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Nurse Family Partnership (NFP)®

Meets DHHS criteria for an evidenced based model

Last Updated: May 2016

In Brief for Positive Parenting Practices Outcomes

Impact Studies Rated High


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. A randomized controlled trial. JAMA: The Journal of the American Medical Association, 278(8), 644–652.
Show Study Effects Details
Outcome Effect Sample Timing of Follow-Up Sample Size Program Group Comparison Group Mean Difference or Odds Ratio
Statistical Significance
Effect Size
Outcome Type
Beliefs associated with child abuse (AAPI total score) Favorable Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 2 years postpartum 672 mothers Adjusted mean = 98.7 Adjusted mean = 100.5 MD = -1.8 Statistically significant,
p < 0.01
Not available Primary
HOME (emotional/ cognitive stimulation) Favorable Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 2 years postpartum 675 mothers Adjusted mean = 32.30 Adjusted mean = 30.90 MD = 1.40 Statistically significant,
p < 0.01
Not available Primary
NCAST Maternal Teaching (total score) No Effect Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 2 years postpartum 675 mothers Adjusted mean = 36.7 Adjusted mean = 36.5 MD = 0.2 Not statistically significant,
p > 0.05
Not available Primary
Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
AAPI The AAPI assesses parenting and childrearing attitudes. The researchers examined the AAPI total score to measure beliefs associated with child abuse. Parent/caregiver report Not reported by author Primary
HOME: Total score The HOME assesses parenting practices and aspects of the home environment. Parent/caregiver interview and observational assessment Not reported by author Primary
NCAST: Caregiver total score The NCAST assesses the quality of teaching interaction between caregivers and young children. The researchers examined the composite score for parent interaction. Observation Not reported by author Primary

