Children First, Oklahoma's nurse-family partnership annual report, 2010/11

              Children First, Oklahoma’s Nurse-Family Partnership
Annual Report, State Fiscal Year 2011
Women participating in the C1 program must:
Be expecting their first • child;
Have a household • income at or below 185% of the Federal Poverty Level; and
Be less than 29 weeks pregnant at • the time of enrollment.
Enrollment Criteria
Currently, Oklahoma ranks among the worst in the nation (43rd) in terms of overall child health and well-being.1 This ranking is due to the state’s poor performance in areas includ­ing family and social environment, physical environment and safety, economic circum­stances, health habits and access to medical care. Children First (C1), Oklahoma’s Nurse-Family Partnership (NFP) program, strives to improve health and birth outcomes in the state by addressing families’ needs in these areas in order to:
Help women alter their health-related behaviors, including reducing the use of • cigarettes, alcohol and illegal drugs;
Help mothers have normal birth weight babies that are carried to term; •
Help parents provide more responsible and competent care for their children; and•
Help parents plan future pregnancies, continue their education and find work to • reduce long term social service dependency.
Additionally, C1 nurses address several key issues targeted in the Oklahoma Children’s Health Plan2 and the Oklahoma Health Improvement Plan (OHIP)3 such as immunization coverage, child maltreatment, injury prevention, smoking cessation and infant and early childhood mental health.
Children First, Oklahoma’s Nurse-Family Partnership
C1 is a nurse home visitation program utilizing the evidence-based Nurse-Family Partner­ship (NFP) model. This model is designed to address and minimize the risk factors known to contribute to child maltreatment, reduce the cost of long-term social services and benefit multiple generations.4 Specially trained registered nurses make regular home visits to low-income women expecting their first child. Services begin before the 29th week of pregnancy and can continue until the child’s second birthday. During home visits, nurses provide brief health assessments,5 child growth and development evaluations, nutrition, safety and parenting education, relationship information and links to services such as child care, education and job training. While the nurse home visitor works with the cli­ent’s doctor, C1 services are not intended to replace the care of the physician.
Program Outcomes
The C1 program serves clients who demonstrate characteristics known to contribute to poor health and birth outcomes, as well as instances of child maltreatment, in an effort to en­courage participating families to achieve the healthiest lifestyles possible. The typical client entering the C1 program is single, has an average yearly household income under $15,000, has at least a high school education or GED and is under 21 years of age. This population is at higher risk for poor health due to things such as a lack of access to medical care, substan­dard housing, poor nutrition and physical activity choices, lack of social support and poverty. The Robert Wood Johnson Foundation recently reported that children in poor families are nearly seven times as likely to be in worse health as those in higher income families.6
Immunizations
Immunizations are one of the most cost effective ways to prevent childhood illness and hospitalization from preventable diseases and associated productivity losses due to par­ents missing work to care for sick children. In 2010, the state’s immunization coverage for children at 24 months of age was 70.8%.7 This can be significantly increased to 80-90% for the state if children receive just one more dose of DTaP by 24 months.8
1 Annie E. Casey Foundation. KIDS COUNT Data Book. KIDS COUNT Overall Rank (Number), 2011. Obtained from http://datacenter.kidscount.org/data/acrossstates/Map.aspx?loct=2&map_colors=Solid&dtm=10657&ind=137&tf=867.
2 Oklahoma State Department of Health. Oklahoma Children’s Health Plan: Keeping Kids Healthy, 2011-2014. Obtained from http://www.ok.gov/health/documents/OHIP-ChildrensHealthPlan.pdf.
3 Oklahoma State Department of Health. Oklahoma Health Improvement Plan: A Comprehensive Plan to Improve the Health of All Oklahomans, 2011-2014. Obtained from http://www.ok.gov/health/documents/OHIP-viewing.pdf.
4 Nurse-Family Partnership. Oklahoma Children First Program Evaluation Report 7, September 24, 2010.
5 C1 services are not intended to replace the care of a physician/obstetrician.
6 Center on Social Disparities in Health. The Social Determinants of Health and Infectious Disease, October 19, 2010. Obtained from http://www.cdc.gov/socialdeterminants/docs/Braveman-SDOH-Symposium-101910-508.pdf.
7 Annie E. Casey Foundation. KIDS COUNT Data Book. 2-year-olds who were immunized (Percent), 2010. Obtained from http://datacenter.kid­scount.org/data/acrossstates/Map.aspx?loct=2&ind=19&dtm=281&tf=38#.
8 Oklahoma State Department of Health. Oklahoma Children’s Health Plan: Keeping Kids Healthy, 2011-2014. Obtained from http://www.ok.gov/health/documents/OHIP-ChildrensHealthPlan.pdf.
Age of C1 Clients at Program Intake, SFY 2011
Separated
Divorced
Widowed
Single/Never Married
Married
Marital Status of C1 Clients at Program Intake, SFY 2011
Don't Know
Dependent on
Parent/Guardian
Over $30,000
$20,001-$30,000
$15,001-$20,000
$9,001-$15,000
$3,001-$9,000
$3,000 or less
Annual Income of C1 Clients at Program Intake, SFY 2011
Educational Attainment of C1 Clients at
Program Intake, SFY 2011
1
, 12.8%
, 25.3%
, 25.0%
, 10.3%
, 3.7%
, 2.8%
, 22.2%
, 73.8%
, 0.2%
, 2.2%
, 1.5%
, 17.0%
, 16.5%
, 21.2%
, 13.0%
, 12.4%
, 4.7%
, 6.2%
, 8.8%
, 15.9%
, 37.0%
, 6.7%
, 1.2%
, 20.2%
, 18.7%
Older than 35 years
30-35 years
25-29 years
22-24 years
20-21 years
18-19 years
12-17 years
, 18.0%
Currently enrolled in
vocational program or college
Currently enrolled in
HS/GED program
Graduate degree
Associate's/Bachelor's degree
Vocational training/
Some college
HS diploma/GED