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103-470: Nurse-Family Partnership ( NFP ) is a non-profit organization operating in the United States that connects mothers pregnant with their first child with registered nurses , who provide home visits until the child's second birthday. NFP intervention has been associated with improvements in maternal health, child health, and economic security. NFP started as a randomized control trial. The trial

206-440: A New England group practice who were prescribed antihypertensive medication participated in an adherence to antihypertensive medication intervention. The vast majority (73%) of the intervention group who were previously pre-Action were adhering to their prescribed medication regimen at the 12-month follow-up when compared to the control group. Members of a large New England health plan and various employer groups who were prescribed

309-587: A bachelor's degree in nursing. NFP nurse training consists of three phases. First, there is an orientation unit, which includes 40 hours of self-study. Second, there is an in-person education/experiential practice unit, which takes place in 25 hours over 2–4 days in Denver, Colorado. Finally, there is a long-distance education unit, with around 10 hours of team-based, supervisor-led professional development modules. "Nurse supervisors provide nurse home visitors clinical supervision with reflection, demonstrate integration of

412-465: A certain situation. This core construct identifies the depth or complexity of presenting problems according to five levels of increasing complexity. Different therapeutic approaches have been recommended for each level as well as for each stage of change. The levels are: In one empirical study of psychotherapy discontinuation published in 1999, measures of levels of change did not predict premature discontinuation of therapy. Nevertheless, in 2005

515-571: A change in environment or in the child's role. Nurses study the mother's relationships with her partner and other people in her life, as well as the greater community dynamic, to help mothers navigate potential challenges they may face in motherhood. NFP begins during pregnancy to take advantage of this ecological transition point in the mother's life. Bandura's theory of self-efficacy holds that when people believe in their ability to meet challenges and be successful, they are more likely to do so, and each success further fuels this belief. Giving someone

618-463: A child's development, making the quality of parental care in early childhood vital. Attachment theory is used in NFP in two ways. First, it is used to encourage mothers to bond with their children (e.g., explaining that infants learn to recognize mother's voice in the womb, pointing out when the child expresses trust in and dependence on the mother). Second, it is used to inform the nurse's relationship with

721-470: A cholesterol lowering medication participated in an adherence to lipid-lowering drugs intervention. More than half of the intervention group (56%) who were previously pre-Action were adhering to their prescribed medication regimen at the 18-month follow-up. Additionally, only 15% of those in the intervention group who were already in Action or Maintenance relapsed into poor medication adherence compared to 45% of

824-454: A community agency. Sessions last between 60 and 90 minutes. NFP is client-centered , meaning the nurse continuously adapts to ensure relevant and valuable sessions for the client; relational , meaning the primary tool for growth and learning is the relationship between the mother and nurse; strengths-based , meaning mothers reflect on their own successes to facilitate their learning and behavior change; and multi-dimensional , meaning it takes

927-522: A construct called contextual focus , a spectrum from physiological microcontext to environmental macrocontext: "The horizontal, contextual focus dimension resembles TTM's Levels of Change, but emphasizes the breadth of an intervention, rather than the latter's focus on intervention depth ." The outcomes of the TTM computerized tailored interventions administered to participants in pre-Action stages are outlined below. A national sample of pre-Action adults

1030-506: A decisional "balance sheet" of comparative potential gains and losses. The balance between the pros and cons varies depending on which stage of change the individual is in. Sound decision making requires the consideration of the potential benefits (pros) and costs (cons) associated with a behavior's consequences. TTM research has found the following relationships between the pros, cons, and the stage of change across 48 behaviors and over 100 populations studied. The evaluation of pros and cons

1133-424: A delegate structure to allow for the representation of groups or corporations as members. Alternatively, it may be a non-membership organization and the board of directors may elect its own successors. The two major types of nonprofit organization are membership and board-only. A membership organization elects the board and has regular meetings and the power to amend the bylaws. A board-only organization typically has

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1236-476: A financial rating of 56.98/70 and an accountability rating of 66/70. The Center for High Impact Philanthropy listed the Nurse-Family Partnership as a high-impact opportunity in its holiday giving guide and elsewhere on its website. The Coalition for Evidence-Based Policy published a detailed review of the evidence of success of the NFP's programs on its website. GuideStar has awarded

1339-554: A fiscally viable entity. Nonprofits have the responsibility of focusing on being professional and financially responsible, replacing self-interest and profit motive with mission motive. Though nonprofits are managed differently from for-profit businesses, they have felt pressure to be more businesslike. To combat private and public business growth in the public service industry, nonprofits have modeled their business management and mission, shifting their reason of existing to establish sustainability and growth. Setting effective missions

