A Qualitative Inquiry into Nurse-Family Partnership Black Client Perspectives

Nurse-Family Partnership (NFP) is a home visiting program designed to improve pregnancy outcomes, child health and development, and life course outcomes for families facing socioeconomic inequalities through support and education provided by nurses to first-time mothers during pregnancy and up to 2 years postpartum. Studies show that home visiting programs like NFP have positive outcomes, but attrition remains a concern which may impact the desired health equity goals. Black mothers are more likely to withdraw from the NFP program, and research is lacking regarding their experiences in home visiting programs despite facing maternal health inequities rooted in racism. The present study aimed to understand factors that influenced program continuation and provide insights for program improvement. Semi-structured qualitative interviews were conducted with 21 Black NFP clients from multiple sites. Key findings include the importance of the nurse-client relationship, access to reliable health information, and racial concordance in the nurse-client pairing. Clients valued supportive, nonjudgmental nurses who provided dependable support and education. Racially concordant partnerships were perceived as more comfortable and understanding, fostering trust and open communication. Clients also suggested that invasion of privacy during home visits and a lack of connection with their nurse could contribute to program discontinuation. Efforts to increase program retention of Black clients should focus on fostering a strong nurse-client alliance. Recommendations include increasing racial diversity in the nurse workforce, implementing a nurse-client matching system, and allowing clients to request a new nurse if needed.