Nurse-Family Partnership (NFP)® Meets HHS Criteria

Model effectiveness research report last updated: 2024

Effects shown in research

Reductions in child maltreatment

Findings rated high

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
Percentage abused
FavorableUnfavorable or ambiguousNo Effect
15-year follow-up Nurse visited during pregnancy + infancy and comparison (Elmira) 228 adolescents = 0.39 = 0.37 Mean difference = 2.00 Not available Statistical significance not reported
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Information on sample sizes for this study was received through communication with the authors. HomVEE previously rated 24-month outcomes for nurse home visitors Moderate due to high attrition. Upon further examination, HomVEE noted that the outcomes had low attrition, and therefore they rate High.

Percentage neglected
FavorableUnfavorable or ambiguousNo Effect
15-year follow-up Nurse visited during pregnancy + infancy and comparison (Elmira) 228 adolescents = 0.61 = 0.63 Mean difference = -2.00 Not available Statistical significance not reported
Submitted by user on

Information on sample sizes for this study was received through communication with the authors. HomVEE previously rated 24-month outcomes for nurse home visitors Moderate due to high attrition. Upon further examination, HomVEE noted that the outcomes had low attrition, and therefore they rate High.

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
Number of days hospitalized–injuries/ingestions
FavorableUnfavorable or ambiguousNo Effect
2 years postnatal Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 671 children Adjusted mean = 0.04 Adjusted mean = 0.18 Mean difference = -0.14 Not available Statistically significant,
p < 0.01
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Statistical significance reported on authors’ calculations of the log-incidence difference.
Number of emergency department visits–injuries/ingestions
FavorableUnfavorable or ambiguousNo Effect
2 years postnatal Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 671 children Adjusted mean = 0.33 Adjusted mean = 0.34 Mean difference = -0.01 Not available Not statistically significant,
p > 0.05
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Statistical significance reported on authors’ calculations of the log-incidence difference.
Number of hospitalizations–injuries/ingestions
FavorableUnfavorable or ambiguousNo Effect
2 years postnatal Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 671 children Adjusted mean = 0.01 Adjusted mean = 0.03 Mean difference = -0.02 Not available Not statistically significant,
p > 0.05
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Statistical significance reported on authors’ calculations of the log-incidence difference.
Number of outpatient visits–injuries/ingestions
FavorableUnfavorable or ambiguousNo Effect
2 years postnatal Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 671 children Adjusted mean = 0.11 Adjusted mean = 0.20 Mean difference = -0.09 Not available Statistically significant,
p ≤ 0.05
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Statistical significance reported on authors’ calculations of the log-incidence difference.
Total number of health care encounters–injuries/ingestions
FavorableUnfavorable or ambiguousNo Effect
2 years postnatal Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 671 children Adjusted mean = 0.43 Adjusted mean = 0.56 Mean difference = -0.13 Not available Statistically significant,
p ≤ 0.05
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Statistical significance reported on authors’ calculations of the log-incidence difference.
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

Any substantiated maltreatment report

FavorableUnfavorable or ambiguousNo Effect

15-month follow-up

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States,full sample

1157 mothers Adjusted proportion = 0.02 Adjusted proportion = 0.03 Difference = -0.01 Study reported = -0.30

Not statistically significant, p ≥ 0.05

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Negative effect is favorable to the intervention.

The statistical significance after adjusting for multiple comparisons is reported; precise p-values are not available.

Loss of custody

FavorableUnfavorable or ambiguousNo Effect

15-month follow-up

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States,full sample

1039 mothers Adjusted proportion = 0.02 Adjusted proportion = 0.01 Difference = 0.00 Study reported = 0.08

Not statistically significant, p ≥ 0.05

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Negative effect is favorable to the intervention.

The statistical significance after adjusting for multiple comparisons is reported; precise p-values are not available.

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

Any Medicaid-paid health care encounter for injury or ingestion, % (fixed effect random slope analysis)

FavorableUnfavorable or ambiguousNo Effect

15 months old

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample

895 children Not reported Not reported Difference = -0.04 Not available

Not statistically significant, p= 0.42

Any Medicaid-paid health care encounter for injury or ingestion, % (restricted maximum likelihood analysis)

FavorableUnfavorable or ambiguousNo Effect

15 months old

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample

895 children Not reported Not reported Difference = -0.04 Not available

Not statistically significant, p= 0.35

Any Medicaid-paid health care encounter for injury or ingestion, % (split-sample analysis)

FavorableUnfavorable or ambiguousNo Effect

15 months old

NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample

895 children Not reported Not reported Difference = -0.03 HomVEE calculated = -0.10

