Meeting with Professor MacMillan and Debbie Sheehan at McMaster University in Hamilton Ontario, was such a pleasure. They have extensive experience of the NFP program and personal acquaintance with Professor Olds, the founder of the program.
Dr Harriet MacMillan is a Professor in Psychiatry and Paediatrics at McMaster University and the founding Director of the Child Advocacy and Assessment Program (CAAP) at McMaster Children’s Hospital, a multidisciplinary program committed to reducing the burden of suffering associated with family violence.
Her research focuses on the epidemiology of family violence, including prevention of child maltreatment and intimate partner violence. Along with colleagues from the US and Canada, she is evaluating the effectiveness of an intervention to reduce intimate partner violence within the context of an existing home visitation program – the Nurse Family Partnership.
Given our shared research interest in Intimate Partner Violence, we were able to talk about research projects in Australia, such as MOVE.
Professor McMaster’s colleague Dr Susan Jack, who was not available to meet with me when I was in Canada, has researched the role of the NFP program in reducing child abuse, and Intimate Partner Violence. Dr Jack is leading the qualitative work to explore the transferability of the Nurse-Family Partnership program of nurse home visitation in the Canadian context.
Programs found to be successful among Americans have not always shown the same positive outcomes among Canadians. Canada’s uniquely vulnerable populations of Aboriginal and immigrant children, its challenging remote service settings and its more generous social services all may influence program effects. These are similar contextual considerations for Australia, with our large geographical area, indigenous and multi-cultural communities, and extensive universal health services.
My conversation with Debbie Sheehan was a discussion around the roll-out of NFP internationally, including the Australian Nurse Family Partnership Program (ANFPP). She described the challenges of introducing the American program to other countries, including the staged introduction via pilot sites, the RCTs, the learning stage, and then full implementation.
We discussed the principle of “fidelity to the model”, and some of the terms associated with the program – dosage, which means the number of consultations; fidelity goals, which means adherence to the model; and also discussed the key intervention of the program, which is the therapeutic relationship.
“If you look at the opportunity to make a difference in the lives of children and young women, it’s very powerful and very fulfilling,” she says. “As well, cost-benefit analysis shows the program is cost-effective in the short and long term. There are very few interventions that can make this kind of difference.”