Olds, D. L., Henderson Jr., C. R., Chamberlin, R., & Tatelbaum, R. (1986). Preventing child abuse and neglect: A randomized trial of nurse home visitation. Pediatrics, 78, 65–78.
Show Study Effects Details
Outcome Effect Sample Timing of Follow-Up Sample Size Program Group Comparison Group Mean Difference or Odds Ratio
Statistical Significance
Effect Size
Outcome Type
Conflict No Effect Nurse visited during pregnancy and comparison (Elmira) 6 months 164 mothers Adjusted mean = 0.27 Adjusted mean = 0.25 MD = 0.02 Statistical significance not reported Not available Secondary
Conflict No Effect Nurse visited during pregnancy + infancy and comparison (Elmira) 6 months 163 mothers Adjusted mean = 0.29 Adjusted mean = 0.25 MD = 0.04 Not statistically significant,
p ≥ 0.05
Not available Secondary
HOME (avoidance of restriction and punishment) No Effect Nurse visited during pregnancy + infancy and comparison (Elmira) 22 months 180 mothers Adjusted mean = 5.82 Adjusted mean = 6.28 MD = -0.46 Not statistically significant,
p ≥ 0.05
Not available Primary
HOME (avoidance of restriction and punishment) No Effect Nurse visited during pregnancy and comparison (Elmira) 22 months 171 mothers Adjusted mean = 5.53 Adjusted mean = 6.28 MD = -0.75 Statistical significance not reported Not available Primary
HOME (avoidance of restriction and punishment) No Effect Nurse visited during pregnancy and comparison (Elmira) 10 months 184 mothers Adjusted mean = 5.77 Adjusted mean = 5.60 MD = 0.17 Statistical significance not reported Not available Primary
HOME (avoidance of restriction and punishment) No Effect Nurse visited during pregnancy + infancy and comparison (Elmira) 10 months 191 mothers Adjusted mean = 5.40 Adjusted mean = 5.60 MD = -0.20 Not statistically significant,
p ≥ 0.05
Not available Primary
HOME (provision of appropriate play materials) No Effect Nurse visited during pregnancy + infancy and comparison (Elmira) 10 months 201 mothers Adjusted mean = 7.36 Adjusted mean = 7.26 MD = 0.10 Not statistically significant,
p ≥ 0.05
Not available Primary
HOME (provision of appropriate play materials) No Effect Nurse visited during pregnancy and comparison (Elmira) 10 months 195 mothers Adjusted mean = 7.45 Adjusted mean = 7.26 MD = 0.19 Statistical significance not reported Not available Primary
HOME (provision of appropriate play materials) No Effect Nurse visited during pregnancy and comparison (Elmira) 22 months 190 mothers Adjusted mean = 8.66 Adjusted mean = 8.65 MD = 0.01 Statistical significance not reported Not available Primary
HOME (provision of appropriate play materials) No Effect Nurse visited during pregnancy + infancy and comparison (Elmira) 22 months 198 mothers Adjusted mean = 8.68 Adjusted mean = 8.65 MD = 0.03 Not statistically significant,
p ≥ 0.05
Not available Primary
Spank or hit (number of times last 2 weeks) No Effect Nurse visited during pregnancy + infancy and comparison (Elmira) 6 months 159 mothers Adjusted mean = 0.19 Adjusted mean = 1.09 MD = -0.90 Not statistically significant,
p ≥ 0.05
Not available Secondary
Spank or hit (number of times last 2 weeks) No Effect Nurse visited during pregnancy and comparison (Elmira) 6 months 151 mothers Adjusted mean = 1.71 Adjusted mean = 1.09 MD = 0.62 Statistical significance not reported Not available Secondary
Worry or concern (Sum of positive responses for behavioral problems) No Effect Nurse visited during pregnancy and comparison (Elmira) 6 months 164 mothers Adjusted mean = 0.61 Adjusted mean = 0.54 MD = 0.07 Statistical significance not reported Not available Secondary
Worry or concern (Sum of positive responses for behavioral problems) Favorable Nurse visited during pregnancy + infancy and comparison (Elmira) 6 months 163 mothers Adjusted mean = 0.83 Adjusted mean = 0.54 MD = 0.29 Statistically significant,
p < 0.05
Not available Secondary
Yell or scold (number of times last 2 weeks) No Effect Nurse visited during pregnancy + infancy and comparison (Elmira) 6 months 159 mothers Adjusted mean = 3.99 Adjusted mean = 7.90 MD = -3.91 Not statistically significant,
p ≥ 0.05
Not available Secondary
Yell or scold (number of times last 2 weeks) No Effect Nurse visited during pregnancy and comparison (Elmira) 6 months 151 mothers Adjusted mean = 7.56 Adjusted mean = 7.90 MD = -0.34 Statistical significance not reported Not available Secondary
Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
Conflict Sum of positive responses to behavioral problems, such as feeding difficulties and crying Parent/caregiver self-report Not reported by author Secondary
HOME: Avoidance of restriction and punishment, Provision of appropriate play materials The HOME assesses parenting practices and aspects of the home environment. The assessment had six dimensions, including the avoidance of restriction and punishment and the provision of appropriate play materials. Parent/caregiver interview and observational assessment Rates of inter-observer agreement on the individual items ranged from 82 to 100 percent. Primary
Spank or hit Counts of the number of times the mother spanked or hit her child during the last two weeks Parent/caregiver self-report Not reported by author Secondary
Worry or concern Sum of positive responses to behavioral problems, such as feeding difficulties and crying Parent/caregiver self-report Not reported by author Secondary
Yell or scold Counts of the number of times the mother yelled at or scolded her child during the last two weeks Parent/caregiver self-report Not reported by author Secondary

