Updates

A team of researchers from the Children’s Health Policy Centre (CHPC) have partnered with the Fraser Health Authority, Population and Public Health, to evaluate their new Enhanced Family Visiting (EFV) Program.

Led by Principal Investigator and CHPC Associate Director Nicole Catherine, the CHPC team aims to understand the experiences of those who took part in the EFV Program.

“The EFV Program was designed by Fraser Health to be more inclusive of diverse children and mothers,” said Catherine. “We now want to engage with mothers and nurses who participated in the program to learn about their experiences.”

EFV is an early prevention program designed to address avoidable childhood adversities. It is modelled on the Nurse-Family Partnership program (NFP), which involves intensive nurse-home visits starting in early pregnancy through to child age two years.

The CHPC team co-led the 10-year randomized controlled trial evaluation of NFP — the BC Healthy Connections Project — showing promising benefits for mothers and children by age two years. These benefits included reduced prenatal substance exposure; improved child mental health and language development, maternal mental health, and income; and reduced intimate partner violence exposure.

But while NFP is designed to reach young, English-speaking, first-time mothers experiencing disadvantage, the EFV Program serves a broader range of families. Those eligible for EFV also include Indigenous families, mothers with more than one child, older mothers, refugees and newcomers.

In collaboration with Fraser Health, the CHPC team will conduct research interviews with select EFV maternal clients to learn about their experiences with the program. The researchers will also survey EFV public health nurses to evaluate the delivery of the program. The survey questions will examine training, service implementation and additional resources needed.

The findings will help inform EFV program refinements to better reach and serve culturally diverse children and mothers who are experiencing disadvantage. Providing early prevention programs like EFV — for children experiencing disadvantage — is more cost-effective than later remediation. “It’s crucial that policymakers invest in effective early prevention programs to ensure that all young Canadians reach their potential,” said Catherine.

Funding effective prevention programs could significantly reduce youth drug use — that was the message shared by Adjunct Professor with the Children’s Health Policy Centre Christine Schwartz in an article published last week by CBC Health’s Second Opinion.

The article featured new research evidence showing that PreVenture, a school-based program developed by a researcher at the University of Montréal, produced a 35% reduction in the annual increase in the odds of teens developing substance use disorder, compared to a control group.

The piece also highlighted the need for sustained government funding to support and deliver programs such as PreVenture in schools across Canada.

Schwartz noted in her interview with CBC Health that policymakers are “increasingly turning to the research evidence” to evaluate drug prevention programs — and a growing body of evidence demonstrates the effectiveness of several prevention programs.

Second Opinion shared the link to a recent edition of The Children’s Mental Health Research Quarterly in which the CHPC presented findings from an evaluation of two such programs: Strengthening Families and Project PATHS. The CHPC team found that they were not only successful in reducing opioid misuse, but that they also reached large numbers of young people, highlighting the benefits of school delivery.

The missing piece, Schwartz told CBC Health, is funding to maintain these programs and put them in place more widely. But she is optimistic that the CHPC’s prevention-focused message will continue to reach policymakers and shape the national dialogue on youth substance use.

“It’s great to see this evidence on the effectiveness of school-based prevention programs being shared in national media,” she says. “These programs increase the likelihood that young people can lead happy, healthy lives and make it less likely they will suffer harms from substance use later on. This is a conversation we need to be having as a country, and one I’m sure policymakers will be paying close attention to.”

A team of researchers led by Children’s Health Policy Centre scholars Kimberly Thomson and Nicole Catherine has received a 2024 Convening and Collaborating (C2) Award from Michael Smith Health Research BC. The award funding will help the research team improve the evaluation of upstream public health interventions in British Columbia.

Public health interventions are more effective when they address the bigger picture of people’s lives — the social conditions in which they are born, live, and age. These “upstream” interventions aim to tackle the root causes of health problems, addressing systemic inequities that traditional healthcare approaches may overlook. But the impacts of these interventions can be difficult to measure.

Thomson and Catherine will address this challenge by facilitating a series of conversations between policymakers, researchers and health practitioners. Through online consultations and an in-person Thought Exchange event, they will bring together researchers and research users to discuss the evaluation of upstream public health projects in BC.

The goal of these conversations is to help participants:

• better understand current evaluation methods
• identify opportunities for coordination between public health researchers and institutions
• improve innovation and evaluation capacity
• set future research priorities

“We’re really excited to have these rich discussions with our public health partners,” said Thomson. “It’s a great opportunity to shape our collaborative research priorities, including for upcoming child health policy initiatives in BC that we’ll be measuring and monitoring.”

The C2 Award supports researchers in British Columbia who are working collaboratively to address public health challenges. More information about the project and the award can be found on the Michael Smith Health Research BC website.

A recent report by the Children’s Health Policy Centre found that home visiting programs can have significant benefits for mothers and children facing adversity.

The report looked at randomized controlled trial evaluations of 13 home visiting programs across Canada, the U.S. and other high-income jurisdictions to investigate the effectiveness of these programs. Seven intensive programs based on the Nurse Family Partnership (NFP) model demonstrated particularly robust benefits.

The benefits for children included:

• reduced prenatal substance exposure
• improved language
• improved cognitive development
• better mental health
• better school readiness and reading
• fewer injuries or maltreatment concerns

Benefits for mothers included:

• better social supports
• greater self-efficacy
• fewer subsequent pregnancies
• increased breastfeeding duration
• better mental health
• improved parenting
• improved socioeconomic status
• reduced exposure to intimate partner violence

NFP is an early intervention where nurses visit girls and women through pregnancy and their child’s early years. Nurses explore topics such as healthy pregnancy, parenting skills, healthy relationships and child development.

The report also identified six other home visiting programs that benefitted children and mothers. However, these programs had fewer positive outcomes than the NFP-based programs due to shorter durations, later interventions and the varied skill levels of providers.

These findings provide critical evidence that policymakers in British Columbia can use to build on the success of existing programs, develop new intervention strategies and ensure that children and mothers flourish.

To learn more, read the full report.