Nurse-Family Partnership (NFP)^®

Last updated: 2019

Effects shown in research & outcome measure details

Positive parenting practices

Findings rated high

Izzo, C., Eckenrode, J., Smith, E., Henderson, C., Cole, R., Kitzman, H., & Olds, D. L. (2005). Reducing the impact of uncontrollable stressful life events through a program of nurse home visitation for new parents. Prevention Science, 6(4), 269–274.

Nurse-Family Partnership (NFP)^®

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Parenting practices - Hostility: Child Report of Parental Behavior Inventory (CRPBI)	FavorableUnfavorable or ambiguousNo Effect	15 years	Nurse-visited group 4 vs. comparison groups 1 and 2, Elmira sample	300 children	Unadjusted mean = 1.38	Unadjusted mean = 1.99	MD = -0.61	HomeVEE calculated = -1.22	Statistically significant, p = 0.00	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations. , Negative effect is favorable Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
Parenting practices - Inconsistent discipline: Child Report of Parental Behavior Inventory (CRPBI)	FavorableUnfavorable or ambiguousNo Effect	15 years	Nurse-visited group 4 vs. comparison groups 1 and 2, Elmira sample	300 children	Unadjusted mean = 1.90	Unadjusted mean = 1.99	MD = -0.09	HomeVEE calculated = -0.16	Not statistically significant, p = 0.23	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Parenting practices - Parent involvement: Child Report of Parental Behavior Inventory (CRPBI)	FavorableUnfavorable or ambiguousNo Effect	15 years	Nurse-visited group 4 vs. comparison groups 1 and 2, Elmira sample	300 children	Unadjusted mean = 3.34	Unadjusted mean = 3.33	MD = 0.01	HomeVEE calculated = 0.02	Not statistically significant, p = 0.89	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Parenting practices - Supervision: Parenting Style Index measure by Steinberg et al. (1993)	FavorableUnfavorable or ambiguousNo Effect	15 years	Nurse-visited group 4 vs. comparison groups 1 and 2, Elmira sample	300 children	Unadjusted mean = 0.86	Unadjusted mean = 0.89	MD = -0.03	HomeVEE calculated = -0.26	Not statistically significant, p = 0.05	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Parenting practices - Warmth: Child Report of Parental Behavior Inventory (CRPBI)	FavorableUnfavorable or ambiguousNo Effect	15 years	Nurse-visited group 4 vs. comparison groups 1 and 2, Elmira sample	300 children	Unadjusted mean = 3.65	Unadjusted mean = 3.67	MD = -0.02	HomeVEE calculated = -0.04	Not statistically significant, p = 0.76	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.

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Outcome measure	Outcome measure description	Collection method	Properties	Operations links
Parenting practices - Hostility: Child Report of Parental Behavior Inventory (CRPBI)	The Child Report of Parental Behavior Inventory (CRPBI) is designed to assess parenting behavior based on child and parent reports.	Child report	Properties not reported by author.
Parenting practices - Inconsistent discipline: Child Report of Parental Behavior Inventory (CRPBI)	The Child Report of Parental Behavior Inventory (CRPBI) is designed to assess parenting behavior based on child and parent reports.	Child report	Properties not reported by author.
Parenting practices - Parent involvement: Child Report of Parental Behavior Inventory (CRPBI)	The Child Report of Parental Behavior Inventory (CRPBI) is designed to assess parenting behavior based on child reports.	Child report	Properties not reported by author.
Parenting practices - Supervision: Parenting Style Index measure by Steinberg et al. (1993)	The Parenting Style Index is a measure developed by Steinberg and colleagues in 1993, in part to assess personal communication between parents and children.	Child report	Properties not reported by author.
Parenting practices - Warmth: Child Report of Parental Behavior Inventory (CRPBI)	The Child Report of Parental Behavior Inventory (CRPBI) is designed to assess parenting behavior based on child and parent reports, using psychometric measures.	Child report	Properties not reported by author.

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.

