By Nicole Catherine, MSc, PhD, Charlotte Waddell, MSc, MD, CCFP, FRCPC, Lenora Marcellus, RN, BSN, MN, PhD
Research initiatives that involve collaborations among researchers, public health practitioners and policy makers allow integrated and reciprocal knowledge exchange and ensure that new findings are readily applicable in “real world” settings. One such collaboration is the British Columbia Healthy Connections Project (BCHCP): a randomized controlled trial (RCT) evaluating the effectiveness of the Nurse-Family Partnership (NFP) program at improving children’s mental health and development compared with existing (usual) services.
NFP is a public health nurse home visitation program that focuses on young women who are preparing to parent for the first time and who are experiencing socioeconomic disadvantage. Visits start early in pregnancy and continue until children reach age two years. NFP has proven effective in the United States – improving children’s mental health and development as well as maternal wellbeing, and showing long-term cost-effectiveness. But it is not known whether the same benefits will be obtained in Canada and other countries, where core public health and social services differ. Studies are now underway in a number of countries around the world to evaluate how the program works in different contexts.
In British Columbia, children’s mental health has been a long-standing priority for the BC Government, starting in 2003 with BC’s unique five-year Child and Youth Mental Health Plan. In 2010, BC then announced Healthy Minds, Healthy People, a 10-year mental health plan. This plan made promotion and prevention high priorities, featuring public health nurse home visitation for disadvantaged first-time families as a central initiative. Led by a team at the Children’s Health Policy Centre in the Faculty of Health Sciences at Simon Fraser University (SFU), the BCHCP was launched in 2012. RCT recruitment began in October 2013 and will continue into 2016.
A team of researchers from SFU, McMaster University, UBC and the University of Victoria is jointly supporting the BCHCP. Lenora Marcellus from the School of Nursing is a co-investigator with the scientific team running the RCT, and Lenora and Karen MacKinnon are co-investigators with a nursing process evaluation that is being run concurrently with the RCT.
In conducting this RCT, which is embedded within BC’s public health system, the research team is also working in close collaboration with senior policy makers from the Ministries of Health and Children and Family Development, and with four BC Health Authorities (Fraser Health, Interior Health, Island Health and Vancouver Coastal Health). A fifth Health Authority, Northern Health, also participates in the process evaluation, but not in the RCT. Intensive, reciprocal and sustained research-policy collaborations are essential for a project like this – due to the magnitude and scope of the public health planning required, and to facilitate the widespread dissemination and uptake of trial findings, should these prove positive.
This trial will provide important information about the effectiveness of NFP in the Canadian context for the first time. We hope that by generating new evidence through the BCHCP RCT, BC policy makers – and all Canadians – will be encouraged to take new steps to improve children’s mental health and development starting very early in the life course.
Acknowledgements: The BC Healthy Connections Project is funded by the BC Ministry of Health, with support from the BC Ministry of Children and Family Development, and from Fraser Health, Interior Health, Island Health, Northern Health and Vancouver Coastal Health.
For more information, please visit our website at childhealthpolicy.ca.
Lenora Marcellus was appointed on July 1 as the Director of the Institute for Studies and Innovation in Community University Engagement (https://www.uvic.ca/research/centres/cue/). The work of this institute contributes to the development and implementation of solutions to community issues, with a focus on sustainability, public policy development and improved theory and practice.
From the 2015 Fall Communiqué — Public Health
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