Not statistically significant, p= 0.29

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
Substantiated reports of child abuse and neglect (incidence)
FavorableUnfavorable or ambiguousNo Effect
15-year follow-up Nurse visited during pregnancy and comparison (Elmira) 227 mothers Adjusted mean = 0.35 Adjusted mean = 0.54 Mean difference = -0.19 Not available Statistical significance not reported
Substantiated reports of child abuse and neglect (incidence)
FavorableUnfavorable or ambiguousNo Effect
15-year follow-up Nurse visited during pregnancy + infancy and comparison (Elmira) 245 mothers Adjusted mean = 0.29 Adjusted mean = 0.54 Mean difference = -0.25 Not available Statistically significant,
p < 0.01
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Statistical significance reported on authors’ calculations of the log-incidence difference.
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
Number of emergency room visits for accidents and poisonings (first year of life)
FavorableUnfavorable or ambiguousNo Effect
1-year follow-up Nurse visited during pregnancy and comparison (Elmira) 205 children Adjusted mean = 0.12 Adjusted mean = 0.06 Mean difference = 0.06 Not available Statistical significance not reported
Number of emergency room visits for accidents and poisonings (first year of life)
FavorableUnfavorable or ambiguousNo Effect
1-year follow-up Nurse visited during pregnancy + infancy and comparison (Elmira) 223 children Adjusted mean = 0.12 Adjusted mean = 0.06 Mean difference = 0.06 Not available Not statistically significant,
p > 0.05
Number of emergency room visits for accidents and poisonings (second year of life)
FavorableUnfavorable or ambiguousNo Effect
2-year follow-up Nurse visited during pregnancy and comparison (Elmira) 185 children Adjusted mean = 0.32 Adjusted mean = 0.34 Mean difference = -0.02 Not available Statistical significance not reported
Number of emergency room visits for accidents and poisonings (second year of life)
FavorableUnfavorable or ambiguousNo Effect
2-year follow-up Nurse visited during pregnancy + infancy and comparison (Elmira) 196 children Adjusted mean = 0.15 Adjusted mean = 0.34 Mean difference = -0.19 Not available Statistically significant,
p < 0.05
Substantiated abuse or neglect
FavorableUnfavorable or ambiguousNo Effect
2-year follow-up Nurse visited during pregnancy and comparison 247 children % (adjusted) = 8.00 Adjusted mean % = 10.00 Mean difference = -2.00 HomVEE calculated = -0.15 Not statistically significant,
p > 0.10
Substantiated abuse or neglect
FavorableUnfavorable or ambiguousNo Effect
2-year follow-up Nurse visited during pregnancy + infancy and comparison 256 children % (adjusted) = 5.00 Adjusted mean % = 10.00 Mean difference = -5.00 HomVEE calculated = -0.45 Not statistically significant,
p > 0.10
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
New substantiated cases of abuse/neglect from 25 to 48 months
FavorableUnfavorable or ambiguousNo Effect
48 months Nurse visited during pregnancy and comparison (Elmira) 245 children % (adjusted) = 4.00 Adjusted mean % = 5.00 Mean difference = -1.00 HomVEE calculated = -0.14 Statistical significance not reported
New substantiated cases of abuse/neglect from 25 to 48 months
FavorableUnfavorable or ambiguousNo Effect
48 months Nurse visited during pregnancy + infancy and comparison (Elmira) 253 children % (adjusted) = 8.00 Adjusted mean % = 5.00 OR = 1.80 Study reported = 0.30 Not statistically significant
p > 0.05
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The HomVEE reversed the odds ratio from the study-reported calculation to reflect the odds of the treatment versus the control group.
Number of emergency department visits for injuries/ingestions (25 to 50 months)
FavorableUnfavorable or ambiguousNo Effect
50 months Nurse visited during pregnancy + infancy and comparison (Elmira) 221 children Adjusted mean = 0.47 Adjusted mean = 0.61 Mean difference = -0.14 Not available Not statistically significant,
p > 0.05
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Statistical significance reported on authors’ calculations of the log-incidence difference.
Number of injuries/ingestions in physician record (25 to 50 months)
FavorableUnfavorable or ambiguousNo Effect
50 months Nurse visited during pregnancy + infancy and comparison (Elmira) 221 children Adjusted mean = 0.34 Adjusted mean = 0.57 Mean difference = -0.23 Not available Statistically significant,
p ≤ 0.05
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Statistical significance reported on authors’ calculations of the log-incidence difference.
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
Child foster care placements
FavorableUnfavorable or ambiguousNo Effect
0 to 12 years Nurse visited during pregnancy and infancy and development screening comparison (Memphis) 594 mothers %(adjusted) = 12.00 Adjusted mean % = 4.00 OR = 3.33 HomVEE calculated = 0.72 Not statistically significant, p ≥ 0.05
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
Number maltreatment, substantiated reports (percentage)
FavorableUnfavorable or ambiguousNo Effect
15-year follow-up Nurse visited during pregnancy + infancy and comparison (Elmira) Unknown = 0.76 = 0.68 = 8.00 HomVEE calculated = 0.24 Statistical significance not reported
Number neglect, substantiated reports (percentage)
FavorableUnfavorable or ambiguousNo Effect
15-year follow-up Nurse visited during pregnancy + infancy and comparison (Elmira) Unknown = 0.83 = 0.73 = 10.00 HomVEE calculated = 0.36 Statistical significance not reported
Onset of maltreatment
FavorableUnfavorable or ambiguousNo Effect
15-year follow-up Nurse visited during pregnancy + infancy and comparison (Elmira) Unknown Not available Not available HR = 0.73 Not available Statistical significance not reported
Onset of neglect
FavorableUnfavorable or ambiguousNo Effect
15-year follow-up Nurse visited during pregnancy + infancy and comparison (Elmira) Unknown Not available Not available HR = 0.59 Not available Statistical significance not reported

Findings rated moderate

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
Number of emergency department visits for injuries/ingestions (25 to 50 months)
FavorableUnfavorable or ambiguousNo Effect
50 months Nurse visited during pregnancy and comparison (Elmira) 209 children Adjusted mean = 0.46 Adjusted mean = 0.61 Mean difference = -0.15 Not available Statistical significance not reported
Number of injuries/ingestions in physician record (25 to 50 months)
FavorableUnfavorable or ambiguousNo Effect
50 months Nurse visited during pregnancy and comparison (Elmira) 209 children Adjusted mean = 0.56 Adjusted mean = 0.57 Mean difference = -0.01 Not available Statistical significance not reported
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