1442-400: A gradually increasing relationship to stage of change for bike commuting. As expected, intention or willingness to perform the behaviour increases by stage. Similarly, Bamberg uses various behavior models, including the transtheoretical model, theory of planned behavior and norm-activation model, to build the stage model of self-regulated behavior change (SSBC). Bamberg claims that his model is

1545-477: A holistic view of the mother and her life, aiming to affect various aspects of it. Nurses use Prochaska's Transtheoretical Model of Change to help mothers work through problems. This framework assesses the mother's readiness to embrace a new behavior change and provides processes of change to guide her. Content of Visits The goal of prenatal visits is to facilitate compliance with health guidelines, coordinate care with physicians, and provide encouragement to

1648-471: A low-stress work environment that the employee can associate him or herself positively with. Other incentives that should be implemented are generous vacation allowances or flexible work hours. When selecting a domain name , NPOs often use one of the following: .org , the country code top-level domain of their respective country, or the .edu top-level domain (TLD), to differentiate themselves from more commercial entities, which typically use .com . In

1751-457: A nonprofit entity without having tax-exempt status. Key aspects of nonprofits are accountability, integrity, trustworthiness, honesty, and openness to every person who has invested time, money, and faith into the organisation. Nonprofit organizations are accountable to the donors, founders, volunteers, program recipients, and the public community. Theoretically, for a nonprofit that seeks to finance its operations through donations, public confidence

1854-526: A number of think tanks including the Center for American Progress and the Brookings Institution . Practitioners may experience burn-out given that nurses carry a caseload of at least 25 families, endure emotionally taxing work, and often lack agency support. This can lead to high turnover, which then compounds the situation as current nurses must take on departing nurses' caseloads. However,

1957-419: A population basis. The treatment produced the highest population impact to date on multiple health risk behaviors. The effectiveness of the use of this model in weight management interventions (including dietary or physical activity interventions, or both, and also combined with other interventions) for overweight and obese adults was assessed in a 2014 systematic review. The results revealed that there

2060-681: A relapse. Achieving a long-term behavior change often requires ongoing support from family members, a health coach, a physician, or another motivational source. Supportive literature and other resources can also be helpful to avoid a relapse from happening. The 10 processes of change are "covert and overt activities that people use to progress through the stages". To progress through the early stages, people apply cognitive, affective, and evaluative processes. As people move toward Action and Maintenance, they rely more on commitments, counter conditioning, rewards, environmental controls, and support. Prochaska and colleagues state that their research related to

2163-482: A related, but untreated behavior: fruit and vegetable consumption. Over 48% of those in the treatment group in a pre-Action stage at baseline progressed to Action or Maintenance for eating at least 5 servings a day of fruit and vegetables as opposed to 39% of the comparison group. Individuals in the treatment group who were in a pre-Action stage for exercise at baseline were also significantly more likely to reach Action or Maintenance (44.9% vs. 38.1%). The treatment also had

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2266-697: A self-selected board and a membership whose powers are limited to those delegated to it by the board. A board-only organization's bylaws may even state that the organization does not have any membership, although the organization's literature may refer to its donors or service recipients as 'members'; examples of such organizations are FairVote and the National Organization for the Reform of Marijuana Laws . The Model Nonprofit Corporation Act imposes many complexities and requirements on membership decision-making. Accordingly, many organizations, such as

2369-429: A significant effect on managing emotional distress without eating, with 49.7% of those in a pre-Action stage at baseline moving to Action or Maintenance versus 30.3% of the comparison group. The groups differed on weight lost at 24 months among those in a pre-Action stage for healthy eating and exercise at baseline. Among those in a pre-Action stage for both healthy eating and exercise at baseline, 30% of those randomized to

2472-460: A solution to criticism raised towards the TTM. Some researchers in travel, dietary, and environmental research have conducted empirical studies, showing that the SSBC might be a future path for TTM-based research. This core construct is "the situation-specific confidence people have that they can cope with high-risk situations without relapsing to their unhealthy or high risk-habit". The construct

2575-450: A specific stage, while others can be used in one or more stages. This core construct "reflects the individual's relative weighing of the pros and cons of changing". Decision making was conceptualized by Janis and Mann as a " decisional balance sheet " of comparative potential gains and losses. Decisional balance measures, the pros and the cons, have become critical constructs in the transtheoretical model. The pros and cons combine to form

2678-426: A stable workforce is associated with higher retention. Non-profit organization A nonprofit organization ( NPO ), also known as a nonbusiness entity , nonprofit institution , or simply a nonprofit , is a legal entity organized and operated for a collective, public or social benefit, as opposed to an entity that operates as a business aiming to generate a profit for its owners. A nonprofit organization

