When more than 10 research articles have been published in peer-reviewed journals, the CEBC selects 10 for inclusion, with a preference for randomized controlled trials (RCTs) and controlled studies. The 10 articles chosen for Nurse-Family Partnership (NFP) are listed below:
Olds, D. L., Henderson, C. R., Chamberlin, R., &, Tatelbaum, R. (1985). Preventing Child Abuse and Neglect: A randomized trial of nurse home visitation. Pediatrics, 78, 65-78.
Type of Study: Randomized controlled trial
Number of Participants: 400 mothers
Population:
- Age range — 47% younger than 19
- Race/Ethnicity — 89% Caucasian. Non-Caucasian sample reported in separate paper.
- Gender — Not Specified
- Status — Determined at intake to have at least one risk factor: mother < 19, single parent status, or low socioeconomic status.
Location / Institution: Elmira, New York
Summary: (To include comparison groups, outcomes, measures, notable limitations)
Volunteers and women recruited due to a risk factor were randomly
assigned to one of 4 conditions: Nurse home visitation during the first
two years of life, nurse home visitation during pregnancy only, free
transportation to regular prenatal and perinatal visits, and sensory and
developmental screening at 12 and 24 months only. Nurse home visits
included education on parenting, involving friends and family, enhancing
social support, and linking families to other health and human
services. Measures included medical examinations and developmental
testing using the Bayley and Cattell Scales at 6, 12, and 24 months, and home observation using the Caldwell and Bradley Procedure.
The list of participants was also checked against verified cases of
abuse and neglect and medical records were examined. Among women at
highest risk, those visited by a nurse had fewer reports of child abuse
and neglect, were observed to restrict and punish children less
frequently, provided more appropriate play materials and had fewer
emergency room visits. In the second year, all nurse-visited women,
regardless of risk status, had fewer emergency room visits and fewer
physician visits for accidents and poisoning.
Length of post-intervention follow-up: 2 years after birth of child.
Olds, D. L., Henderson, C. R., & Kitzman, H. (1994). Does prenatal and infancy nurse home visitation have enduring effects on
qualities of parental caregiving and child health at 25 to 50 months of
life? Pediatrics, 93, 89-98.
Type of Study: Randomized controlled trial
Number of Participants: 316 to 340, depending on assessment period
Population:
- Age range — 47% of mothers less than 19 years of age
- Race/Ethnicity — 89% Caucasian. Non-Caucasian sample reported in separate paper.
- Gender — Not Specified
- Status — Determined at intake to have at least one risk factor: mother < 19, single parent status, or low socioeconomic status.
Location / Institution: Elmira, New York
Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: This study used the same sample as Olds, et al.,
1985. Volunteers and women recruited due to a risk factor were randomly
assigned to one of 4 conditions: Nurse home visitation during the first
two years of life, nurse home visitation during pregnancy only, free
transportation to regular prenatal and perinatal visits, and sensory and
developmental screening at 12 and 24 months only. Home assessments were
made using the Caldwell and Bradley Home Inventory. Interviewers also compiled a checklist evaluating children’s exposure to hazardous substances and situations in the home. The Stanford Binet
test of intelligence was administered at 36 and 48 months. Finally,
pediatric and hospital records were reviewed for the 25th through the
50th month and Child Protective Service records were checked against the
list of participants. No treatment differences were found for child
abuse, neglect, or in intellectual functioning. Children in the
nurse-visited condition had fewer hazards in the home, fewer injuries
and ingestions, and fewer behavioral and parental coping problems noted
on medical records. Nurse visited mothers showed higher levels of
punishment and restriction, but the authors suggest that their analysis
shows this level was associated with the lower instance of injuries and
ingestions for the treatment group.
Length of post-intervention follow-up: 25 to 50 months after birth of child.
Kitzman, H., Olds, D. L., Henderson, C. R., Hanks, C., Cole, R., Tatelbaum, R., et al. (1997). Effect of prenatal and infancy home visitation by nurses on pregnancy outcomes, childhood injuries, and repeated childbearing. Journal of the American Medical Association, 278(8), 644-652.
