Public health nurses' perceptions of their interactions with child protection services when supporting socioeconomically disadvantaged young mothers in British Columbia, Canada

• Published in: Child abuse & neglect 2022-02, Vol.124, p.105426-105426, Article 105426
• Main Authors: Marcellus, Lenora, Tonmyr, Lil, Jack, Susan M., Gonzalez, Andrea, Sheenan, Debbie, Varcoe, Colleen, Kurtz Landy, Christine, Campbell, Karen, Catherine, Nicole, MacMillan, Harriet, Waddell, Charlotte
• Format: Article
• Language: English
• Subjects: Adolescent mothers; British Columbia - epidemiology; Child; Child Abuse; Child protection; Child Protective Services; Child Safety; Child welfare; Children; Clinical trials; Coding; Collaboration; Developmental delays; Disadvantaged; Early intervention; Evaluation; Families & family life; Female; Focus Groups; Formative Evaluation; Health services; Health status; Home visitation; House Calls; Humans; Integrated care; Mapping; Maternal & child health; Maternal characteristics; Mothers; Nurse-Family Partnership; Nurses; Nurses, Public Health; Organizational effectiveness; Process evaluation; Protection; Public health; Public health nurse; Public health nurses; Randomized Controlled Trials; Structural models; Uncertainty; Young mothers; Young women
• ISSN: 0145-2134; 1873-7757
• DOI: 10.1016/j.chiabu.2021.105426

Children of girls and young women experiencing socioeconomic disadvantage are at risk of maltreatment and associated health and developmental problems. Nurse-Family Partnership (NFP) is an early intervention program designed to improve child and maternal health outcomes. The effectiveness of NFP is being evaluated in British Columbia (BC) through a randomized controlled trial, augmented by a process evaluation to identify influences on how NFP was implemented. To describe how public health nurses providing NFP perceived their interactions with child protection professionals. Forty-seven public health nurses across BC. The principles of interpretive description informed the qualitative component of the process evaluation. Data from interviews and focus groups were analyzed using the framework analysis approach. A thematic framework was generated through processes of coding, charting and mapping, with a focus on organizational and systems influences. Nurses' practice in supporting families often involved engagement with child protection services. Four themes about the nature of this work were identified: 1) developing a deeper understanding of the disciplinary perspectives of child protection, 2) striving for strengthened collaboration, 3) navigating change and uncertainty, and 4) responding to family and community complexity. Participants valued the contribution of child protection professionals and expressed willingness to collaborate to support families. However, collaboration was constrained by multiple structural barriers. Collaborative models offer possibilities for integrated practice, although can be difficult to implement within current health and child protection systems and child protection regulatory contexts.