Home Visiting Evidence of Effectiveness

The program is intended to provide 62 home visits for women who enroll at 16 weeks gestation. In this study, the nurses completed a mean of 7 home visits (range of 0 to 18) during pregnancy and 26 home visits (range of 0 to 71) during the first 2 years after birth. Generally the difference between the recommended and actual number of visits was the result of participants dropping out of the program.

The sample included pregnant, first-time mothers who were less than 30 weeks pregnant. Women were recruited through health and human services agencies, including health clinics, Planned Parenthood, and public schools. In these locations, pregnant women who were less than 19 years old, were single parents, or had low socioeconomic status were actively recruited for the study. Between April 1978 and September 1980, 500 women were interviewed and 400 were randomly assigned. For this study, 46 nonwhite women were excluded from the sample. At enrollment, on average, the women were about 19 years old, 17 weeks pregnant, and had approximately 11 years of education. Roughly 42 percent of the sample was married. This study measured the sample in the 32nd week of pregnancy and the time of birth. The study sample included 354 women, 189 in the program group and 165 in the comparison group.

The study was conducted in Elmira, a metropolitan area within a semi-rural county in the Appalachian region of New York that has approximately 100,000 residents.

The study included two treatment groups, which were combined for the analyses. The first treatment group received home visits from a nurse during pregnancy. The nurse visited the family every other week and made nine visits, on average, which lasted one hour and 15 minutes. This treatment group also received the screening and transportation services described below for the comparison groups. The second treatment group received the same services as the first treatment group, but the home visiting continued until the child was 2 years old. Home visits were weekly for the first month after delivery, decreasing over time to once every 6 weeks when the child was 18-24 months. Home visits focused on parent education, enhancing the women’s support systems, and linkages to community services.

The study included two comparison groups, which were combined for the analyses. The first comparison group did not receive any services during pregnancy. When the children were 12 and 24 months old, they were screened for sensory and developmental problems and referred to other specialists, as appropriate. The second treatment group received free transportation (through a contract with a local taxi company) for prenatal and well-child care at local clinics and doctors’ offices. The second comparison group also received the 12- and 24-month developmental screening.

All home visitors were nurses. No other information on training is provided.

Bureau of Community Health Services (HHS-MCR-360403-06), the Robert Wood Johnson Foundation (grant 5263), and the W. T. Grant Foundation (grant 0723-80). The serum cotinine assays were carried out in the laboratories of Dr. Helen Van Vunakis at Brandeis University and were partially supported by grant DA 2407 from the Department of Health and Human Services.

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

The sample included pregnant, first-time mothers who were less than 30 weeks pregnant. The study actively recruited and included pregnant, first-time mothers who were less than 25 weeks pregnant, were less than 19 years old, were single parents, or had low socioeconomic status. Between April 1978 and September 1980, 500 women were interviewed and 400 were randomly assigned. This study is a longitudinal follow-up at 15 years for the women originally enrolled in the study and their children. At this follow-up, the study included data on 330 of the original mothers (177 in the program group and 152 in the comparison group) and 315 children of the original mothers (171 in the program group and 144 in the comparison group). At enrollment, on average, the women included in this study were about 19 years old and had approximately 11 years of education. Roughly 40 percent of the sample was married.

The study was conducted in Elmira, a metropolitan area within a semi-rural county in the Appalachian region of New York that has approximately 100,000 residents (information obtained from other studies using the Elmira sample).

The study included two treatment groups, which were combined for the analyses. The first treatment group received home visits from a nurse during pregnancy. The nurse visited the family every other week and made nine visits, on average, which lasted one hour and 15 minutes. The treatment group also received the screening and transportation services described below for the comparison groups. The second treatment group received the same services as the first treatment group, but the home visiting continued until the child was 2 years old. Home visits were once a week for the first month after delivery, decreasing over time to once every 6 weeks when the child was 18-24 months. Home visits focused on parent education, enhancing the women’s support systems, and linkages to community services.

The study included two comparison groups, which were combined for the analyses. The first comparison group did not receive any services during pregnancy. When the children were 12 and 24 months old, they were screened for sensory and developmental problems and referred to other specialists, as appropriate. The second treatment group received free transportation (through a contract with a local taxi company) for prenatal and well-child care at local clinics and doctors’ offices. The second comparison group also received the 12- and 24-month developmental screening.

All home visitors were nurses. No other information on training is provided.

Senior Research Scientist Award 1-K05-MH01382-01 (Dr. Olds); the Prevention Research and Behavioral Medicine Branch of the National Institute of Mental Health (R01-MH49381) and the Assistant Secretary for Planning and Evaluation, Department of Health and Human Services (grant 96ASPE278A).

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

The authors recruited women from the obstetric and pediatric care public system. A total of 743 pregnant women were enrolled and randomly assigned to treatment (228 women) or comparison (515 women). At the study’s onset, 92 percent of women in the sample were African American, 98.1 percent were unmarried, 64.1 percent were younger than 19 years, and 85 percent were living in households with incomes below the federal poverty threshold. For the 12-year follow-up, 594 women were interviewed. This sample is the same as that described in Kitzman et al. (2010) and reports on different outcomes from those described in that study.

Memphis, TN

Mothers in the nurse-visited condition were provided home visiting from pregnancy through their child’s second birthday, and the same assessment and referrals and transportation services provided to those in the comparison group.

Mothers in the comparison group were provided developmental screening and referral services for their child at age 6, 12, and 24 months, and free transportation for scheduled prenatal care.

All home visitors were nurses. No other information on training is provided.

This project was supported by grant 1R01MH68790-01 from the National Institute of Mental Health, National Institutes of Health, and by grant 2004-52854-CO-JS0 from the Office of Juvenile Justice and Delinquency Prevention.

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