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Health district’s nurse-family partnership to expand

Five-month-old Emma Ohnesorg is examined by Public Health nurse Alison Rasmussen, left as her mother, Holly, looks on with a smile, on Thursday, April 6, 2017. The visit is part of the Nurse-Famliy Partnership. (Kathy Plonka / The Spokesman-Review)
Five-month-old Emma Ohnesorg is examined by Public Health nurse Alison Rasmussen, left as her mother, Holly, looks on with a smile, on Thursday, April 6, 2017. The visit is part of the Nurse-Famliy Partnership. (Kathy Plonka / The Spokesman-Review)

A Spokane County program that provides new mothers with one-on-one visits from a nurse is expanding as part of a research study.

The Spokane Regional Health District’s nurse-family partnership will now take mothers who have had previous children as part of a study by the Prevention Research Center at the University of Colorado.

Nurse-family partnerships across the country have shown success in lowering rates of child abuse and involvement with social services for new mothers, as well as improving birth outcomes, vaccination rates and other health measures.

It’s a serious issue in Spokane County, where the health district has recorded about 50,000 child abuse cases over the past decade. Parents who are overwhelmed, don’t have the support they need and don’t know how to best care for a fussy child are particularly at risk.

“The philosophy behind nurse-family partnership is that in every woman’s life when she becomes pregnant there’s kind of a golden opportunity to make change by talking with a nurse,” said Sue Schultz, the director of the health district’s program.

The research project, which is looking at seven agencies across the country, will see if the same gains hold for mothers who have already had a child.

In Spokane County, nurses do home visits starting in the 28th week of pregnancy and continuing until the child is 2, offering support and help with nutrition, breastfeeding and child development.

“It’s a relationship-based program,” Schultz said. Nurses become close with the families they work with, and families often find it easier to take advice from someone they’ve grown to know and trust, she said.

During the early portion of the program, visits are weekly, and nurses track health indicators for the mom and the new baby.

“We want to try to get them early in pregnancy so we can have a positive impact on birth outcomes,” Schultz said.

There are typically about 125 families in the nurse-family partnership, of whom maybe one or two are involved with Child Protective Services, Schultz said. That’s much lower than the involvement rate for parents of similar demographics.

Spokane had extra capacity for about 50 more women in the existing program and agreed to participate in the research so they could use some of those slots.

Schultz is hoping to sign up pregnant women at higher risk for poor birth outcomes because of risk factors like previous babies with low birth weight, prior pre-term births, homelessness, substance abuse or mental illness.

But the only requirements are for women to be less than 28 weeks pregnant and low-income. Qualifying for Medicaid for Women, Infants and Children meets the income guidelines.

“I don’t want it to be a program where people think that that doesn’t apply to me because I don’t have all of those things,” Schultz said.

The study will track programs until 2019. Right now, the health district is focusing on recruitment and outreach through internal medicine specialists who often care for women with high-risk pregnancies.

“We see these vulnerable families and we see inadequate resources and feel like we can really make a difference in the lives of these families,” Schultz said.