2781-471: A strong vision of how to operate the project, try to retain control of the organization, even as new employees or volunteers want to expand the project's scope or change policy. Resource mismanagement is a particular problem with NPOs because the employees are not accountable to anyone who has a direct stake in the organization. For example, an employee may start a new program without disclosing its complete liabilities. The employee may be rewarded for improving

2884-421: A task that they believe they can perform is one way to enhance self-efficacy. NFP aims to give mothers more confidence by asking them to recall past successes, as well as engaging them in problem-solving tasks. Bowlby's attachment theory holds that infants are biologically driven to bond with others, and this drive is reinforced by attentive parenting. Further, it is the child–caregiver relationship that shapes

2987-581: A wide diversity of structures and purposes. For legal classification, there are, nevertheless, some elements of importance: Some of the above must be (in most jurisdictions in the US at least) expressed in the organization's charter of establishment or constitution. Others may be provided by the supervising authority at each particular jurisdiction. While affiliations will not affect a legal status, they may be taken into consideration by legal proceedings as an indication of purpose. Most countries have laws that regulate

3090-399: Is a factor in the amount of money that a nonprofit organization is able to raise. Supposedly, the more a nonprofit focuses on their mission, the more public confidence they will gain. This will result in more money for the organization. The activities a nonprofit is partaking in can help build the public's confidence in nonprofits, as well as how ethical the standards and practices are. There

3193-461: Is a key for the successful management of nonprofit organizations. There are three important conditions for effective mission: opportunity, competence, and commitment. One way of managing the sustainability of nonprofit organizations is to establish strong relations with donor groups. This requires a donor marketing strategy, something many nonprofits lack. Nonprofit organizations provide public goods that are undersupplied by government. NPOs have

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3296-439: Is an important distinction in the US between non-profit and not-for-profit organizations (NFPOs); while an NFPO does not profit its owners, and money goes into running the organization, it is not required to operate for the public good. An example is a club, whose purpose is its members' enjoyment. Other examples of NFPOs include: credit unions, sports clubs, and advocacy groups. Nonprofit organizations provide services to

3399-414: Is an important distinction in the US between non-profit and not-for-profit organizations (NFPOs); while an NFPO does not profit its owners, and money goes into running the organization, it is not required to operate for the public good. An example is a sports club, whose purpose is its members' enjoyment. The names used and precise regulations vary from one jurisdiction to another. According to

3502-419: Is based on Bandura's self-efficacy theory and conceptualizes a person's perceived ability to perform on a task as a mediator of performance on future tasks. In his research Bandura already established that greater levels of perceived self-efficacy leads to greater changes in behavior. Similarly, Ajzen mentions the similarity between the concepts of self-efficacy and perceived behavioral control. This underlines

3605-557: Is concerned. In many countries, nonprofits may apply for tax-exempt status, so that the organization itself may be exempt from income tax and other taxes. In the United States, to be exempt from federal income taxes, the organization must meet the requirements set forth in the Internal Revenue Code (IRC). Granting nonprofit status is done by the state, while granting tax-exempt designation (such as IRC 501(c) )

3708-453: Is granted by the federal government via the IRS. This means that not all nonprofits are eligible to be tax-exempt. For example, employees of non-profit organizations pay taxes from their salaries, which they receive according to the laws of the country. NPOs use the model of a double bottom line in that furthering their cause is more important than making a profit, though both are needed to ensure

3811-470: Is inconclusive evidence regarding the impact of these interventions on sustainable (one year or longer) weight loss . However, this approach may produce positive effects in physical activity and dietary habits, such as increased in both exercise duration and frequency, and fruits and vegetables consumption, along with reduced dietary fat intake, based on very low quality scientific evidence. Multiple studies have found individualized interventions tailored on

3914-408: Is not classifiable as another category. Currently, no restrictions are enforced on registration of .com or .org, so one can find organizations of all sorts in either of those domains, as well as other top-level domains including newer, more specific ones which may apply to particular sorts of organization including .museum for museums and .coop for cooperatives . Organizations might also register by

4017-520: Is part of the formation of decisional balance. During the change process, individuals gradually increase the pros and decrease the cons forming a more positive balance towards the target behaviour. Attitudes are one of the core constructs explaining behaviour and behaviour change in various research domains. Other behaviour models, such as the theory of planned behavior (TPB) and the stage model of self-regulated change, also emphasise attitude as an important determinant of behaviour. The progression through

4120-608: Is recommended that people in this stage seek support from and talk with people whom they trust, spend time with people who behave in healthy ways, and remember to engage in healthy activities (such as exercise and deep relaxation) to cope with stress instead of relying on unhealthy behavior. Relapse (recycling) Relapse in the TTM specifically applies to individuals who successfully quit smoking or using drugs or alcohol, only to resume these unhealthy behaviors. Individuals who attempt to quit highly addictive behaviors such as drug, alcohol, and tobacco use are at particularly high risk of