Type of Study: Randomized controlled trial
Number of Participants: 1139
Population:
- Age range — 64% less than 19 years of age
- Race/Ethnicity — 92% African American
- Gender — Not Specified
- Status — Actively recruited if they had two risk factors: unmarried,
Location / Institution: Memphis, TN
Summary: (To include comparison groups, outcomes, measures, notable limitations)
Women were randomly assigned to 1 of 4 conditions: free transportation
to scheduled prenatal visits only; transportation plus developmental
screening and referrals at 6, 12, and 24 months; the above services plus
intensive prenatal home visiting services; the above plus continuing
nurse visitation through 24 months. Assessments included abstraction of
medical records for pregnancy-induced hypertension, preterm delivery,
low birth-weight, children’s injuries, ingestions, and immunizations.
Mothers reported on children’s behavioral problems and their own
subsequent pregnancy, educational achievement, and employment. Use of
welfare was derived from state records, and children’s mental
development was tested. Children visited by nurses have fewer total
health care encounters for injuries and ingestions and had fewer
outpatient visits for injuries and ingestions. There was no effect on
children’s mental development or behavioral problems or mother’s
education or employment.
Length of post-intervention follow-up: 2 years after birth of child.
Olds, D. L., Eckenrode, J., Henderson, C. R., Kitzman, H., Powers, J., Cole, R., et al. (1997). Long-term effects of home visitation on maternal life course and child
abuse and neglect. Fifteen-year follow-up of a randomized trial. Journal of the American Medical Association, 278(8), 637-643.
Type of Study: Randomized controlled trial
Number of Participants: 324
Population:
- Age range — 47% of mothers less than 19 years of age at intake
- Race/Ethnicity — 89% Caucasian at intake.
- Gender — Not Specified
- Status — Determined at intake to have at least one risk factor: mother < 19, single parent status, or low socioeconomic status.
Location / Institution: Elmira, New York
Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: This study used the same sample as Olds, et al.,
1985 and 1994. Volunteers and women recruited due to a risk factor were
randomly assigned to one of 4 conditions: Nurse home visitation during
the first two years of life, nurse home visitation during pregnancy
only, free transportation to regular prenatal and perinatal visits, and
sensory and developmental screening at 12 and 24 months only.
Assessments at this follow-up included behavioral impairments due to
drug or alcohol use, use of welfare, and reviews of Child Protective
Services and New York State criminal justice records. Women visited by
nurses were less likely to be perpetrators of child abuse and neglect,
and had fewer arrests, convictions, and number of days jailed.
Length of post-intervention follow-up: 15 years after birth of child.
Eckenrode, J., Ganzel, B., Henderson, C. R., Smith, E., Olds, D. L., Powers, J., et al. (2000). Preventing child abuse and neglect with a program of nurse home visitation. Journal of the American Medical Association, 284(11), 1385-1391.
Type of Study: Randomized controlled trial
Number of Participants: 324
Population:
- Age range — 47% of mothers less than 19 years of age at intake
- Race/Ethnicity — 89% Caucasian mothers at intake
- Gender — Not Specified
- Status — Mothers determined at intake to have at least one risk factor: mother < 19, single parent status, or low socioeconomic status.
Location / Institution: Semi-rural community in New York
Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: This study used the same sample as Olds, et al., 1985, 1994, 1997,
and 1998. Participants were randomly assigned to 1 of 4 treatment
groups: Nurse home visitation during the first two years of life, nurse
home visitation during pregnancy only, free transportation to regular
prenatal and perinatal visits, and sensory and developmental screening
at 12 and 24 months only. Mothers were interviewed at 15 years, using a
life history calendar designed to help them recall major life events.
They also estimated how many months they received Aid to Families with
Dependent Children, Medicaid, or food stamps. Mothers reported incidents
of domestic violence using the Conflict Tactics Scale and provided
consent for researchers to review CPS records. Families receiving nurse
visitation during pregnancy and infancy had fewer child maltreatment
reports involving mother as perpetrator and study child as victim. The
treatment effect decreased as level of overall domestic violence
increased. The authors conclude that the presence of domestic violence
may limit the effectiveness of early visitation interventions.
Length of post-intervention follow-up: 15 years after birth of child.
