Women's reasons for attrition from a nurse home visiting program

Area of Science:

• Maternal and Child Health
• Sociology of Health
• Public Health Interventions

Background:

• Home visiting programs, such as the Nurse-Family Partnership (NFP), aim to improve child well-being for low-income mothers.
• Understanding reasons for early program departure is crucial for optimizing intervention effectiveness and resource allocation.

Purpose of the Study:

• To identify and describe mothers' primary reasons for discontinuing participation in an NFP home visiting program before completion.
• To explore the perspectives of both mothers and service providers regarding barriers to program retention.

Main Methods:

• A qualitative descriptive study was conducted at a NFP site in New York State.
• Data were collected through semistructured interviews with 21 mothers who dropped out and focus groups with 8 nurses and 3 nurse supervisors.
• Content analysis was employed to analyze the qualitative data.

Main Results:

• Key reasons for early departure included perceived poor fit with personal needs and life circumstances, unmet expectations of the nurse, lack of program content relevance, and a desire to end visits post-infancy.
• Mothers and nurses highlighted the importance of maternal organizational and communication skills for program engagement.
• External factors such as nurse turnover, unstable housing, and frequent moves significantly impacted retention, often interacting to create complex barriers.

Conclusions:

• Enhancing NFP program retention may involve tailoring program relevance to individual maternal circumstances and needs.
• Strengthening mothers' organizational and communication skills through targeted support could improve engagement and program completion.