4223-605: Is subject to the non-distribution constraint: any revenues that exceed expenses must be committed to the organization's purpose, not taken by private parties. Depending on the local laws, charities are regularly organized as non-profits. A host of organizations may be nonprofit, including some political organizations, schools, hospitals, business associations, churches, foundations, social clubs, and consumer cooperatives. Nonprofit entities may seek approval from governments to be tax-exempt , and some may also qualify to receive tax-deductible contributions, but an entity may incorporate as

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4326-881: Is supported through a combination of individual and foundation/corporation donors. Foundations and corporations that support or have supported NFP include the Edna McConnell Clark Foundation , Bill and Melinda Gates Foundation , Robert Wood Johnson Foundation , W.K. Kellogg Foundation , Kresge Foundation , Johnson & Johnson , and others. Many of NFP's programs are carried out in conjunction with federal, state, and local governments and are funded through various programs of these governments. Funding sources include Affordable Care Act , Medicaid and Temporary Assistance for Needy Families . Charity evaluator GiveWell reviewed Nurse-Family Partnership in Fall of 2010. Until November 2011, Nurse-Family Partnership

4429-411: Is the remuneration package, though many who have been questioned after leaving an NPO have reported that it was stressful work environments and the workload. Public- and private-sector employment have, for the most part, been able to offer more to their employees than most nonprofit agencies throughout history. Either in the form of higher wages, more comprehensive benefit packages, or less tedious work,

4532-476: Is unique in which source of income works best for them. With an increase in NPOs since 2010, organizations have adopted competitive advantages to create revenue for themselves to remain financially stable. Donations from private individuals or organizations can change each year and government grants have diminished. With changes in funding from year to year, many nonprofit organizations have been moving toward increasing

4635-709: The NHS to deliver a service to 16,000 of the most disadvantaged new parents in the country. However, there has been less success in the UK than in the USA. A 2015 study from Robling, et al. found improved/earlier identification of safeguarding risks and a valued relationship between mother and nurse, but no benefit to short-term outcomes. In response, FNP has introduced Next Steps, which aims to increase beneficial outcomes, program flexibility, personalization, cost-effectiveness, and knowledge-exchange between services. A 2011 study found that NFP

4738-667: The National Center for Charitable Statistics (NCCS), there are more than 1.5 million nonprofit organizations registered in the United States , including public charities , private foundations , and other nonprofit organizations. Private charitable contributions increased for the fourth consecutive year in 2017 (since 2014), at an estimated $ 410.02 billion. Out of these contributions, religious organizations received 30.9%, education organizations received 14.3%, and human services organizations received 12.1%. Between September 2010 and September 2014, approximately 25.3% of Americans over

4841-596: The Wikimedia Foundation , have formed board-only structures. The National Association of Parliamentarians has generated concerns about the implications of this trend for the future of openness, accountability, and understanding of public concerns in nonprofit organizations. Specifically, they note that nonprofit organizations, unlike business corporations, are not subject to market discipline for products and shareholder discipline of their capital; therefore, without membership control of major decisions such as

4944-486: The 14 TTM variables for smoking cessation to effectively recruit and retain pre-Action participants and produce long-term abstinence rates within the range of 22% – 26%. These interventions have also consistently outperformed alternative interventions including best-in-class action-oriented self-help programs, non-interactive manual-based programs, and other common interventions. Furthermore, these interventions continued to move pre-Action participants to abstinence even after

5047-879: The Action or Maintenance stage at baseline, the intervention helped prevent disease progression to Major Depression during the follow-up period. Five-hundred-and-seventy-seven overweight or moderately obese adults (BMI 25-39.9) were recruited nationally, primarily from large employers. Those randomly assigned to the treatment group received a stage-matched multiple behavior change guide and a series of tailored, individualized interventions for three health behaviors that are crucial to effective weight management: healthy eating (i.e., reducing calorie and dietary fat intake), moderate exercise, and managing emotional distress without eating. Up to three tailored reports (one per behavior) were delivered based on assessments conducted at four time points: baseline, 3, 6, and 9 months. All participants were followed up at 6, 12, and 24 months. Multiple Imputation

5150-546: The Gold participation level to Nurse-Family Partnership for its commitment to data transparency. Great Nonprofits awarded Nurse-Family Partnership the Top-Rated Nonprofit award. Nurse-Family Partnership has been covered in media outlets such as Time , The New York Times , The New Republic , The Washington Post , and USA Today . NFP has received favorable coverage in the blogs and opinion pieces of

