title: Status of Breastfeeding and Child Immunization Outcomes in Clients of the Nurse-Family Partnership.
abstract: Background The Nurse-Family Partnership (NFP) is a home visiting program serving first-time, low-income mothers, with an area of focus on healthy early childhood development. Previous foundational trials of program effect on breastfeeding and immunizations have shown a mix of neutral and positive results. The present evaluation investigates these effects following program scale-up, using a large contemporary cohort of clients. Methods Nurse-Family Partnership client breastfeeding and immunization status were compared to National Survey of Children's Health data and National Immunization Survey data, respectively. Sample differences in demographic covariates were adjusted using logistic regression. Results Nurse-Family Partnership clients were significantly more likely to have ever breastfed (adjusted prevalence ratio [aPR: 1.20 (1.17, 1.23)] and maintain breastfeeding at 6 [aPR: 1.17 (1.10, 1.24)] and 12 [aPR: 1.39 (1.25, 1.53)] months, but less likely to exclusively breastfeed at 6 months [aPR: 0.84 (0.70, 0.95)] NFP clients were significantly more likely to be up-to-date on immunizations at 6 [aPR: 1.23 (1.22, 1.25)], 18 [aPR: 1.33 (1.30,1.35)], and 24 [aPR: 1.15 (1.14, 1.16)] months of age than the reference cohort, with no significant difference at 12 months. Discussion Nurse-Family Partnership clients had more beneficial breastfeeding and immunization outcomes than children of mothers with demographically similar profiles. However, exclusive breastfeeding at 6 months lags behind the reference sample and represents a potential area for further improvement.
authors.affiliation: Nurse-Family Partnership, National Service Office, 1900 Grant St., Denver, CO, 80203, USA. bill.thorland@nursefamilypartnership.org.
authors.forename: William
authors.identifier: 0000-0003-1740-2738
authors.initials: W
authors.lastname: Thorland
authors.affiliation: Nurse-Family Partnership, National Service Office, 1900 Grant St., Denver, CO, 80203, USA.|Department of Epidemiology, Colorado School of Public Health, 13001 E. 17th Place, Aurora, CO, 80045, USA.
authors.forename: Dustin
authors.initials: D
authors.lastname: Currie
authors.affiliation: Chapin Hall at the University of Chicago, 1313 E. 60th St., Chicago, IL, 60637, USA.
authors.forename: Emily R
authors.initials: ER
authors.lastname: Wiegand
authors.affiliation: University of Chicago, 5801 S. Ellis Ave., Chicago, IL, 60637, USA.
authors.forename: Joe
authors.initials: J
authors.lastname: Walsh
authors.affiliation: Chapin Hall at the University of Chicago, 1313 E. 60th St., Chicago, IL, 60637, USA.
authors.forename: Nick
authors.initials: N
authors.lastname: Mader
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data / Q000639:trends*; D015331:Cohort Studies; D005260:Female; D006792:House Calls / Q000706:statistics & numerical data*; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data / Q000639:trends*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009035:Mothers / Q000523:psychology / Q000706:statistics & numerical data; D009723:Nurse-Patient Relations; D010298:Parity; D011203:Poverty / Q000706:statistics & numerical data; D015397:Program Evaluation / Q000379:methods; D044469:Racial Groups / Q000706:statistics & numerical data
keywords: Breastfeeding; Immunizations; Nurse–Family Partnership; Program evaluation