Starting Up: Challenges and Strengths of Beginning a Statewide Home Visiting Program for Pregnant/Parenting Adolescents


Poster Presentation


To describe the experience of nurses implementing an evidence-based home visitation program (Nurse Family Partnership) in six different areas of one state. The Nurse Family Partnership is a home visitation program serving first-time pregnant and parenting adolescents.


This secondary analysis was part of a study assessing the systematic statewide implementation of an evidence-based home visitation program in South Carolina.


Six counties in the state of South Carolina.


This report describes findings from in-depth, semistructured interviews of 15 nurses. Fourteen of the 15 participants were women; 50% had a graduate degree, and mean age was 50.6 (range = 29-65 years). Nurses had lived in their communities for at least 7 years.


The interview guide was derived from the conceptual model of the larger study and addressed the nurse's perceptions of program implementation, collaborative processes, patient needs, and model fidelity. All interviews were taped and transcribed verbatim. Transcripts were reviewed by two independent reviewers with a third reviewer assisting with any discrepancies.


Two broad themes emerged: first, preparation for implementation with subthemes of training, motivation, model fidelity, tools for the field, and role evolution; second, challenges in the field with subthemes of patient needs, referrals, recruitment, and nurse–patient relationship. Of note, many participants identified an altruistic motivation for involvement in the evidence-based home visitation program, a need for understanding the scope of model fidelity and having a supportive system.

Conclusion/Implications for Nursing Practice

This study adds to the growing body of knowledge on the translation of evidence-based home visitation programs into practice. A systematic understanding of the experiences of nurses during the implementation process can play a key part in ensuring fidelity of a program to the model from the outset.