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Study Detail

Holmberg, John; Luckey, Dennis; Olds, David. (2011) Teacher data for the Denver Year-9 follow-up. Unpublished report submitted to the U.S. Department of Justice.

Program(s) Reviewed: Nurse Family Partnership (NFP)®, NFP with Paraprofessional Home Visitors

Study Screening Details

Screening DecisionScreening Conclusion
Study Passes ScreensEligible for Review

Study Design Details

RatingDesignSampleAttritionBaseline EquivalenceReassignmentConfounding Factors
HighRandomized controlled trialDenver,Colorado sampleLowEstablished on race/ethnicity and SESNoneNone

This study received a mixed rating. Some outcomes rate high, others moderate, and still others low. For the low psychological resources subgroup, we were unable to determine attrition and if the baseline information provided corresponds to the analytic sample, so the outcomes for the low psychological resources subgroup rate low. For paraprofessional versus control comparison in the whole sample, the study rates high because there is low attrition and demonstration of baseline equivalence on race/ethnicity and socioeconomic status (SES). For the nurse versus control comparison in the whole sample, most of the outcomes had high attrition, but baseline equivalence was established on race/ethnicity and SES, so these outcomes rate moderate. Within the nurse versus control comparison in the whole sample, there are two outcomes for which attrition is low, and these outcomes rate high. 

Study Characteristics

Study Participants

Women were recruited through 21 antepartum clinics that served low-income pregnant women. Recruitment focused on women who had no previous live births and either qualified for Medicaid or had no private health insurance. From March 1994 to June 1995, 1,178 women were invited to participate and 735 consented and were randomly assigned to one of three conditions: a control group, nurse home visiting, and paraprofessional home visiting. Randomization was conducted within strata based on maternal race (Hispanic, white, black, American Indian, or Asian); maternal gestational age (fewer than 32 weeks, 32 weeks or more); and geographic region. This study augments the data collection procedures of the Denver trial of the NFP . The authors conducted follow-up evaluations with interviews and direct tests of the children on 575 families.


Denver, Colorado metropolitan area

Home Visiting Services

The study included two program groups: one serviced by paraprofessionals and one serviced by nurses. Women assigned to either group received developmental screening and referral services for their children and home visits during pregnancy and infancy (until the child was 2 years old). Both groups had the same goals: (1) to improve women’s health-related behaviors, (2) to support parents in providing competent care, and (3) to encourage planning future pregnancies and promote education and employment. Paraprofessionals conducted 6.3 home visits, on average, during pregnancy and 16 visits during infancy. Nurses conducted 6.5 home visits, on average, during pregnancy and 21 visits during infancy.

Comparison Condition

Women in the comparison group received developmental screening and referral services for their children at 6, 12, 15, 21, and 24 months.

Staff Characteristics and Training

Nurse home visitors were required to have a Bachelor's of Science in Nursing and experience in community or maternal and child health nursing. Paraprofessionals were required to have a high school education. Although those with college preparation in the “helping” professions were excluded, preference was given to paraprofessionals who had worked in human services. Both the nurse and paraprofessional home visitors received one month of training before working with families. Nurses and paraprofessionals had the same caseloads (approximately 25 families), but paraprofessionals had 2 supervisors for 10 visitors, compared with 1 supervisor for 10 nurse home visitors.

Funding Source

Not specified.

Author Affiliation

David L. Olds, a study author, is a developer of this program model.


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