The Florida County of Pinellas has a population of approximately 970,637 residents as of 2017, with 52% female and 82.7% White, 11.1% Black, and 9.7% Hispanic. Situated on 608 square miles, only 274 of which are land, Pinellas County is the most densely populated county in Florida, with a density of 3,292/sq. mi. The Florida Department of Health in Pinellas County (FDOH in Pinellas) was established in 1936 and maintains public health jurisdiction over Pinellas County. FDOH in Pinellas is one of 67 County Health Departments and operates under the auspices of Department of Health, Florida's state agency dedicated to protecting, promoting, and improving the health of all people in Florida. FDOH in Pinellas serves Pinellas County with more than 700 employees in six health department locations throughout the county. FDOH in Pinellas is divided into six divisions that provide a wide range of public health services including infectious disease control, health promotion, chronic disease prevention, environmental health monitoring, disaster preparedness and response, as well as personal health services, including home visiting and clinic services.
FDOH in Pinellas has two home visiting programs that currently offer nursing services: Healthy Families, and Nurse Family Partnership. The Nurse-Family Partnership (NFP) is a home visiting-based program intended to promote well-being of first-time, low-income mothers and their children. Nurses provide parenting education, referrals to community resources, and promote family enrichment beginning in pregnancy prior to 28 weeks gestation through the child's second birthday. Goals for the program include improving pregnancy outcomes, child health and development, and family economic self-sufficiency. FDOH in Pinellas has offered NFP since 2011. The Healthy Families program is modeled after the highly successful Hawaii Healthy Start program and part of a National Network of Healthy Families America (HFA) sites. This intensive home visiting and family support program has been in operation since 1992.The program offers enhanced services provided by specialty staff including nurses, mental health counselors, father services specialists, and resource specialists that assist families until the child reaches kindergarten age. The program was designed to promote positive parenting, enhance child health and development and prevent child abuse and neglect.
While the structure and goals of both programs vary, both share a focus on positive parenting, creating a home environment that fosters child development, and improved health outcomes through pregnancy and early childhood. One factor in achieving these goals is healthy interpregnancy intervals. Short interpregnancy intervals (less than 24 months) are associated with adverse birth outcomes, such as low birth weight and premature/preterm birth, increased parental stress levels about parenting, and increased risk for post-partum depression. By integrating family planning services into home visits, nurses encourage longer interpregnancy intervals by providing family planning counseling and supplies.
Healthy Families and Nurse Family Partnership both have nurses that are cross-trained to provide not just family planning counseling, but provide in-home assessments and hormonal birth control supplies, utilizing the Providing Quality Family Planning Services Recommendations of CDC and the U.S. Office of Population Affairs”. Nurses receive Title X trainings, including Putting the QFP into Practice”, and are trained on state policies and local protocols. Under protocol, the nurses assess clients and match them with appropriate family planning methods. Through the state issuance program, the nurses can provide starter packs for birth control supplies such as combined oral contraceptives, progestin-only pills, and DMPA injections. The nurses have telephonic access to a physician for orders not covered under protocol.
Healthy Families nurses started providing family planning visits in the field in 1997, and Nurse Family Partnership has provided these services since 2017. Healthy Families Florida set a goal that 80% percent of mothers enrolled in the project will not have a subsequent pregnancy within two years of the target child's birth. Healthy Families Pinellas has achieved 100% in this measure during 2017-2018. Nurse Family Partnership set a goal that at least 25% of all NFP Moms have 24 months between pregnancies. Pinellas County's NFP has had 40% of mothers with at least 24 months interpregnancy interval in 2017-2018. While there is still low participation in family planning services in the Pinellas NFP, the impact on health for the women participating is noticeable. With increase interpregnancy intervals, these women have more time to focus on developing healthy relationships and bonding with their children and decrease the likelihood of adverse pregnancy outcomes when they decide to have another child.
The website for FHOH in Pinellas is http://pinellas.floridahealth.gov/