5253-474: The NFP nurses facilitated resources and provided motivation to help change and eliminate these adversities to help create a better lifestyle and growing environment for both the parent and the child (Rowe, 2016). Bronfenbrenner's theory of human ecology holds the idea that throughout the lifespan, humans are impacted by their environments, and likewise, humans impact their environments. At "ecological transition" points, developmental opportunities are created from

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5356-416: The NFP provided a tremendous number of benefits to children born in poverty stricken environments (Mason, 2016). Many of the families that participate in these trials had been experiencing many adversities, traumatic lifestyles events, and exposed to environments that were harmful to themselves and potentially harmful for their child. These parents expressed deep desires to protect and nurture their children and

5459-455: The NPO's reputation, making other employees happy, and attracting new donors. Liabilities promised on the full faith and credit of the organization but not recorded anywhere constitute accounting fraud . But even indirect liabilities negatively affect the financial sustainability of the NPO, and the NPO will have financial problems unless strict controls are instated. Some commenters have argued that

5562-461: The age of 16 volunteered for a nonprofit. In the United States, both nonprofit organizations and not-for-profit organizations are tax-exempt. There are various types of nonprofit exemptions, such as 501(c)(3) organizations that are a religious, charitable, or educational-based organization that does not influence state and federal legislation, and 501(c)(7) organizations that are for pleasure, recreation, or another nonprofit purpose. There

5665-649: The appropriate country code top-level domain for their country. In 2020, nonprofit organizations began using microvlogging (brief videos with short text formats) on TikTok to reach Gen Z, engage with community stakeholders, and overall build community. TikTok allowed for innovative engagement between nonprofit organizations and younger generations. During COVID-19, TikTok was specifically used to connect rather than inform or fundraise, as its fast-paced, tailored For You Page separates itself from other social media apps such as Facebook and Twitter. Some organizations offer new, positive-sounding alternative terminology to describe

5768-399: The average yearly income was $ 9,000. While NFP was developed to target mothers, the program welcomes fathers, partners, family members and close friends, to participate. The goal is to ensure that everyone who will be supporting the baby and ideally forming close attachments with him or her will be well-equipped to do so. Clients enroll in the program early in their pregnancy (usually during

5871-401: The best of the newly minted workforce. It has been mentioned that most nonprofits will never be able to match the pay of the private sector and therefore should focus their attention on benefits packages, incentives and implementing pleasurable work environments. A good environment is ranked higher than salary and pressure of work. NPOs are encouraged to pay as much as they are able and offer

5974-479: The better prepared they are, the more likely they are to keep progressing. Stage 4: Action (current action) People at this stage have changed their behavior within the last 6 months and need to work hard to keep moving ahead. These participants need to learn how to strengthen their commitments to change and to fight urges to slip back. People in this stage progress by being taught techniques for keeping up their commitments such as substituting activities related to

6077-565: The community; for example aid and development programs, medical research, education, and health services. It is possible for a nonprofit to be both member-serving and community-serving. Nonprofit organizations are not driven by generating profit, but they must bring in enough income to pursue their social goals. Nonprofits are able to raise money in different ways. This includes income from donations from individual donors or foundations; sponsorship from corporations; government funding; programs, services or merchandise sales, and investments. Each NPO

6180-440: The controls. Further, participants who were at risk for physical activity and unhealthy diet were given only stage-based guidance. The treatment group doubled the control group in the percentage in Action or Maintenance at 18 months for physical activity (43%) and diet (25%). Participants were 350 primary care patients experiencing at least mild depression but not involved in treatment or planning to seek treatment for depression in

6283-409: The creators of the TTM stated that it is important "that both therapists and clients agree as to which level they attribute the problem and at which level or levels they are willing to target as they work to change the problem behavior". Psychologist Donald Fromme, in his book Systems of Psychotherapy , adopted many ideas from the TTM, but in place of the levels of change construct, Fromme proposed

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6386-479: The different stages of change is reflected in a gradual change in attitude before the individual acts. Due to the use of decisional balance and attitude, travel behaviour researchers have begun to combine the TTM with the TPB. Forward uses the TPB variables to better differentiate the different stages. Especially all TPB variables (attitude, perceived behaviour control, descriptive and subjective norm) are positively show

6489-402: The diversity of their funding sources. For example, many nonprofits that have relied on government grants have started fundraising efforts to appeal to individual donors. Most nonprofits have staff that work for the company, possibly using volunteers to perform the nonprofit's services under the direction of the paid staff. Nonprofits must be careful to balance the salaries paid to staff against

6592-511: The dominant model of health behaviour change, having received unprecedented research attention, yet it has simultaneously attracted exceptional criticism". James O. Prochaska of the University of Rhode Island , and Carlo Di Clemente and colleagues developed the transtheoretical model beginning in 1977. It is based on analysis and use of different theories of psychotherapy, hence the name "transtheoretical". Prochaska and colleagues refined