Nurse-Family Partnership (NFP)^®

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
HOME (emotional/ cognitive stimulation)	FavorableUnfavorable or ambiguousNo Effect	2 years postpartum	Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis)	675 mothers	Adjusted mean = 32.30	Adjusted mean = 30.90	Mean difference = 1.40	Not available	Statistically significant, p < 0.01
NCAST Child Responsiveness (total score)	FavorableUnfavorable or ambiguousNo Effect	2 years postnatal	Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis)	1082 children	Adjusted mean = 17.70	Adjusted mean = 17.40	Mean difference = 0.30	Not available	Not statistically significant, p > 0.05
NCAST Maternal Teaching (total score)	FavorableUnfavorable or ambiguousNo Effect	2 years postpartum	Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis)	675 mothers	Adjusted mean = 36.70	Adjusted mean = 36.50	Mean difference = 0.20	Not available	Not statistically significant, p > 0.05
Beliefs associated with child abuse (AAPI total score)	FavorableUnfavorable or ambiguousNo Effect	2 years postpartum	Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis)	672 mothers	Adjusted mean = 98.70	Adjusted mean = 100.50	Mean difference = -1.80	Not available	Statistically significant, p < 0.01

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Outcome measure	Outcome measure description	Collection method	Properties	Operations links
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
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
HOME: Total score	The HOME assesses parenting practices and aspects of the home environment.	Parent/caregiver interview and observational assessment	Not reported by author
NCAST Child Responsiveness	Mothers and children were observed while the mothers taught their children a developmentally challenging task. The mothers’ behaviors were coded and summarized to characterize their sensitivity, responsiveness, and quality of teaching. The infants’ behaviors were coded and aggregated to characterize their responsiveness and clarity of communication toward their mothers.	Observation conducted at the project offices	Not reported by author

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.

Nurse-Family Partnership (NFP)^®

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
HOME (avoidance of restriction and punishment)	FavorableUnfavorable or ambiguousNo Effect	10 months	Nurse visited during pregnancy and comparison (Elmira)	184 mothers	Adjusted mean = 5.77	Adjusted mean = 5.60	Mean difference = 0.17	Not available	Statistical significance not reported
HOME (avoidance of restriction and punishment)	FavorableUnfavorable or ambiguousNo Effect	10 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	191 mothers	Adjusted mean = 5.40	Adjusted mean = 5.60	Mean difference = -0.20	Not available	Not statistically significant, p ≥ 0.05
HOME (avoidance of restriction and punishment)	FavorableUnfavorable or ambiguousNo Effect	22 months	Nurse visited during pregnancy and comparison (Elmira)	171 mothers	Adjusted mean = 5.53	Adjusted mean = 6.28	Mean difference = -0.75	Not available	Statistical significance not reported
HOME (avoidance of restriction and punishment)	FavorableUnfavorable or ambiguousNo Effect	22 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	180 mothers	Adjusted mean = 5.82	Adjusted mean = 6.28	Mean difference = -0.46	Not available	Not statistically significant, p ≥ 0.05
HOME (provision of appropriate play materials)	FavorableUnfavorable or ambiguousNo Effect	10 months	Nurse visited during pregnancy and comparison (Elmira)	195 mothers	Adjusted mean = 7.45	Adjusted mean = 7.26	Mean difference = 0.19	Not available	Statistical significance not reported
HOME (provision of appropriate play materials)	FavorableUnfavorable or ambiguousNo Effect	10 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	201 mothers	Adjusted mean = 7.36	Adjusted mean = 7.26	Mean difference = 0.10	Not available	Not statistically significant, p ≥ 0.05
HOME (provision of appropriate play materials)	FavorableUnfavorable or ambiguousNo Effect	22 months	Nurse visited during pregnancy and comparison (Elmira)	190 mothers	Adjusted mean = 8.66	Adjusted mean = 8.65	Mean difference = 0.01	Not available	Statistical significance not reported
HOME (provision of appropriate play materials)	FavorableUnfavorable or ambiguousNo Effect	22 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	198 mothers	Adjusted mean = 8.68	Adjusted mean = 8.65	Mean difference = 0.03	Not available	Not statistically significant, p ≥ 0.05
Conflict	FavorableUnfavorable or ambiguousNo Effect	6 months	Nurse visited during pregnancy and comparison (Elmira)	164 mothers	Adjusted mean = 0.27	Adjusted mean = 0.25	Mean difference = 0.02	Not available	Statistical significance not reported
Conflict	FavorableUnfavorable or ambiguousNo Effect	6 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	163 mothers	Adjusted mean = 0.29	Adjusted mean = 0.25	Mean difference = 0.04	Not available	Not statistically significant, p ≥ 0.05
Spank or hit (number of times last 2 weeks)	FavorableUnfavorable or ambiguousNo Effect	6 months	Nurse visited during pregnancy and comparison (Elmira)	151 mothers	Adjusted mean = 1.71	Adjusted mean = 1.09	Mean difference = 0.62	Not available	Statistical significance not reported
Spank or hit (number of times last 2 weeks)	FavorableUnfavorable or ambiguousNo Effect	6 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	159 mothers	Adjusted mean = 0.19	Adjusted mean = 1.09	Mean difference = -0.90	Not available	Not statistically significant, p ≥ 0.05
Worry or concern (Sum of positive responses for behavioral problems)	FavorableUnfavorable or ambiguousNo Effect	6 months	Nurse visited during pregnancy and comparison (Elmira)	164 mothers	Adjusted mean = 0.61	Adjusted mean = 0.54	Mean difference = 0.07	Not available	Statistical significance not reported
Worry or concern (Sum of positive responses for behavioral problems)	FavorableUnfavorable or ambiguousNo Effect	6 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	163 mothers	Adjusted mean = 0.83	Adjusted mean = 0.54	Mean difference = 0.29	Not available	Statistically significant, p < 0.05
Yell or scold (number of times last 2 weeks)	FavorableUnfavorable or ambiguousNo Effect	6 months	Nurse visited during pregnancy and comparison (Elmira)	151 mothers	Adjusted mean = 7.56	Adjusted mean = 7.90	Mean difference = -0.34	Not available	Statistical significance not reported
Yell or scold (number of times last 2 weeks)	FavorableUnfavorable or ambiguousNo Effect	6 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	159 mothers	Adjusted mean = 3.99	Adjusted mean = 7.90	Mean difference = -3.91	Not available	Not statistically significant, p ≥ 0.05

