Sample Undergraduate 2:1 Nursing Literature Review
Although there have been attempts to provide comprehensive approaches to enhance the wellbeing of children, young people, and their families, inequalities and child poverty still persist, hindering vulnerable and disadvantaged groups from achieving their full potential in all aspects of their health, development, and wellbeing. Early intervention in a child’s life is seen as vital in shaping their health, social, educational, and cognitive outcomes, and this is reflected in current policies, guidelines, and research, which advocate for child-focused services and care provision. Rather than providing services based on reactive or crisis management models, there is a call for transformative changes that prioritize early support, prevention, and intervention. As part of this renewed focus on early intervention, providing parenting support has become increasingly important, with the view that parents are best placed to improve their children’s outcomes. Parenting support can come in various forms, including the provision of parenting programs delivered in group settings or within the home. Therefore, there is a need for evidence-based parenting programs to be available to parents in the UK who could benefit from this additional support to ensure that the needs of children and young people are met promptly. Although many parenting programs exist in the UK and internationally, the Family Nurse Partnership is a widely available program throughout the UK that originates from the USA and has a strong evidence base. The program involves 64 home visits, beginning prenatally and lasting until the child is two years old, and is delivered by highly trained nurses. This paper aims to review the literature on early interventions for vulnerable or disadvantaged children and families, explore the potential impacts of early experiences on infant brain development, and critically evaluate the role of parenting programs, particularly the literature on the Family Nurse Partnership in the UK.
Early childhood prevention strategies and early interventions are crucial to improve outcomes for children. Studies suggest that interventions in the early years of a child’s life can have long-term benefits by reducing criminality and violent offending as well as drug and alcohol misuse. The cost of intervening early is cost-effective, and returns on investment are substantial, but support reduces the later it is provided. Spending on early interventions is low, and most budgets go to older children aged 12-17 years. The foundations of a child’s brain architecture are laid in early life, and the development of strong, secure attachments with caregivers is essential for optimal brain development. Children who experience neglectful or abusive environments are at risk of poorly developed social skills, lack empathy, and have difficulty regulating their emotions, leading to mental health, relationship, and antisocial problems. Parenting support can protect children and improve outcomes by providing sensitive parenting, based on supportive relationships and quality parent-child relationships. Parenting programmes are key to improving outcomes for vulnerable or disadvantaged children and families.
The Family Nurse Partnership
The FNP is a program designed by Olds in 2006 to provide preventative home visits for first-time mothers under the age of 19, with the main goals of improving maternal health and pregnancy outcomes, child health and development, and parental economic self-sufficiency. The program has a significant evidence base demonstrating both short and long-term benefits to families and children, making it superior to other parenting programs, according to Trotter (2012). The FNP is widely offered in the USA, serving approximately 26,000 families annually, and has also been implemented in Canada, the Netherlands, and the UK (Olds et al, 2013). Olds believes that using randomized control trials in different national contexts with varying populations is crucial in establishing a robust evidence base to confirm the value of the program. Trials have revealed that children who participate in the FNP program experience improved emotional and speech development, better school readiness and performance, fewer behavioral problems, and less use of alcohol and substances. Women who receive the program also experience fewer subsequent pregnancies and improved employment opportunities (Olds, 2006; Landy et al, 2012).
Providing early interventions is crucial in improving outcomes for disadvantaged or vulnerable children and their families. What children experience during their early years greatly affects their future health, development, and wellbeing. Positive parenting and relationships foster strong attachments, which enhance their self-regulation, empathy, social skills, and cognitive abilities, as stated by Allan (2011).
Recent research continues to highlight the significance of supporting families during the early years to offer nurturing parenting and reduce inequalities that persist both in the UK and globally, according to the Department of Health (2008). Parenting support is a key feature of most current UK policies that affect children and families, with emphasis on parenting programs as a method of helping parents improve their children’s outcomes. Although several parenting programs are available throughout the UK, their fidelity and effectiveness vary widely. However, the FNP has undergone rigorous evaluation and is, therefore, being implemented worldwide.
According to the literature review, children who participate in the program experience a range of positive outcomes, including improved emotional regulation, speech and language development, school readiness and attainment, fewer behavioral problems, reduced use of alcohol and substances, and fewer injuries. Mothers also benefit from increased spacing between pregnancies, fewer subsequent pregnancies, and improved employment outcomes. These findings are supported by Olds (2006), Landy et al (2012), and Barnes (2012). However, a recent study by Robling et al (2016) contradicts these results and suggests that the program does not significantly improve outcomes compared to children who receive universal health visiting services. It is also noted that the transferability of the program to UK settings needs further evaluation to ensure fidelity to the program’s license.
This conflict in findings needs further exploration as it contrasts with the vast amount of literature supporting the FNP program. Despite the conflicting results, the program continues to be delivered to a large number of families in the UK and internationally, highlighting the critical role of parenting support in improving outcomes for children and their families.