Olds, D. L., Robinson, J., O’Brien, R., Luckey, D. W., Pettitt, L. M., Henderson, C. R., et al. (2002). Home visiting by paraprofessionals and by nurses: A randomized controlled trial. Pediatrics, 110(3), 486-496.
Type of Study: Randomized controlled trial
Number of Participants: 735
Population:
- Age range — Average 19.8 years
- Race/Ethnicity — Approximately 16% African American, 35% Caucasian and 45% Hispanic.
- Gender — Not Specified
- Status — Recruited from clinics serving low income women if no previous live
births and either qualified for Medicaid or had no private health
insurance.
Location / Institution: Denver, CO
Summary: (To include comparison groups, outcomes, measures, notable limitations)
Women were assigned to one of three conditions: developmental screening
and referral at 6, 12, 15, 21, and 24 months; the above screenings plus
home visitation by a paraprofessional during pregnancy and the first 2
years of the child’s life; and equivalent services with home visitations
conducted by a nurse. Paraprofessionals were limited to those who had a
high school education and no bachelors degree or coursework in a
helping profession, in order to gauge the viability of using this type
of worker in home visiting in comparison with nurses. The
paraprofessionals were recruited from other home visitation programs. At
baseline, mothers interviewed to assess socioeconomic conditions,
mental health, conflict with partners and their own mothers, and
experience of domestic violence. They were also screened for substance
abuse. At 12, 15, 21, and 24 months, women were interviewed to assess
timing of subsequent pregnancies, work history and use of welfare.
Mothers were videotaped in the laboratory and at home to assess
responsive interaction with their children. Children were assessed by
observation on their interactions with mothers and emotional responses
and also on language and cognitive development, using the Mental Development Index.
No major differences were found in outcomes between the
paraprofessional home visitation group and the control group. Mothers
visited by a nurse had fewer and more widely spaced pregnancies, worked
more, and showed more responsive interaction with their children.
Children visited by a nurse showed fewer language delays and higher
mental development.
Length of post-intervention follow-up: 2 years after birth of child.
Olds, D. L., Robinson, J., Pettitt, L. M., Luckey, D. W., Holmberg, J., Ng, R. K., et al. (2004). Effects of home visits by paraprofessionals and by nurses: age 4 follow-up results of a randomized trial. Pediatrics, 114, 1560-1568.
Type of Study: Randomized controlled trial
Number of Participants: 635
Population:
- Age range — Average 19.8 years at intake
- Race/Ethnicity — Approximately 16% African American, 35% Caucasian and 45% Hispanic at intake.
- Gender — Not Specified
- Status — Recruited from clinics serving low income women if no previous live
births and either qualified for Medicaid or had no private health
insurance.
Location / Institution: Denver, CO
Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: This study used the same sample as Olds, et al., 2002. Women were
assigned to one of three conditions: developmental screening and
referral at 6, 12, 15, 21, and 24 months; the above screenings plus home
visitation by a paraprofessional during pregnancy and the first 2 years
of the child’s life; and equivalent services with home visitations
conducted by a nurse. Paraprofessionals were limited to those who had a
high school education and no bachelors degree or coursework in a helping
profession, in order to gauge the viability of using this type of
worker in home visiting in comparison with nurses. The paraprofessionals
were recruited from other home visitation programs. Assessed at this
follow-up were maternal reports of subsequent pregnancies, education and
work histories, marriage, cohabitation, domestic violence, mental
health, substance use, and sense of mastery. Mother-child interaction
and the home environment were observed. Children were assessed for
language and executive functioning, and mothers reported on children’s
externalizing behavior problems. Women visited by paraprofessionals were
less likely to be married or live with the biological father of the
child, but worked more and had better mental health and sense of
mastery. Children visited by paraprofessionals displayed greater
sensitivity and responsiveness, and had home environments supportive of
early learning. Nurse-visited women had greater intervals between 1st
and 2nd children, experienced less domestic violence, and enrolled their
children less in formal daycare or preschool. Nurse-visited children
had better home environments, better language and executive functioning
skills, and better behavioral adaptation during testing.
Length of post-intervention follow-up: 4 years after birth of child.
Olds, D. L., Kitzman, H., Hanks, C., Cole, R., Anson, E., Sidora-Arcoleo, K., et al. (2007). Effects of nurse home visiting on maternal and child functioning: Age 9 follow-up of a randomized trial. Pediatrics, 120, e832-e845.
