The Nurse Family Partnership (NFP) program is a home visitation program that targets low income parents expecting their first child. With the nurse delivering services, the program is designed to facilitate positive changes that improve health outcomes for the woman and her baby. Despite successful program implementation in mostly urban communities across the United States, obstacles exist to implement Nurse Family Partnership in rural communities. The purpose of this practice inquiry was to collaborate with Pima County Health Department and Nurse Family Partnership to evaluate the feasibility of implementing the Nurse Family Partnership program in Pima County rural communities. As part of this practice inquiry collaboration, the first aim completed a community assessment of Arivaca to identify rural community strengths and potential barriers to implementation and thus serve as an implementation prototype for Pima County Health Department. Descriptive statistics were utilized from the Arizona Department of Health Services Arizona Vital Statistics, U.S. Census Bureau, and Arizona Department of Health Services needs assessment data sets to assess population characteristics and the Nurse Family Partnership eligible population in Arivaca. Additionally, a windshield survey was conducted to assess community referral capacity and/or program champions, existing public/community health programs or services linkages, and issues due to rurality such as transportation challenges and driving time/distances. The second practice inquiry aim developed an implementation plan, including an evaluation component, alongside Pima County Health Department that expands Nurse Family Partnership into additional rural communities in Pima County. The Nurse Family Partnership implementation plan template was utilized to identify community need and population characteristics, Pima County Health Department mission and culture, organization capacity, nursing practice and support, community linkages, sustainability, and financing and fiscal policy support. Descriptive statistics were utilized from the Arizona Department of Health Services Arizona Vital Statistics, U.S. Census Bureau, and Arizona Department of Health Services needs assessment data sets to describe a community profile to complete the Nurse Family Partnership implementation plan template. This practice inquiry demonstrated that completion of a windshield survey and review of descriptive data sets in the proposed service areas helps to identify community referral capacity and/or program champions, existing public/community health programs or services linkages, and issues due to rurality. This process can be used as a prototype for Pima County Health Department prior to implementation in the entire proposed service area.

The prevalence of autism spectrum disorder (ASD) has increased two percent from 2012–2014 (Centers for Disease Control and Prevention, 2018) and the Centers of Disease Control and Prevention (CDC) has considered ASD to be a major health concern. The demands of caring for a child with developmental disabilities, including ASD can be overwhelming and the caregivers are experiencing heightened levels of stress in comparison to rearing typically developing children (Argumedes, Lanovaz, & Larivée, 2017; Lindo, Kliemann, Combes, & Frank, 2017). There is a need for more family support to implement more effective coping strategies to deal with the maladaptive functioning of the child with ASD (Hall, & Graff, 2011). The WE C.A.R.E. 2 Program is a nine-week evidence-based community pilot program that will provide an inclusive opportunity with additional family support and effective coping strategies e.g., breathing techniques, yoga postures and positive coping cognitions (e.g., positive self-talk and reappraisals) to decrease the stress levels of caregivers and promote healthy behaviors and healthy child development with the support and training from trained facilitators and a network of caregivers. This individualized plan will tailor to the needs of each dyad to create the necessary mechanisms of change (behavior, cognition, physiological, and sensory modulation) among the children and adults in the yoga group. The professional collaboration of different disciplines (occupational therapy, yoga therapist and teacher) will provide the appropriate modifications to the environment and provide the necessary input for the “just right” experience for a positive outcome.