Process Evaluation of British Columbia Healthy Connections Project

1.2.	Introduction

The British Columbia Healthy Connections Project (BCHCP) is scheduled to begin in spring 2013 and its effectiveness compared to baseline services will be evaluated by a randomized controlled trial (RCT). The Public Health Agency of Canada (PHAC) has a requirement to have evaluated the process of implementing the BCHCP. The BCHCP is a Canadian adaptation of the Nurse-Family Partnership (NFP), an American program of prenatal and infancy home visiting proven to improve health and development outcomes for young, socially disadvantaged first time mothers and their children.  As such it is of key interest in terms of PHAC's commitment to prevent mental illness, promote health, and support determinants of health in vulnerable populations. The NFP is defined by 18 model elements (e.g., client participation is voluntary; client has low income; client is a first-time mother; client is visited in her home; nurse home visitors apply the visit guidelines, individualized to the strengths and challenges of each family; nurse home visitor has no more than 25 clients; visits begin in pregnancy and continue until child's second birthday).  The nurses need to learn the program, then implement it with enrolled families. The Process Evaluation is necessary in order to inform PHAC how the NFP could be used in Canada, including in rural and remote regions, to further key Health Portfolio objectives.

1.3.	Objectives of the Requirement
The objectives are to design, conduct, and share an evaluation of the process of implementing an adapted version of the NFP in Canada (32 health agencies in British Columbia). The process evaluation must include some, (but not be limited to) health agencies participating in the RCT. The expected results of the process evaluation are a series of at least three peer-reviewed publications describing the successful completion of the process evaluation, and the production of materials that could be used in future implementations of the program and in evaluations of any future implementations.