Nurse-Family Partnership program expands to Grand County |

Nurse-Family Partnership program expands to Grand County

Alli Langley
Frisco resident and first-time mother Ritu Tuladhar sits with her daughter Reeva, 2, and Sonata Ridzvanaviciute — her nurse home visitor through the local Nurse-Family Partnership program — at Tuladhar's home in Frisco on Thursday, Sept. 24, 2015. The program was started by a Colorado medical professor in the early 1970s and has since expanded to communities around the U.S. and world.
Alli Langley / |


Children’s health and development by helping parents provide responsible, competent care

Families’ economic self-sufficiency by helping parents envision their future, plan future pregnancies, continue their education and find jobs

Pregnancy outcomes by helping women practice preventative health behaviors, including obtaining good prenatal care, improving their diet and reducing use of tobacco, alcohol and other harmful substances

Ritu Tuladhar held her crying toddler in her Frisco apartment and remembered the five S’s.

The techniques — swaddle, side/stomach, shush, swinging and sucking — are designed to soothe infants and young children by mimicking the womb.

Over about an hour, she used those and other methods to de-escalate moments when her 2-year-old daughter Reeva was misbehaving or upset, and she never appeared flustered. But the first-time mother said she wasn’t always so confident in her parenting.

“In every step, I thought I was making a mistake,” she said on Thursday, Sept. 24.

She was guided through decisions, taught parenting strategies and comforted about what to expect by a nurse through the free Nurse-Family Partnership program.

“I have learned to be calm,” Tuladhar said, and she couldn’t recommend the program enough.

The free program for first-time parents in Summit, Chaffee, Clear Creek, Gilpin, Park and Lake counties who meet income guidelines is expanding this fall into Grand County.

After 14 years, the inter-mountain program will serve 13 more families — up from its current caseload of 132 and will employ eight nurse home visitors starting Oct. 8.


Tuladhar connected with the program after she visited the Summit Community Care Clinic and confirmed she was pregnant. She didn’t have health insurance and didn’t know what to do.

Besides her husband, all of her family is in Nepal.

The 33-year-old moved to the U.S. when she was 21. She earned a bachelor’s degree in sociology and a master’s degree in nonprofit management, and now she jokes she is earning a Ph.D. in daughter.

Through the state and federally-funded Nurse-Family Partnership program, she was connected with registered nurse Sonata Ridzvanaviciute.

The nurse home visitor started visiting Tuladhar one-on-one at her home during her pregnancy, and the pair met roughly every two weeks for an hour until her daughter turned 2.

The nurses don’t do clinical assessments, Ridzvanaviciute said, but they do talk about seeing doctors and healthy habits.

“It’s all mostly conversation,” she said, often about what’s normal and what’s not. “A lot of times, we just validate what they’re going through — that they’re not alone.”

Her nurse provided emotional support, Tuladhar said, when her father was sick during her pregnancy.

Then after Reeva was born, Ridzvanaviciute helped troubleshoot breastfeeding and diaper rash issues and talked with Tuladhar about infant growth, eating transitions, vaccinations, multilingual-language development, safety and toilet training.

She learned through hands-on activities about how babies learn best through laughing, positive emotions and love, but they also need limits. Parents can improve their children’s moods and behaviors by providing rules and communicating expectations.

Nurse home visitors also talk with their clients about what kind of parents they want to be and achieving other heart’s desires like educational and career goals.

“They are the experts on their lives, and we’re just there to support them in that,” Ridzvanaviciute said. “It’s such a privilege and an honor to be on a journey with these families.”


Lynne Easterly, the intermountain program supervisor, said the program teaches parents about how little behaviors during pregnancy can impact their babies later.

For example, nurse home visitors encourage parents to read the same book to their baby every day because babies start to hear 13 weeks after conception and can hear well at 25 weeks.

Then, when the parents read that book to the baby after birth, she said, “the baby remembers.”

Mothers are referred to the program by the Summit County Public Health Department, Medicaid, local schools, private clinics and other clients. Easterly said the program is always trying to reach new families.

Mothers in the program range in age from teens to women in their 40s and they have wide-ranging education levels, but they generally tend to skew toward younger women with fewer years of formal schooling.

Easterly said some of the mothers and families are higher-risk. They may lack education or familial support or they struggle with substance abuse, mental illness, unemployment, shared housing or homelessness.

Over nearly 40 years, the Nurse-Family Partnership model has been expanded all over the U.S. as well as other countries, and long-term studies have shown the program improves prenatal health, reduces childhood injuries, decreases subsequent pregnancies, raises time between births, increases maternal employment and improves school readiness.

In Colorado, funding for the program comes from the state’s allocation of ongoing settlement payments from big tobacco companies as well as a federal Medicaid match.

Through savings to Medicaid, food-assistance programs and other subsidies as well as to the education and criminal justice system, studies have also shown the program’s benefits outweigh its costs.

Tuladhar’s favorite parts of the program were learning to think about her own parenting positively and with less fear about what she might be doing wrong, she said, as well as learning more about herself.

For more information about the local program, contact supervisor Lynne Easterly at (970) 668-9711. For more information about the international Nurse-Family Partnership, visit

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