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(1), 89–98.
Show Study Effects Details
Outcome Effect Sample Timing of Follow-Up Sample Size Program Group Comparison Group Mean Difference or Odds Ratio
Statistical Significance
Effect Size
Outcome Type
Hazardous exposures observed in home No Effect Nurse visited during pregnancy and comparison (Elmira) 34 months 202 mothers Adjusted mean = 0.23 Adjusted mean = 0.38 MD = -0.15 Statistical significance not reported Not available Primary
Hazardous exposures observed in home Favorable Nurse visited during pregnancy + infancy and comparison (Elmira) 34 months 209 mothers Adjusted mean = 0.22 Adjusted mean = 0.38 MD = -0.16 Statistically significant,
p < 0.05
1
Not available Primary
Hazardous exposures observed in home No Effect Nurse visited during pregnancy and comparison (Elmira) 46 months 202 mothers Adjusted mean = 0.31 Adjusted mean = 0.46 MD = -0.15 Statistical significance not reported Not available Primary
Hazardous exposures observed in home Favorable Nurse visited during pregnancy + infancy and comparison (Elmira) 46 months 209 mothers Adjusted mean = 0.21 Adjusted mean = 0.46 MD = -0.25 Statistically significant,
p < 0.01
1
Not available Primary
HOME inventory (total score) No Effect Nurse visited during pregnancy + infancy and comparison (Elmira) 46 months 238 mothers Adjusted mean = 39.66 Adjusted mean = 39.67 MD = -0.01 Not statistically significant,
p ≥ 0.05
Not available Primary
HOME inventory (total score) No Effect Nurse visited during pregnancy and comparison (Elmira) 46 months 227 mothers Adjusted mean = 40.18 Adjusted mean = 39.67 MD = 0.51 Statistical significance not reported Not available Primary
HOME inventory (total score) No Effect Nurse visited during pregnancy + infancy and comparison (Elmira) 34 months 238 mothers Adjusted mean = 39.08 Adjusted mean = 39.03 MD = 0.05 Not statistically significant,
p ≥ 0.05
Not available Primary
HOME inventory (total score) No Effect Nurse visited during pregnancy and comparison (Elmira) 34 months 227 mothers Adjusted mean = 38.45 Adjusted mean = 39.03 MD = -0.58 Statistical significance not reported Not available Primary

1 Statistical significance reported on authors’ calculation of incidence ratio.

Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
Hazardous exposures observed in HOME A checklist indicating the degree of the child’s exposure to the following categories of household hazards: (1) chipped or flaking paint, (2) sharp objects, (3) danger of burns, and (4) objects that pose a risk for falls. Interviewer observation For each hazard category, the inter-observer reliability at 34 months exceeded 93% (n = 30 pairs) and at 46 months exceeded 86% (n = 22 pairs). Primary
HOME: Total score The HOME assesses parenting practices and aspects of the home environment. Parent/caregiver interview and observational assessment Inter-observer reliability for the HOME total scores were greater than 95% at both the 34- (n = 28 pairs) and 46-month observations (n = 24 pairs). Primary

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.
Results with paraprofessional home visitors.
Show Study Effects Details
Outcome Effect Sample Timing of Follow-Up Sample Size Program Group Comparison Group Mean Difference or Odds Ratio
Statistical Significance
Effect Size
Outcome Type
HOME environment score No Effect Paraprofessional home visitor and comparison (Denver) 21 months 420 mothers Adjusted mean = 37.40 Adjusted mean = 37.10 MD = 0.30 Not statistically significant,
p > 0.05
Not available Primary
Mother-infant responsive interaction No Effect Paraprofessional home visitor and comparison (Denver) 24 months 392 mothers Adjusted mean = 100.15 Adjusted mean = 98.99 MD = 1.16 Not statistically significant,
p > 0.05
Not available Primary
Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
HOME: Environment score The HOME assesses parenting practices and aspects of the home environment Parent/caregiver interview and observational assessment Not reported by author Primary
Mother-infant responsive interaction Subscale scores were factor analyzed and identified a single internally consistent principal component, responsive interaction, which was standardized to a mean of 100 and a standard deviation of 10. The outcome was measured at the 24th month of the child’s life. Parent/caregiver-infant interaction was videotaped either in the laboratory or at home Not reported by author Primary

