By Meg Massey, Urban Institute, Outreach Manager, Pay for Success
When we talk about the “evidence base” of a program, we refer to the program evaluations and other studies that look at the data coming out of a program and tell us whether or not the program is having the intended effect. And while an intervention’s evidence base is a critical component of the pay for success conversation, it’s also important to understand at a human level why a program is having an impact.
The “real-world” impact of Nurse-Family Partnership—which boasts an exceptionally strong evidence base—is explored in an episode of The New Yorker Presents, a new documentary series available on Amazon that adapts New Yorker stories into segments. NFP pairs nurses with low-income first-time mothers during their pregnancy and for two years following the child’s birth to support healthy development for both mom and baby. The organization explains on their web site that their nurses “form a much-needed, trusting relationship with the first-time moms, instilling confidence and empowering them to achieve a better life for their children – and themselves.” This trust is rooted in valuing these young women as mothers. As Urban’s Nancy LaVigne recently wrote, the language we use to describe people who are served by social programs sends a powerful message—one that enhances and humanizes what’s in an evaluation.
The NFP segment in The New Yorker Presents, “Lone Star Nurse,” shows us the power of this trusting relationship. The segment follows an NFP nurse in Texas named Nicole Schroeder as she visits her “girls” and their children on a typical day. Often, the low-income women in the program “have been told over and over again what they’re doing wrong and not a whole lot about what they’re doing right,” Schroeder explains. Her job is to reinforce their successes and offer nonjudgmental support when they have questions or something clearly isn’t working. One young mother summarizes how all of Schroeder’s girls seem to feel about her: “I trust her. I tell her everything.” Another mother reiterates: “She’s someone who actually cares, and she values what I have to say.” This, fundamentally, is why NFP works.
One mother, Maci, explains to Schroeder that she wants to enforce house rules but doesn’t want her daughter “to feel like she’s constantly in trouble.” Schroeder applauds this instinct, and calmly walks her through some ideas for language to use while explaining rules, such as “we put our shoes here” instead of “you don’t put your shoes there.”
Another mother, Monique, talks with Schroeder about how to share her feelings with her son. As Schroeder relates to Monique parent-to-parent during their conversation, Monique breaks down in tears because she misses her own parents, who both died several years earlier. Schroeder does not hesitate to envelope her in a hug and remind her: “I’m so, so, so proud of you.” She looks down at Monique’s son and tells him: “Your mom is a rock star.” Juxtaposed with Monique’s earlier struggle to find a job and affordable child care, the power of Schroeder’s faith and support is amplified.
The New Yorker Presents puts a real and indelible face on the people served by NFP and other evidence-based programs. When we say that a program is having a “proven” impact on a community, we mean the data and real-world experiences show that it’s supporting women like Maci and Monique who want desperately to do what’s best for the children and just need somebody they trust to help get them there. Schroeder’s positive and unfailing support is a useful reminder that the only way anyone gets anywhere is with someone in their corner.
The New Yorker Presents is available online to Amazon Prime subscribers. “The Lone Star Nurse” is featured in episode 7 of the first season of series.
As an organization, the Urban Institute does not take positions on issues. Scholars are independent and empowered to share their evidence-based views and recommendations shaped by research.