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Outcome measure	Outcome measure description	Collection method	Properties	Operations links
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.
Conflict	Sum of positive responses to behavioral problems, such as feeding difficulties and crying	Parent/caregiver self-report	Not reported by author
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
Worry or concern	Sum of positive responses to behavioral problems, such as feeding difficulties and crying	Parent/caregiver self-report	Not reported by author
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

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.

Nurse-Family Partnership (NFP)^®

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
HOME inventory (total score)	FavorableUnfavorable or ambiguousNo Effect	34 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	238 mothers	Adjusted mean = 39.08	Adjusted mean = 39.03	Mean difference = 0.05	Not available	Not statistically significant, p ≥ 0.05
HOME inventory (total score)	FavorableUnfavorable or ambiguousNo Effect	34 months	Nurse visited during pregnancy and comparison (Elmira)	227 mothers	Adjusted mean = 38.45	Adjusted mean = 39.03	Mean difference = -0.58	Not available	Statistical significance not reported
HOME inventory (total score)	FavorableUnfavorable or ambiguousNo Effect	46 months	Nurse visited during pregnancy and comparison (Elmira)	227 mothers	Adjusted mean = 40.18	Adjusted mean = 39.67	Mean difference = 0.51	Not available	Statistical significance not reported
HOME inventory (total score)	FavorableUnfavorable or ambiguousNo Effect	46 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	238 mothers	Adjusted mean = 39.66	Adjusted mean = 39.67	Mean difference = -0.01	Not available	Not statistically significant, p ≥ 0.05
Hazardous exposures observed in home	FavorableUnfavorable or ambiguousNo Effect	34 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	209 mothers	Adjusted mean = 0.22	Adjusted mean = 0.38	Mean difference = -0.16	Not available	Statistically significant, p < 0.05	footnote4 Submitted by user on Fri, 03/15/2019 - 14:29 Statistical significance reported on authors’ calculation of incidence ratio.
Hazardous exposures observed in home	FavorableUnfavorable or ambiguousNo Effect	34 months	Nurse visited during pregnancy and comparison (Elmira)	202 mothers	Adjusted mean = 0.23	Adjusted mean = 0.38	Mean difference = -0.15	Not available	Statistical significance not reported
Hazardous exposures observed in home	FavorableUnfavorable or ambiguousNo Effect	46 months	Nurse visited during pregnancy and comparison (Elmira)	202 mothers	Adjusted mean = 0.31	Adjusted mean = 0.46	Mean difference = -0.15	Not available	Statistical significance not reported
Hazardous exposures observed in home	FavorableUnfavorable or ambiguousNo Effect	46 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	209 mothers	Adjusted mean = 0.21	Adjusted mean = 0.46	Mean difference = -0.25	Not available	Statistically significant, p < 0.01	footnote4 Submitted by user on Fri, 03/15/2019 - 14:29 Statistical significance reported on authors’ calculation of incidence ratio.

