Opening doors: An innovative public health nursing initiative

Participant retention in preventive health initiatives concern public health professionals. Program “drop-outs” miss opportunities to achieve personal goals. Attrition patterns require ongoing provider attention. Factors that influence drop out decisions need documentation. This presentation describes the Philadelphia Nurse-Family Partnership (NFP) innovative program “Opening Doors” funded by the Pew Charitable Trusts to address retention until graduation challenges. The goal is 60% of enrolled women. The Philadelphia Nurse-Family Partnership is a replication model. The model was developed by Dr. David Olds in the late 1970s. NFP is an intensive public health nurse home visitation program targeting first time, low-income mothers-to-be and their offspring until age two years of age (graduation). Program descriptions, program outcomes, cost-benefit analyses and other facts regarding NFP are available on the National Service Office website: www: nursefamilypartnership.org. The Philadelphia NFP was established in 2001. Over time, the demographic, social, economic and health profiles of NFP mothers have changed. Women are poorer and report more mental health diagnoses. They have marginal housing and move frequently. Many clients (30%) move five or more times in one year. The Opening Doors grant supports the Housing Specialist Social Worker position to work with NFP mothers regarding life skills and housing options. The evolution of the Opening Doors program, the Housing Specialist roles, and responsibilities, and short-term participant/program outcomes are presented. The addition of the Housing Specialist represents an innovative strategy to address a pervasive retention until graduation issue. Lessons learned and potential replication opportunities with similar low-income, high risk populations are discussed.