6695-432: The election of the board, there are few inherent safeguards against abuse. A rebuttal to this might be that as nonprofit organizations grow and seek larger donations, the degree of scrutiny increases, including expectations of audited financial statements. A further rebuttal might be that NPOs are constrained, by their choice of legal structure, from financial benefit as far as distribution of profit to members and directors

6798-475: The establishment and management of NPOs and that require compliance with corporate governance regimes. Most larger organizations are required to publish their financial reports detailing their income and expenditure publicly. In many aspects, they are similar to corporate business entities though there are often significant differences. Both not-for-profit and for-profit corporate entities must have board members, steering-committee members, or trustees who owe

6901-724: The expecting mother. These sessions include completion of diet histories and tracking of weight gain, assessment and subsequent reduction of harmful health behaviors such as alcohol and drug use, training in identification of pregnancy complications, and coordination of help-seeking from nurses and physicians. The goal of postnatal visits is to improve the child's physical and emotional care and promote parent–child attachment. These sessions include training in identification and management of child illness, facilitation of understanding child communicative signals, and enhancement of parent–child interactions that safely promote cognitive and emotional development. NFP nurses must be registered nurses with

7004-409: The first trimester) and continue until the child's second birthday. Ideally, the mother enrolls by week 16 of pregnancy, and it is required that the first meeting occur by week 28. The following table illustrates the standard visit schedule, but this is flexible, and is often adjusted based on the client's needs and availability. Visits can take place in the client's home, or in another location such as

7107-422: The healthy behavior a part of their lives. For example, they tell their friends and family that they want to change their behavior. People in this stage should be encouraged to seek support from friends they trust, tell people about their plan to change the way they act, and think about how they would feel if they behaved in a healthier way. Their number one concern is: when they act, will they fail? They learn that

7210-531: The highest-risk families enrolled, most notably seen in government costs. For example, the increased economic self-sufficiency of enrolled families reduced Medicaid enrollment, leading to an 8.5% reduction in costs. NFP operates in over 700 counties across 40 states, as well as in the U.S. Virgin Islands. In the UK the programme is known as the Family Nurse Partnership and has been backed by

7313-442: The idea that the best time to teach health and development behaviors is during the mother's first pregnancy. This also gives time for mothers to work on potentially problematic behaviors before interacting face-to-face with the child. The mothers are often young and single; based on data collected from 1995 to 2017, the mothers in the program had a median age of 20, and 84% were unmarried. Additionally, 57% had completed high school, and

7416-414: The integrative nature of the transtheoretical model which combines various behavior theories. A change in the level of self-efficacy can predict a lasting change in behavior if there are adequate incentives and skills. The transtheoretical model employs an overall confidence score to assess an individual's self-efficacy. Situational temptations assess how tempted people are to engage in a problem behavior in

7519-426: The kind of person they could be if they changed their behavior and learn more from people who behave in healthy ways. Others can influence and help effectively at this stage by encouraging them to work at reducing the cons of changing their behavior. Stage 3: Preparation (ready) People at this stage are ready to start taking action within the next 30 days. They take small steps that they believe can help them make

7622-472: The model on the basis of research that they published in peer-reviewed journals and books. This construct refers to the temporal dimension of behavioural change. In the transtheoretical model, change is a "process involving progress through a series of stages": In addition, the researchers conceptualized "Relapse" (recycling) which is not a stage in itself but rather the "return from Action or Maintenance to an earlier stage". The quantitative definition of

7725-511: The money paid to provide services to the nonprofit's beneficiaries. Organizations whose salary expenses are too high relative to their program expenses may face regulatory scrutiny. A second misconception is that nonprofit organizations may not make a profit. Although the goal of nonprofits is not specifically to maximize profits, they still have to operate as a fiscally responsible business. They must manage their income (both grants and donations and income from services) and expenses so as to remain

7828-467: The mother to build trust, and to model the skill. NFP nurses work with mothers and families to achieve three major goals, which include improving: "1) the outcomes of pregnancy by helping women improve their prenatal health; 2) children's subsequent health and development by helping parents provide competent care; and 3) women's own health and self-sufficiency by helping them set goals for themselves and take steps to accomplish those goals, including planning

7931-412: The multiple benefits of changing an unhealthy behavior. Stage 2: Contemplation (getting ready) At this stage, participants are intending to start the healthy behavior within the next 6 months. While they are usually now more aware of the pros of changing, their cons are about equal to their Pros. This ambivalence about changing can cause them to keep putting off taking action. People here learn about

