Tennessee Nurse Family Partnership Program Patti Vanhook, PhD, - - PowerPoint PPT Presentation

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Tennessee Nurse Family Partnership Program Patti Vanhook, PhD, - - PowerPoint PPT Presentation

Sep 11, 2023 447 likes •823 views

Rural poverty-stricken first-time moms and BSN partnerships. The story of NE Tennessee Nurse Family Partnership Program Patti Vanhook, PhD, FNP-BC, FAAN Julie Hubbard, MSN, RN Annual Rural Health Association of Tennessee Meeting November 15,

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Rural poverty-stricken first-time moms and BSN partnerships. The story of NE Tennessee Nurse Family Partnership Program Patti Vanhook, PhD, FNP-BC, FAAN Julie Hubbard, MSN, RN

Annual Rural Health Association of Tennessee Meeting November 15, 2018 Music Road Convention Center Sevierville, TN

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Disclosures

  • Dr. Vanhook, FNP-BC-nothing to disclose
  • Julie Hubbard, MSN, RN-nothing to disclose
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Patti Vanhook, PhD, FNP-BC, FAAN Julie Hubbard, MSN, RN

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Goal

First-time moms living in poverty are at risk for staying in poverty. The Northeast Tennessee ETSU Nurse Family Partnership Program connects these moms with BSN prepared nurses who guide them through support and education to have better birth

  • utcomes. How this is accomplished in NE

Tennessee will be shared.

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Objectives

  • 1. Participants will compare the

differences between urban and rural Nurse Family Partnership Programs

  • 2. Participants will influence policy-

makers to support NFP programs both urban and rural

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Funding Information

  • ETSU

Community Outreach- Families First

  • 2-generation

approach

  • Partnership
  • ETSU College of

Nursing-Nurse-Led Clinics

  • Success in program

development

  • Partnership
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Where are we?

8 Counties NE Tennessee

2897 sq. miles population 507,244 Hancock Co 30 residents/sq mi Johnson Co 60/sq mi

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National Crisis? Teen Pregnancy?

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https://www.cdc.gov/teenpregnancy/about/index.htm

Decline in teen pregnancy for US rural counties

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42 20 20 19 17 10 20 30 40 50 60 70 2014 2015 2016 2017

Teen Pregnancy NE Tennessee Per 1,000

Johnson Co Hancock Co. Hawkins Co. Hawkins Co Carter Co. Unicoi Co Greene Co. Washington Co. Sullivan Co STATE US

Robert Woods Johnson County Health Rankings www.county healthrankings.org

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Northeast Tennessee NFP Demographics

  • < 15 years old-5.3%
  • 15-17-year olds-21.1%
  • 18-19-year olds-21.1%
  • 20-24-year olds 36.8%
  • 25-29-year olds- 15.8%
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Teenage Pregnancy

47.5%

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NFP Barriers

Communication Engagement Geographic Location Other Family Members

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What Happened to You-The Impact of Adverse Childhood Experiences ACES

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Adverse Childhood Experiences (ACEs)

  • Stressful/traumatic experiences
  • 1. Abuse
  • 2. Neglect
  • 3. Household dysfunction including: mental

illness, incarcerated relatives, mother treated violently, substance use, divorce, poverty, racisim, and bullying

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The Impact of Adverse Childhood Experiences (ACEs)

  • Disrupts the nurturing environment
  • Is more common for those living in poverty
  • Can overcome the child's undeveloped

coping mechanisms

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The Results of Toxic Stress

  • Impact on brain architecture, biology, and

gene expression

  • May disrupt brain architecture and impair

executive functioning

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Longterm Effects of Toxic Stress

  • Can lead to longterm impairment and

illness-obesity, heart disease, cancer, depression, suicide, drug and alcohol abuse, high risk behaviors, and violence

  • Epigentic mark-changes gene expression

by turning the gene on or off

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# Patients to Mental Health Providers Northeast Tennessee Counties

8070 780 360 1000 2000 3000 4000 5000 6000 7000 8000 9000 Johnson Carter Unicoi Hancock Hawkins Greene Washington Sullivan STATE US 2015 2016 2017

To a single mental health provider! Robert Woods Johnson County Health Rankings www.county healthrankings.org

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Northeast TN NFP Statistics

  • Mothers using mental health services
  • 1. Intake-8.82%
  • 2. Infant birth-5.19%
  • 3. At 6 months-5.66%
  • 4. At 12, 18, 24 months-0%
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NAS

1,068 infants were diagnosed with neonatal abstinence syndrome in 2016 — more than any year prior.

