Jamie Tuckett is the registered nurse assigned to visit the Newtons. Tuckett helps the young parents in all kinds of ways. When Kailey considered dropping out of high school because of the pregnancy, Tuckett reminded the expectant mother of her goal to be the first person in her family to go to college. As Kailey and Andrew planned their wedding, Tuckett coached them on dealing with conflict in marriage. And when Kailey had painful contractions during her seventh month of pregnancy, Tuckett gave her advice on what to do.
On a recent visit, Kailey told Tuckett about Rhiley's recent bout of fussiness. Tuckett responded lovingly with useful information. "Four months is around the time babies start teething," she said. Together they checked the baby's mouth for teeth. Although nothing was visible yet, it's just a matter of time before little white caps will appear on Rhiley's middle bottom gums.
Tuckett gave the couple suggestions to minimize teething discomfort. "Baby Tylenol and Orajel, which you can get at Walmart, work best," she said. She also recommended cold chew toys and teething tablets that dissolve in the baby's mouth.
NFP isn't the only parenting intervention for low income families, but it has the distinction of being the only program that produces results for children and their parents in a cost-effective way, said Greg Duncan, professor of education at UC Irvine. The program, which is funded by grants from federal and state governments, costs $8,000 per family. While that isn't an insignificant sum, the government ultimately saves money when families participate, according to a 2005 study by the RAND Corporation.
Families who participate in the program are less likely to need financial support in the form of welfare, food stamps and child-care credits, which is why, according to the RAND study, the government saves $9,000 on each low-risk family that participates in the program and almost $40,000 on each participant considered higher risk.
Participants report a 48 percent reduction in child abuse and neglect and a 56 percent reduction in emergency room visits for accidents and poisoning. NFP babies are also more likely to be born full-term, more likely to have healthy birth weights because their mothers are more likely to receive prenatal care and have a diet, and are less likely to smoke and drink.
Why it works
NFP succeeds where other programs fail for a few reasons, according to Duncan.
First, NFP parental coaches are registered nurses. That's a significant component because registered nurses are consistently rated the most honest and ethical professionals by Americans, according to Gallup research.
"Our patients trust us," Tuckett says. Kami Peterson, Tuckett's boss, suggests patient confidence is a function of nurses' training. "As nurses, we have a mix of medical and developmental knowledge," she said. "That helps patients feel reassured that we can help them." Nurses can answer questions about mothers' changing bodies, developing babies and temperamental emotions. Social workers, volunteers and teachers won't necessarily have that information.
A second reason the program works, according to Duncan, is that NFP nurses have lots of contact with their patients. NFP nurses visit their patients twice monthly throughout the pregnancy and up until the child is 2. Most other parental coaching programs are taught in classroom settings over a period of 12 to 14 weeks.
Related to the amount of time nurses spend with patients is the fact that the program is patient-directed. "We talk about the things they want to talk about," said Tuckett. NFP also stresses a non-judgmental culture. "My job isn't to tell my patients what to do," said Tuckett, "it is to support them in defining their own goals."
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