Open Access Highly Accessed Study protocol

Addressing risk factors for child abuse among high risk pregnant women: design of a randomised controlled trial of the nurse family partnership in Dutch preventive health care

Jamila Mejdoubi1, Silvia van den Heijkant1, Elle Struijf2, Frank van Leerdam1, Remy HiraSing1 and Alfons Crijnen3*

Author Affiliations

1 EMGO+ Institute for Health and Care Research, VU University Medical Center, Department of Public and Occupational Health, Amsterdam, The Netherlands

2 GGD Hollands Noorden, Department of Youth Health Care, Schagen, The Netherlands

3 Fier Fryslan, Child and Adolescent Trauma Center, Leeuwarden, The Netherlands

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BMC Public Health 2011, 11:823  doi:10.1186/1471-2458-11-823

Published: 21 October 2011



Low socio-economic status combined with other risk factors affects a person's physical and psychosocial health from childhood to adulthood. The societal impact of these problems is huge, and the consequences carry on into the next generation(s). Although several studies show these consequences, only a few actually intervene on these issues. In the United States, the Nurse Family Partnership focuses on high risk pregnant women and their children. The main goal of this program is primary prevention of child abuse. The Netherlands is the first country outside the United States allowed to translate and culturally adapt the Nurse Family Partnership into VoorZorg. The aim of the present study is to assess whether VoorZorg is as effective in the Netherland as in the United States.


The study consists of three partly overlapping phases. Phase 1 was the translation and cultural adaptation of Nurse Family Partnership and the design of a two-stage selection procedure. Phase 2 was a pilot study to examine the conditions for implementation. Phase 3 is the randomized controlled trial of VoorZorg compared to the care as usual. Primary outcome measures were smoking cessation during pregnancy and after birth, birth outcomes, child development, child abuse and domestic violence. The secondary outcome measure was the number of risk factors present.


This study shows that the Nurse Family Partnership was successfully translated and culturally adapted into the Dutch health care system and that this program fulfills the needs of high-risk pregnant women. We hypothesize that this program will be effective in addressing risk factors that operate during pregnancy and childhood and compromise fetal and child development.

Trial registration

Current Controlled Trials ISRCTN16131117

Randomized Controlled Trial; Child abuse; Social Class; Home nursing; Pregnancy