Show outcome measure summary

Outcome measure	Outcome measure description	Collection method	Properties	Operations links
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).
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).

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.

Nurse-Family Partnership (NFP)^®

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
HOME total score	FavorableUnfavorable or ambiguousNo Effect	4-year follow-up	Nurse home visitor and comparison (Denver)	408 mothers	Adjusted mean = 25.32	Adjusted mean = 25.09	Mean difference = 0.23	Study reported = 0.07	Not statistically significant, p = 0.47
Sensitive/responsive interaction	FavorableUnfavorable or ambiguousNo Effect	4-year follow-up	Nurse home visitor and comparison (Denver)	408 mothers	Adjusted mean = 100.51	Adjusted mean = 98.66	Mean difference = 1.85	Study reported = 0.18	Not statistically significant, p = 0.06

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Outcome measure	Outcome measure description	Collection method	Properties	Operations links
HOME: Total score	The HOME assesses parenting practices and aspects of the home environment.	Parent/caregiver interview and observational assessment	Not reported by author
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

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.

NFP with Paraprofessional Home Visitors

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
HOME environment score	FavorableUnfavorable or ambiguousNo Effect	21 months	Paraprofessional home visitor and comparison (Denver)	420 mothers	Adjusted mean = 37.40	Adjusted mean = 37.10	Mean difference = 0.30	Not available	Not statistically significant, p > 0.05
Mother-infant responsive interaction	FavorableUnfavorable or ambiguousNo Effect	24 months	Paraprofessional home visitor and comparison (Denver)	392 mothers	Adjusted mean = 100.15	Adjusted mean = 98.99	Mean difference = 1.16	Not available	Not statistically significant, p ≥ 0.05

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Outcome measure	Outcome measure description	Collection method	Properties	Operations links
HOME: Environment score	The HOME assesses parenting practices and aspects of the home environment	Parent/caregiver interview and observational assessment	Not reported by author
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

Findings 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.

Nurse-Family Partnership (NFP)^®

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
HOME environment score	FavorableUnfavorable or ambiguousNo Effect	Unknown	Nurse home visitor and comparison (Denver)	406 mothers	Adjusted mean = 37.79	Adjusted mean = 37.10	Mean difference = 0.69	Not available	Not statistically significant, p > 0.05	footnote3 Submitted by user on Fri, 03/15/2019 - 14:29 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).
Mother-infant responsive interaction	FavorableUnfavorable or ambiguousNo Effect	Unknown	Nurse home visitor and comparison (Denver)	372 mothers	Adjusted mean = 100.31	Adjusted mean = 98.99	Mean difference = 1.32	Not available	Statistically significant, p ≤ 0.05	footnote17 Submitted by user on Fri, 03/15/2019 - 14:29 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.

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Outcome measure	Outcome measure description	Collection method	Properties	Operations links
HOME: Total score	The HOME assesses parenting practices and aspects of the home environment.	Parent/caregiver interview and observational assessment	Not reported by author
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

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.

NFP with Paraprofessional Home Visitors

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
HOME total score	FavorableUnfavorable or ambiguousNo Effect	4-year follow-up	Paraprofessional home visitor and comparison (Denver)	412 mothers	Adjusted mean = 25.08	Adjusted mean = 25.09	Mean difference = -0.01	Study reported = 0.00	Not statistically significant, p = 0.96
Sensitive/responsive interaction	FavorableUnfavorable or ambiguousNo Effect	4-year follow-up	Paraprofessional home visitor and comparison (Denver)	412 mothers	Adjusted mean = 100.92	Adjusted mean = 98.66	Mean difference = 2.26	Study reported = 0.23	Statistically significant, p = 0.03

Show outcome measure summary

Outcome measure	Outcome measure description	Collection method	Properties	Operations links
HOME: Total score	The HOME assesses parenting practices and aspects of the home environment.	Parent/caregiver interview and observational assessment	Not reported by author
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

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