8034-638: The next 30 days. Patients receiving the TTM intervention experienced significantly greater symptom reduction during the 9-month follow-up period. The intervention's largest effects were observed among patients with moderate or severe depression, and who were in the Precontemplation or Contemplation stage of change at baseline. For example, among patients in the Precontemplation or Contemplation stage, rates of reliable and clinically significant improvement in depression were 40% for treatment and 9% for control. Among patients with mild depression, or who were in

8137-445: The nonprofit sector today regarding newly graduated workers, and to some, NPOs have for too long relegated hiring to a secondary priority, which could be why they find themselves in the position many do. While many established NPOs are well-funded and comparative to their public sector competitors, many more are independent and must be creative with which incentives they use to attract and maintain people. The initial interest for many

8240-411: The organization a fiduciary duty of loyalty and trust. A notable exception to this involves churches , which are often not required to disclose finances to anyone, including church members. In the United States, nonprofit organizations are formed by filing bylaws, articles of incorporation , or both in the state in which they expect to operate. The act of incorporation creates a legal entity enabling

8343-452: The organization to be treated as a distinct body (corporation) by law and to enter into business dealings, form contracts, and own property as individuals or for-profit corporations can. Nonprofits can have members, but many do not. The nonprofit may also be a trust or association of members. The organization may be controlled by its members who elect the board of directors , board of governors or board of trustees . A nonprofit may have

8446-463: The organization's sustainability. An advantage of nonprofits registered in the UK is that they benefit from some reliefs and exemptions. Charities and nonprofits are exempt from Corporation Tax as well as the trustees being exempt from Income Tax. There may also be tax relief available for charitable giving, via Gift Aid, monetary donations, and legacies. Founder's syndrome is an issue organizations experience as they expand. Dynamic founders, who have

8549-622: The processes that they identified in a number of studies; however, their extended list of processes was removed from later editions of the text, perhaps because the list mixes techniques with processes. There are unlimited ways of applying processes. The additional strategies of Bartholomew et al. were: While most of these processes and strategies are associated with health interventions such as stress management, exercise, healthy eating, smoking cessation and other addictive behaviour, some of them are also used in other types of interventions such as travel interventions. Some processes are recommended in

8652-414: The pros of changing their behavior and to feel emotions about the effects of their negative behavior on others. Precontemplators typically underestimate the pros of changing, overestimate the cons, and often are not aware of making such mistakes. One of the most effective steps that others can help with at this stage is to encourage them to become more mindful of their decision making and more conscious of

8755-550: The public and private sectors have enjoyed an advantage over NPOs in attracting employees. Traditionally, the NPO has attracted mission-driven individuals who want to assist their chosen cause. Compounding the issue is that some NPOs do not operate in a manner similar to most businesses, or only seasonally. This leads many young and driven employees to forego NPOs in favor of more stable employment. Today, however, nonprofit organizations are adopting methods used by their competitors and finding new means to retain their employees and attract

8858-483: The receipt of significant funding from large for-profit corporations can ultimately alter the NPO's functions. A frequent measure of an NPO's efficiency is its expense ratio (i.e. expenditures on things other than its programs, divided by its total expenditures). Competition for employees with the public and private sector is another problem that nonprofit organizations inevitably face, particularly for management positions. There are reports of major talent shortages in

8961-413: The sector in its own terms, without relying on terminology used for the government or business sectors. However, use of terminology by a nonprofit of self-descriptive language that is not legally compliant risks confusing the public about nonprofit abilities, capabilities, and limitations. Transtheoretical model The transtheoretical model is also known by the abbreviation " TTM " and sometimes by

9064-518: The sector. The term civil society organization (CSO) has been used by a growing number of organizations, including the Center for the Study of Global Governance . The term citizen sector organization (CSO) has also been advocated to describe the sector – as one of citizens, for citizens – by organizations including Ashoka: Innovators for the Public . Advocates argue that these terms describe

9167-631: The stages of change (see below) is perhaps the most well-known feature of the model. However it is also one of the most critiqued, even in the field of smoking cessation, where it was originally formulated. It has been said that such quantitative definition (i.e. a person is in preparation if he intends to change within a month) does not reflect the nature of behaviour change, that it does not have better predictive power than simpler questions (i.e. "do you have plans to change..."), and that it has problems regarding its classification reliability. Communication theorist and sociologist Everett Rogers suggested that

9270-465: The stages of change are analogues of the stages of the innovation adoption process in Rogers' theory of diffusion of innovations . Stage 1: Precontemplation (not ready) People at this stage do not intend to start the healthy behavior in the near future (within 6 months), and may be unaware of the need to change. People here learn more about healthy behavior: they are encouraged to think about

9373-512: The term " stages of change ", although this latter term is a synecdoche since the stages of change are only one part of the model along with processes of change, levels of change, etc. Several self-help books — Changing for Good (1994), Changeology (2012), and Changing to Thrive (2016) —and articles in the news media have discussed the model. In 2009, an article in the British Journal of Health Psychology called it "arguably