Type of Study: Randomized controlled trial
Number of Participants: 1139 allocated to treatment; 627 seen in this follow-up.
Population:
- Age range — 64% less than 19 years of age at intake
- Race/Ethnicity — 92% African American at intake
- Gender — Not Specified
- Status — Actively recruited if they had two risk factors: unmarried,
Location / Institution: Memphis, TN
Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: This study used the same sample as Kitzman, et al., 1997 and Olds,
et al., 2004. Women were randomly assigned to 1 of 4 conditions: free
transportation to scheduled prenatal visits only; transportation plus
developmental screening and referrals at 6, 12, and 24 months; the above
services plus intensive prenatal home visiting services; the above plus
continuing nurse visitation through 24 months. Mothers were assessed at
baseline on a created variable called psychological resources,
comprised of intelligence, mental health, self-efficacy, and sense of
mastery. By the time the child was 9 years old, women visited by a nurse
had fewer births and longer intervals between children, used welfare
and food stamps for fewer months, and had longer relationships with
current partners. Researchers matched participants with the National
Death index. Of the 10 children found to have died, control group
children were 4.46 times as likely to have died before the 9-year
follow-up and more likely to have died by preventable causes (e.g.,
Sudden Infant Death syndrome.)
Length of post-intervention follow-up: 9 years after birth of child.
Sidora-Arcoleo, K., Anson, E., Lorber, M., Cole, R., Olds, D., & Kitzman, H. (2010). Differential effects of a nurse home-visiting intervention on physically aggressive behavior in children. Journal of Pediatric Nursing, 25, 35-45.
Type of Study: Randomized controlled trial
Number of Participants: 1,139
Population:
- Age range — 2 to 12 years
- Race/Ethnicity — 92% African American
- Gender — Females
- Status — Participants were mothers from the Olds et al. (2007) sample.
Location / Institution: Memphis, TN
Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated longitudinal data from the Olds et al. (2007) randomized controlled trial of the Nurse-Family Partnership (NFP) home visitation program. In the original study, mothers were randomized to one of four treatment conditions. The present study evaluated the long-term effects of the NFP program on physical aggression and verbal ability in girls and boys. Results at 12-year follow-up indicated that there were significant reductions in physical aggression observed among girls in the intervention group at 2 years old and intervention group children of high-psychological-resource mothers at 6 and 12 years old. Mediation analyses suggest that reductions in physical aggression yield increased verbal ability among girls.
Length of post-intervention follow-up: 12 years.
Eckenrode, J., Campa, M., Luckey, D. W., Henderson, C. R., Cole, R., Kitzman, H., Anson, E., … Olds, D. (2010). Long-term effects of prenatal and infancy nurse home visitation on the life course of youths: 19 year follow-up of a randomized trial. Archives of Pediatrics & Adolescent Medicine, 164(1), 9-16.
Type of Study: Randomized controlled trial
Number of Participants: 310
Population:
- Age range — All 19 years of age
- Race/Ethnicity — 78% Caucasian and 22% Other
- Gender — 53% Female and 47% Male
- Status — Participants were youths whose mothers participated in the Olds et al. (1985) sample.
Location / Institution: Semi-rural country in New York
Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated longitudinal data from the Olds et al. (1985) randomized controlled trial of the Nurse-Family Partnership (NFP) home visitation program. In the original study, mothers were randomized to one of four treatment conditions. To obtain follow-up data, youth in the present study completed a telephone interview to assess their histories of arrests, convictions, delinquent and criminal behavior, use of substances, educational achievement, pregnancies, births, and use of welfare. Results indicated that youths whose mothers participated in either of the two treatment groups were less likely to have ever been arrested or convicted than were those in the comparison group. Girls in the nurse-visited group also had fewer lifetime arrests and convictions than did those in the comparison group. Girls in the nurse-visited group born to high-risk (un-married and low-income) mothers had fewer children and were less likely to have received Medicaid than were high-risk girls in the comparison group. The major study limitation was the reliance on youth self-report as the only outcome measure.
Length of post-intervention follow-up: 19 years.
