Addressing risk factors for child abuse among high risk pregnant women: design of a randomised controlled trial of the nurse family partnership in Dutch preventive health care.
BACKGROUND
Low socio-economic status combined with other risk factors affects a person's physical and psychosocial health from childhood to adulthood. The societal impact of these problems is huge, and the consequences carry on into the next generation(s). Although several studies show these consequences, only a few actually intervene on these issues. In the United States, the Nurse Family Partnership focuses on high risk pregnant women and their children. The main goal of this program is primary prevention of child abuse. The Netherlands is the first country outside the United States allowed to translate and culturally adapt the Nurse Family Partnership into VoorZorg. The aim of the present study is to assess whether VoorZorg is as effective in the Netherland as in the United States.


METHODS
The study consists of three partly overlapping phases. Phase 1 was the translation and cultural adaptation of Nurse Family Partnership and the design of a two-stage selection procedure. Phase 2 was a pilot study to examine the conditions for implementation. Phase 3 is the randomized controlled trial of VoorZorg compared to the care as usual. Primary outcome measures were smoking cessation during pregnancy and after birth, birth outcomes, child development, child abuse and domestic violence. The secondary outcome measure was the number of risk factors present.


CONCLUSIONS
This study shows that the Nurse Family Partnership was successfully translated and culturally adapted into the Dutch health care system and that this program fulfills the needs of high-risk pregnant women. We hypothesize that this program will be effective in addressing risk factors that operate during pregnancy and childhood and compromise fetal and child development.


BACKGROUND
Current Controlled Trials ISRCTN16131117.
EMGO+ Institute for Health and Care Research, VU University Medical Center, Department of Public and Occupational Health, Amsterdam, The Netherlands.
Jamila
J
Mejdoubi
Silvia
S
van den Heijkant
Elle
E
Struijf
Frank
F
van Leerdam
Remy
R
HiraSing
Alfons
A
Crijnen
D002648:Child; D002649:Child Abuse / Q000517:prevention & control*; D003466:Cultural Characteristics; D005260:Female; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D007802:Language; D008430:Maternal-Child Health Centers / Q000458:organization & administration*; D009426:Netherlands; D010865:Pilot Projects; D011247:Pregnancy; D018566:Pregnancy, High-Risk / Q000523:psychology*; D011314:Preventive Health Services / Q000458:organization & administration*; D011368:Professional-Family Relations; D015397:Program Evaluation; D012107:Research Design; D018570:Risk Assessment; D012307:Risk Factors; D012309:Risk-Taking; D014175:Translating