9476-407: The theories, and facilitate professional development essential to the nurse home visitor role through specific supervisory activities, including one-to-one clinical supervision, case conferences, team meetings, and field supervision." NFP Nurse Supervisors must be registered nurses with a bachelor's degree in nursing, and it is preferred that they also have a master's degree in nursing. In addition to

9579-626: The timing of subsequent pregnancies." Based upon such positive results from early clinical trials NFP was implemented across the United States in 1996 and contributed to the inclusion of funding for maternal and infant home visiting in the Affordable Care Act , of 2010. The NFP National Service Office (NSO) does provide support and training to NFP accredited sites to ensure adherence to the NFP model in addition to monitoring program implementation and outcome for quality improvement purposes. NFP targets low-income, first-time mothers, following

9682-489: The traditional domain noted in RFC   1591 , .org is for "organizations that didn't fit anywhere else" in the naming system, which implies that it is the proper category for non-commercial organizations if they are not governmental, educational, or one of the other types with a specific TLD. It is not designated specifically for charitable organizations or any specific organizational or tax-law status, but encompasses anything that

9785-591: The training completed by all nurses, supervisors are required to complete four introductory supervisor-education sessions, including two in-person sessions. Additionally, they attend a three-day, 20-hour supervisor education and refresher in Denver annually. Findings in Relation to Intervention Goals Improve Prenatal Outcomes Improve Child Health and Development Improve Family's Economic Self-Sufficiency and Future Planning Cost/Benefit to Society Every dollar invested in NFP saves $ 5.70 in future costs for

9888-495: The transtheoretical model shows that interventions to change behavior are more effective if they are "stage-matched", that is, "matched to each individual's stage of change". In general, for people to progress they need: The ten processes of change include: Health researchers have extended Prochaska's and DiClemente's 10 original processes of change by an additional 21 processes. In the first edition of Planning Health Promotion Programs , Bartholomew et al. (2006) summarised

9991-405: The treatment group lost 5% or more of their body weight vs. 16.6% in the comparison group. Coaction of behavior change occurred and was much more pronounced in the treatment group with the treatment group losing significantly more than the comparison group. This study demonstrates the ability of TTM-based tailored feedback to improve healthy eating, exercise, managing emotional distress, and weight on

10094-459: The unhealthy behavior with positive ones, rewarding themselves for taking steps toward changing, and avoiding people and situations that tempt them to behave in unhealthy ways. Stage 5: Maintenance (monitoring) People at this stage changed their behavior more than 6 months ago. It is important for people in this stage to be aware of situations that may tempt them to slip back into doing the unhealthy behavior—particularly stressful situations. It

10197-540: Was conducted in a predominantly white, low-income neighborhood, located in Elmira, New York, in the late 1970s. For three consecutive decades, Professor David Olds and his colleagues conducted three similar randomized control trials, gathering research from each trial, which later contributed to the evidence-based development of the NFP. Randomized controlled trials were conducted in Elmira, New York; Memphis, Tennessee; and Denver, Colorado. The outcome of these trials proved that

10300-635: Was provided a stress management intervention. At the 18-month follow-up, a significantly larger proportion of the treatment group (62%) was effectively managing their stress when compared to the control group. The intervention also produced statistically significant reductions in stress and depression and an increase in the use of stress management techniques when compared to the control group. Two additional clinical trials of TTM programs by Prochaska et al. and Jordan et al. also found significantly larger proportions of treatment groups effectively managing stress when compared to control groups. Over 1,000 members of

10403-419: Was rated as the top US charity recommended for GiveWell donors. In November 2011, GiveWell changed NFP's review to outstanding, because they felt that NFP did not have any short-term need for more funding. Nurse-Family Partnership has received two consecutive four-star rating from Charity Navigator , the highest possible rating awarded from the U.S.-based charity evaluator. NFP received a rating of 60.37/70 with

10506-532: Was successfully adapted into the Dutch healthcare system and was expected to have a positive impact on pre- and postnatal risk factors. Later studies found that NFP was successful at reducing intimate partner violence for the duration of the intervention, reducing smoking, increasing duration of breastfeeding, reducing child maltreatment, improving long-term home environments, and reducing child internalizing behaviors, but unsuccessful at targeting pregnancy outcomes. NFP

10609-413: Was used to estimate missing data. Generalized Labor Estimating Equations (GLEE) were then used to examine differences between the treatment and comparison groups. At 24 months, those who were in a pre-Action stage for healthy eating at baseline and received treatment were significantly more likely to have reached Action or Maintenance than the comparison group (47.5% vs. 34.3%). The intervention also impacted

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