Blue Cross Blue Shield Tennesseehttps://bettertennessee.com/health-brief-neonatal-abstinence-syndrome/

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Why is all this important?

Blue Cross Blue Shield Tennesseehttps://bettertennessee.com/health-brief-neonatal-abstinence-syndrome/

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Opportunity?

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Lofty Goals

  • Eight Counties-NE Tennessee
  • Nine Nurses
  • 200 first-time moms

Reality

  • 7 nurses
  • >100 moms
  • Rural counties-culture & distance matters
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NFP Team % Food Stamps % Medicaid % WIC Le Bonheur 22.9% 83.3% 47.9% NE TN NFP 33.3% 75% 66.7% TN Total 25% 81.7% 51.7% National Total 26.6% 78.7% 67%

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Attrition

Pregnancy

NFP Team % Total Attrition % Miscarria ge/Fetal Death % Moved from Area %Unable to Locate

Le Bon- heur 8.3% 1.5% 0.44% 1.9% NET NFP 6.6% 0% 0% 0% TN 8.1% 1.3% 0.4% 1.7% Nat’l 15.2% 1.2% 3.8% 3.1%

Infancy

NFP Team % Total Attrition % Miscarria ge/Fetal Death % Moved from Area %Unable to Locate

Le Bon- heur

32.4% 0.2% 3.9% 11.2%

NET NFP

44.4% 0% 11.1% 22.2%

TN

32.6% 0.2% 4% 11.3%

Nat’l

33.1% 0.3% 7.8% 8.1%

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Breastfeeding

88.2% Initiated at birth!

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36 Births

Infant Gestational Age Pre-Term: (<37weeks) 4.69% Full-Term:(>/=37 weeks) 95.31% Breastfeeding Initiated: 88.2% National: 84.5% At 6 Months Continuing: 41.2% National: 33.7% Ages and Stages Questionnaire Completed at 4 months: 69.2%; National-55.6% 10 months: 100%; National-55.5% In need of further evaluation at 10 months: 0%; National-12.8%

Success In Northeast Tennessee

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Not just about pregnancy

Homeless – 2 Bedroom Apartment Full-term Birth Initiated and Continues to Breast Feed Non-Smoking Meeting Milestones

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Success

 91% of NFP clients receive prenatal care in first trimester

  • f pregnancy

 80% reduction in smoking among NFP clients during pregnancy  Only 2% of NFP babies had an ER visit within their first 6 months of life  Between July 2017 and June 2018 preterm births were

  • nly 6.8% of all births in the NFP program, well below

the state and national rates

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Two-Generation Impact

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Contact Information

Julie Hubard, MSN, RN NFP Director

Northeast Tennessee Nurse- Family Partnership Program East Tennessee State University Center for Community Outreach

  • : 423-439-6062

c: 423-900-3160 HUBBARDJD@ETSU.EDU

Patti Vanhook, PhD, APRN NFP Administrator Associate Professor Associate Dean Practice & Community Partnerships

  • : 423-439-7184

c: 423-306-5818(c) vanhook@etsu.edu

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References

  • About us (2018). Retrieved from https://www.nursefamilypartnership.org/about
  • Blue Cross Blue Shield Health Brief (2017). Retrieved Blue Cross Blue Shield

Tennesseehttps://bettertennessee.com/health-brief-neonatal-abstinence-syndrome/

  • Nurse-Family Partnership Outcomes (2018). Retrieved

from https://www.nursefamilypartnership.org/wp-content/uploads/2018/08/Nurses- Mothers.pdf

  • Reproductive health: Teen pregnancy.(2017). Retrieved from Centers for Disease

Control and Prevention https://www.cdc.gov/teenpregnancy/about/index.htm

  • Robert Woods Johnson County Health Rankings www.county healthrankings.org