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 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. Evidence of effectiveness Findings in Relation to Intervention Goals Improve Prenatal Outcomes 79% reduction in preterm birth for smoking mothers 18% reduction in preterm birth in general 35% reduction in pregnancy-induced hypertension Improve Child Health and Development 48% reduction in child abuse and neglect 56% reduction in emergency room visits for accidents and poisonings 50% reduction in language delays at 21 months 67% reduction in behavioral and intellectual problems at 6 years 59% reduction in child arrests at 15 years Improve Family's Economic Self-Sufficiency and Future Planning 82% increase in months employed for parent 31% decrease in very closely spaced (>6 months) subsequent pregnancies 72% decrease in convictions of mothers Cost/Benefit to Society Every dollar invested in NFP saves $5.70 in future costs for 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. Locations United States NFP operates in over 700 counties across 40 states, as well as in the U.S. Virgin Islands. United Kingdom In the UK the programme is known as the Family Nurse Partnership and has been backed by 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. Netherlands A 2011 study found that NFP 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. Funding Private funding