holds the Canada Research Chair Tier 2 in Child Health Equity and Policy and is an assistant professor in the Faculty of Health Sciences at Simon Fraser University.

“I am thrilled to join HELP as an affiliate faculty member,” she said in the announcement of the honour. 

In an April 27 talk to faculty, staff and trainees at HELP, Catherine said that early prevention of childhood adversities through research-policy-practitioner collaborations is one of her major motivators.

As the former scientific director of a public health randomized controlled trial known as the BC Healthy Connections Project, she told the group: “Our plans to examine the longer-term effectiveness and cost-effectiveness of an early intervention, across adolescence, will directly inform policymakers, those who need to act to help children flourish.”

Audience members said the retention protocol — developed prior to data collection — impressed them because it ensured sustained engagement with 739 unserved families across 2.5 years. Catherine said: “Families that are unfairly labelled difficult to reach, and therefore underserved by health care, still need to be reached.”

Catherine is now leading new work exploring how to adapt enhanced maternal-child health programs, such as Nurse-Family Partnership, for Indigenous children and mothers in BC.

‘Keep the focus on kids’ — Waddell

May 29, 2023

A Canadian South Asian lifestyle magazine based in Vancouver, DARPAN, recently interviewed Children’s Health Policy Centre director Charlotte Waddell.

The feature, called the Darpan 10, is directed at community and thought leaders, addressing them with 10 questions relating to their role. Here, for example, is one of the questions:

“As part of your education and work that you have done with children, can you share some insights that would help better the public education system as a whole?”

Waddell’s answer:

“A huge lesson for me, in thinking of the research and the young people I have cared for as a child and youth psychiatrist, is to address social disparities in our society. Again, I am considering adversities such as socioeconomic disadvantage, colonialism, and racism. These problems do not cause all childhood mental disorders. But they affect kids unequally.

“So some kids have to carry higher burdens than others, through no fault of their own. In turn, the stresses associated with kids having to take these extra burdens can translate into higher rates of certain mental disorders over time. So it would help to address these disparities, treat all kids well, and ensure adequate prevention and treatment services for mental health difficulties. In turn, it will help the public education system if more kids are flourishing.”

The entire interview can be seen here.