A specially trained nurse visits a young, first-time mother at home, starting in early pregnancy and continuing until the child’s second birthday, to improve health and life outcomes for both. This matters because the UK government is rolling out the Family Nurse Partnership (FNP) programme across England, but it is unclear whether the benefits seen in the United States—which has less comprehensive child health services—will hold here. Without a formal trial, policymakers risk spending public money on a programme that may not work as intended in the English context. If the trial shows the FNP is effective, the programme can be expanded with confidence, potentially reducing preterm births, childhood hospital visits, and rapid repeat pregnancies among vulnerable young mothers. If it shows no benefit, government resources can be redirected to other services that do help. The study also examines what makes the programme work better or worse in different settings, helping to fine-tune its delivery. Either way, the result directly informs how taxpayer money is spent on early childhood support.
View original technical description
BackgroundThe Family Nurse Partnership (FNP) is a structured programme of home visits delivered by specially trained nurses for at-risk first time mothers. Part of the Child Health Promotion Programme, this intensive intervention has been introduced to address the elevated risk of social exclusion and health disadvantage that such women and their off-spring face. The programme aims to modify behavioural risk factors and enhance protective factors through regular home visits that start in early pregnancy and continue until the child’s second birthday. Based on the original US programme which has been widely evaluated, the FNP is currently undergoing formative evaluation at 10 English sites. Ten more sites will join to form a sample for a trial of the effectiveness and cost-effectiveness of the FNP.AimsOur study aims firstly to evaluate the effectiveness of the FNP within three outcome domains: pregnancy and birth, child health and development, and parental life course and self-sufficiency. One primary outcome has been specified in each domain: birth weight, emergency attendances / admissions within two years, proportion of women with second pregnancy within two years respectively. Secondary outcomes include health threatening behaviours, self efficacy, social support, child health and development, maternal life course. Our study will assess the incremental costs and consequences of the FNP compared to existing child services. Thirdly, our study aims to evaluate what processes vary the impact of the FNP, to assess its relevance to other settings and to optimise its future implementation.Plan of InvestigationThis individually randomised controlled trial with parallel process evaluation (qualitative and quantitative) and economic modelling studies will last 52 months. Following recruitment and baseline assessment via face-to-face interview, 2400 nulliparous women (ideally Potential ImpactThe UK government is extending the pilot FNP in England as part of universal child health services. However, whether the benefits found for the programme in the US will be replicated in England, which has more comprehensive child health services, is unclear. The formative evaluation of FNP has shown that women find it acceptable and that practitioners can implement it with fidelity but there remain bureaucratic difficulties which limit implementation. This trial will formally evaluate the FNP in England to provide the evidence base for subsequent policy and funding decisions. If no benefit is found, then government resources can be appropriately re-allocated, whilst if it is beneficial further opportunities for enhancement can be identified.
Plain English summaries and category classifications on this site are generated by AI and may not perfectly reflect the original research.
Is something wrong? Let us know