This proposal seeks to address the question: Does the implementation of an augmented competency based approachto trainingof nurse home visitorsand supervisors for delivery of the Nurse-Family Partnership improve staff performance, fidelity to the intervention model, and family outcomes relative to childmaltreatment and risk behaviorsfor youth violence? Nurses and supervisorswill be randomized by site to receive either the standard curriculum(N=75) or an augmented competency based curriculum(N=75) and ongoing structuredclinicalconsultationby NFP's National Office professional development staff. Specific project goals and objectives include: 1. Improve the competence (i.e., knowledge,clinical skills) of nurses to implement the parenting component of the NFP with families (short-term goal). a. Revise the standard curriculum and training of nurses to help them attain greater competency in implementation of program guidelines as it relates to the parenting component (short-term objective). b. Develop and implement a plan of structured clinical consultation by NFP's National Office professional developmentstaff with programsupervisors to assist them in identifying the extent to which their nurses meet expected performance criteria related to the promotion of competent parenting with families and provide training and/or supervisory guidance as needed (shortterm objective). 2. Identify the impact of the augmented competency based approach to training of nurses, coupled with structured clinical consultation to nursingsupervisors, on fidelity of program implementation (e.g., time spent by nurseson promotion of competent parenting) to the program model (intermediate goal). 3. Identify the impact of the augmented competency based approach to training of nurses, coupled with structured clinicalconsultationto nursingsupervisors,on family outcomes relative to child maltreatment and early behaviorsassociatedwith youth violence (long-term goal).
