Family Nurse Partnership evaluation: methods and process

3. Outcome measures

3.1. Outcomes 

The evaluation specification required there to be no pre-specified primary outcome(s). The outcomes of this study closely follow the key activities and outcomes in the FNP programme’s logic model (Appendix 1). A brief list of outcomes to be included in the evaluation is provided in Table 6 below and a full listing of all 54 outcomes is provided as an online supplement. 

Outcomes are listed according to the logic model and the following information provided:

• the data source
• the variables to be used
• whether the outcome is specifically mentioned in the logic model
• the hypothesised direction of FNP programme effect
• the outcome to be analysed with the main method
• any pre-defined sensitivity analyses such as adjustment for FNP

dosage or sub-group analyses to be performed.

Also included in this supplement are all data sources and outcomes considered but subsequently not used, and any identified gaps where it is indicated in the logic model but no data source is available. 

3.1.1. Categorisation of outcomes

The ability to report on outcomes will depend on several factors: geographical and study cohort coverage, data quality (e.g. completeness), and possible bias in outcomes (such as FNP nurses carrying out child health assessments). As a result, the outcomes have been categorised into either short-term, medium-term, or descriptive. 

Short term outcomes (n=20): These map well to the logic model, are known to have good data quality, and coverage across Scotland and our study cohort (thus maximising the number that can be formally analysed using statistical methods). These outcomes are likely to be associated with the pregnancy and birth period, and up to the child’s 2^nd birthday (e.g. child health outcomes). These outcomes will be formally analysed using statistical methods

Medium-term outcomes (n=14): These outcomes rely on data only measured in the period after the 2^nd birthday (e.g. school based outcomes at age 4 years of age onwards) and the population included in the analysis would be restricted as a result. These outcomes will also be formally analysed using statistical methods. Medium term outcomes also include those where the analysis would incorporate a time to event approach that would use our study cohort.

Descriptive outcomes (n=20): We will describe outcomes where the direction of the FNP effect is either uncertain, where outcomes are rare, or where the data are classed as experimental statistics (i.e. a type of official statistic that is undergoing development e.g. child attainment).

Table 6: Maternal and child outcomes and follow-up time points

1. ST - Short term outcome; MT - Medium term outcome; D - Descriptive outcome;

2. Birthweight appropriate for gestational age and adjusted for gestational age, maternal height, maternal weight at booking, parity and ethnic group - Gestation Related Optimal Weight GROW [24]

3. Concern in any of the following areas: Gross and Fine Motor, Speech, Language and Communication, Social, emotional, behavioural, and attention, hearing and vision

4. Learning disability, Dyslexia, Other specific learning difficulty, Other moderate learning difficulty, Deafblind, Autistic spectrum disorder, Physical health problem, and Mental health problem.