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[Correspondence] Questioning the outcome of the Building Blocks trial

Michael Robling and colleagues (Oct 13, p 146)1 are to be congratulated on conducting Building Blocks, a highly rigorous randomised controlled trial of the Family Nurse Partnership (FNP) programme in England, UK, and rightly highlighted the difficulty in showing changes similar to the US studies in a setting with comprehensive universal health services.1 The trial in the Netherlands,2 where FNP showed a positive effect on various primary outcomes, involved substantial adaptation of the programme to the local context, and was also more targeted in terms of risk.