1. Children First Program Tulsa Health Department Nurse Family Partnership

2. What is our Mission? To promote the health and safety of mothers and young children prenatally and postnatally through public health nurse home visitation. This program focuses on the mother-infant dyad through improvement in maternal health habits, parental behaviors, and the psychological,social and environmental context in which the family is functioning

3. What do we hope to impact? Improve Pregnancy Outcomes Improve Child Health and Development Improve Economic Self sufficiency

4. What is our Vision? Healthy pregnancies… Healthy babies… Healthy families… Healthy communities!

5. Foundational Theories Attachment ( Wind Beneath My Wings ) blueprint for how relationships work Human Ecology ( We are Family ) environmental influences on individual Self Efficacy ( I believe I can Fly) belief in ability to accomplish & achieve

6. Client Centered Principles 1. Client is the expert on her life 2. Focus on the strengths 3. Follow the client’s heart’s desire 4. Only a small change is necessary 5. Focus on solutions

7. Eligibility Criteria Less than 29 wks. pregnant (with 1 st child) @ enrollment Income eligible—WIC or Medicaid –Income @ or below 185% FPG Voluntary enrollment and participation Reside in Tulsa County or lower 1/3 Osage County

8. Visit Schedule Begin in Pregnancy--wkly visits X4 then Every other week until delivery Visit weekly --beginning after delivery X 6weeks Infancy --every other wk beginning at 8wks Toddler--every other week until 21 months old--then monthly visits until 24 months. Graduate @ 24 months

9. Six Domains of Focus Personal Health Maternal Role Environmental Health Family and Friends Life Course Development Health and Human Services

10. Curriculum Core Curriculum topics Partners In Parenting Education (PIPE) Nursg.Child Assmt Satellite Trng (NCAST) Ages and Stages Questionnaire (ASQ) Motivational Interviewing (MI) Post Partum Depression (PPD) Child Abuse Medical Examiner (CAME)

11. Supervision 1:1 weekly Uninterrupted Supportive Reflective Collaborative/solution focused Safe place Technical Consultation Assist with identifying resources Should mirror relationships w/clients

12. Technology Laptops/smart phones Electronic referral system HIE/Doc2Doc (coming soon) Social media (Facebook) Texting! (but not while driving!! ) Distance learning/communication THD, OSDH and NFP Websites

13. Quality Quarterly Record Audits Annual Site Visits Ongoing participation in research Fidelity to NFP Model (evidenced based) Logic model (pathway to outcomes) Annual Cont. Education (OHCA) Mentoring Students

14. Age of Clients FY 2010 18y and younger 32% 19-24 52% 25-34 14% 35 + 1%

15. Race FY 2010 Caucasian 32% African American 28% Hispanic 26% Native American 4% “Growing” Burmese Pop.

16. Referral Sources 2010 (n= 565) Other 34% Babyline 27% Self Referral 14% Family Planning 7% WIC 5% 2011=37% of referrals came from WIC!! Faith Based 4% IHC 4% Private Dr. 2% Current/past Clt. 2% Preg. Test Clinic 1%

17. Data SFY 2010 Enrolled in Medicaid 80% Enrolled in WIC 58% Living at or below FGP 99% Premature Births (<37w gest) 12% Initiate Breastfeeding 81% Report still BF @ 6mo 27% Births in 2010 n 219 Graduates n 103

19. Resources Nurse Family Partnership website www.nursefamilypartnership.org Tulsa Health Department website www.tulsa-health.org Oklahoma State Department of Health website www.ok.gov/health