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Vol. 21. Num. 2. - 2012. Pages 129-143

Improving the Life Chances of Vulnerable Children and Families with Prenatal and Infancy Support of Parents: The Nurse-Family Partnership

[Un Programa de Apoyo Parental Prenatal e Infantil para Mejorar las Oportunidades Vitales de Niños y Niñas de Familias Vulnerables: El Nurse-Family Partnership]

Olds,David L.
University of Colorado Denver, USA


https://doi.org/10.5093/in2012a14

Abstract

Pregnancy and the early years of the child's life offer an opportune time to prevent a host of adverse maternal and child outcomes that are important in their own right, but that also have significant implications for the development of criminal behavior. This paper summarizes a three-decade program of research that has attempted to improve the health and development of mothers and infants and their future life prospects with prenatal and infancy home visiting by nurses. The program, known as the Nurse-Family Partnership, is designed for low-income mothers who have had no previous live births. The home visiting nurses have three major goals: to improve the outcomes of pregnancy by helping women improve their prenatal health; to improve the child’s health and development by helping parents provide more sensitive and competent care of the child; and to improve parental life-course by helping parents plan future pregnancies, complete their educations, and find work. Given consistent effects on prenatal health behaviors, parental care of the child, child abuse and neglect, child health and development, maternal life-course, and criminal involvement of the mothers and children, the program is now being offered for public investment throughout the United States, where careful attention is being given to ensuring that the program is being conducted in accordance with the program model tested in the randomized trials. The program also is being adapted, developed, and tested in countries outside of the US: the Netherlands, England, Scotland, Northern Ireland, Australia, and Canada, as well as Native American and Alaskan Native populations in the US, where programmatic adjustments are being made to accommodate different populations served and health and human service contexts. We believe it is important to test this program in randomized controlled trials in these new settings before it is offered for public investment.

Resumen

El embarazo y los primeros años de vida ofrecen un momento oportuno para prevenir una serie de situaciones adversas para la madre y el niño que son relevantes en sí mismas, pero que también tienen importantes implicaciones en el desarrollo de conductas desadaptativas posteriores. En este artículo se resumen tres décadas de un programa de investigación que ha intentado mejorar la salud y el desarrollo de madres e hijos y sus perspectivas vitales futuras con una intervención llevada a cabo por enfermeras en el domicilio familiar durante el embarazo y los primeros años de vida del niño. El programa, conocido como Nurse-Family Partnership, fue diseñado para madres primíparas de bajos ingresos. Las enfermeras que trabajan en el domicilio materno tienen tres metas principales: mejorar los resultados del embarazo ayudando a las madres a mejorar su salud prenatal; mejorar la salud del niño y su desarrollo ayudando a los padres a proporcionarle un cuidado más sensible y competente; y mejorar el futuro desarrollo vital de la madre ayudando a los padres a planificar futuros embarazos, completar su educación y encontrar trabajo. El programa ha demostrado efectos consistentes en la salud prenatal materna, en el cuidado parental, en el maltrato y negligencia infantil, en la salud del niño y su desarrollo, en la calidad de vida posterior de la madre, y en la implicación en delitos de las madres y sus hijos. Por ello, el programa se está ofreciendo en la actualidad en el ámbito público de los Estados Unidos de América con especial atención en asegurar que el programa se lleve a cabo de acuerdo con el modelo original evaluado en diferentes ensayos experimentales. El programa está siendo adaptado, desarrollado y evaluado en otros países: Holanda, Inglaterra, Escocia, Irlanda del Norte, Australia y Canadá, así como con poblaciones nativas de Norteamérica y de Alaska. En todos estos casos se han hecho algunos ajustes para adaptar el programa a las poblaciones a las que se dirige y al contexto específico de los servicios sociales y de salud. Creemos que es importante evaluar este programa a través de ensayos experimentales controlados en aquellos lugares en los que se considere oportuno aplicarlo.

Keywords

crime
development
health
home visiting
nurses
prevention

Palabras clave

delito
desarrollo
enfermeras
intervención en el domicilio
prevención
salud
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