1. Policy, Practice and Science: hand-in-hand to tackle the problem of inequalities in childhood health Rich evidence for poor families Carin Rots, University Tilburg The Nurse Family Partnership in Dutch preventive youth healthcare Jamila Mejdoubi, VuMC Amsterdam Esther Hafkamp-de Groen, Erasmus MC Rotterdam

2. Part I

3. Practice-driven intervention research = research on interventions that are carried out in real-life settings, characterised by a close collaboration between research and practice

4. How to bring about more evidence-based practices in the field of preventive healthcare for children and youth at risk? 2 pathways: A. Top-down approach: implementation of interventions that have been shown to be effective in controlled research settings B. Practice-driven intervention research: aiming to underpin and evaluate promising interventions already being carried out in actual practice

5. 2 Examples of Practice-driven intervention research: A. ‘Poverty and children’s health’, aimed to reduce health-related deprivation in children living in low income families. The intervention builds on a close collaboration between preventive child healthcare and the local Social Benefit Service (SBS) B. ‘Assertive outreach care’, an intervention directed at families who experience a chronic complex of socio-economic and psychosocial problems, and do not make use of regular healthcare facilities or other services.

6. Contact: Carin Rots: M.C.Rots@uvt.nl

7. Part II

8. VoorZorg ~ Nurse Family Partnership: Pregnant women < 25 years Aims: - Primary prevention of child abuse - Improve the outcomes of pregnancy (e.g. reduce smoking, treatment of depression) - Improve the child’s health/development (helping parents provide competent care) - Improve the mother’s own personal development. David Olds

12. Randomised Controlled Trial: Voorzorg vs. Care as usual Start before 28 weeks of pregnancy Follow-up: 2.5 years Voorzorg Home visits: -10 during pregnancy, 20 during the 1st year and 20 during the 2 nd year of life Aims: - structured behavioral changes - health education - discussing questions of the expectant mother, - increasing the mother’s self-efficacy - involving the social network of the mother into the program

13. Previous Nurse Family Partnership trials found: Improvements in women’s prenatal health Reductions in children’s injuries Fewer subsequent pregnancies Greater intervals between births Increases in fathers’ involvement Increases in employment Reductions in welfare and food stamps Improvements in school readiness Important: Science -> Practice

14. Questions? Please contact Jamila Mejdoubi: j.mejdoubi@vumc.nl