Olds, D. L., Robinson, J., Pettitt, L., 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(6), 1560-1568.
Results with nurse home visitors.
Show Study Effects Details
Outcome Effect Sample Timing of Follow-Up Sample Size Program Group Comparison Group Mean Difference or Odds Ratio
Statistical Significance
Effect Size
Outcome Type
HOME total score No Effect Nurse home visitor and comparison (Denver) 4-year follow-up 408 mothers Adjusted mean = 25.32
SE = 0.23
Adjusted mean = 25.09
SE = 0.22
MD = 0.23 Not statistically significant,
p = 0.47
Study reported = 0.07 Primary
Sensitive/responsive interaction No Effect Nurse home visitor and comparison (Denver) 4-year follow-up 408 mothers Adjusted mean = 100.51
SE = 0.72
Adjusted mean = 98.66
SE = 0.69
MD = 1.85 Not statistically significant,
p = 0.06
Study reported = 0.18 Primary
Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
HOME: Total score The HOME assesses parenting practices and aspects of the home environment. Parent/caregiver interview and observational assessment Not reported by author Primary
Sensitive/responsive interaction Mother-child interaction during free play was coded and subsequently analyzed using principal components analysis to derive a single factor for sensitive/responsive interaction. Parent/caregiver interview and observational assessment Cronbach’s α = 0.67 Primary
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Impact Studies Rated Moderate


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.
Results with nurse home visitors.
Show Study Effects Details
Outcome Effect Sample Timing of Follow-Up Sample Size Program Group Comparison Group Mean Difference or Odds Ratio
Statistical Significance
Effect Size
Outcome Type
HOME environment score No Effect Nurse home visitor and comparison (Denver) Unknown 406 mothers Adjusted mean = 37.79 Adjusted mean = 37.10 MD = 0.69 Not statistically significant,
p > 0.05
2
Not available Primary
Mother-infant responsive interaction Favorable Nurse home visitor and comparison (Denver) Unknown1 372 mothers Adjusted mean = 100.31 Adjusted mean = 98.99 MD = 1.32 Statistically significant,
p ≤ 0.05
Not available Primary

1 The study indicates home environments were rated at 12 and 21 months, however, only one result is presented in the article and the timing is not labeled.

2 Authors report the difference in this outcome to be statistically significant, p < 0.10, which is greater than the acceptable alpha for this review (α = 0.05).

Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
HOME: Total score The HOME assesses parenting practices and aspects of the home environment. Parent/caregiver interview and observational assessment Not reported by author Primary
Mother-infant responsive interaction Subscale scores were factor analyzed and identified a single internally consistent principal component, responsive interaction, which was standardized to a mean of 100 and a standard deviation of 10. The outcome was measured at the 24th month of the child’s life. Parent/caregiver-infant interaction was videotaped either in the laboratory or at home Not reported by author Primary

Olds, D. L., Robinson, J., Pettitt, L., 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(6), 1560-1568.
Results with paraprofessional home visitors.
Show Study Effects Details
Outcome Effect Sample Timing of Follow-Up Sample Size Program Group Comparison Group Mean Difference or Odds Ratio
Statistical Significance
Effect Size
Outcome Type
HOME total score No Effect Paraprofessional home visitor and comparison (Denver) 4-year follow-up 412 mothers Adjusted mean = 25.08
SE = 0.22
Adjusted mean = 25.09
SE = 0.22
MD = -0.01 Not statistically significant,
p = 0.96
Study reported = -0.00 Primary
Sensitive/responsive interaction Favorable Paraprofessional home visitor and comparison (Denver) 4-year follow-up 412 mothers Adjusted mean = 100.92
SE = 0.72
Adjusted mean = 98.66
SE = 0.69
MD = 2.26 Statistically significant,
p = 0.03
Study reported = 0.23 Primary
Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
HOME: Total score The HOME assesses parenting practices and aspects of the home environment. Parent/caregiver interview and observational assessment Not reported by author Primary
Sensitive/responsive interaction Mother-child interaction during free play was coded and subsequently analyzed using principal components analysis to derive a single factor for sensitive/responsive interaction. Parent/caregiver interview and observational assessment Cronbach’s α = 0.67 Primary
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