Eckenrode, J., Campa, M., Luckey, D. W., Henderson, C. R., Cole, R., Kitzman, H., Anson, E., Sidora-Arcoleo, K., Powers, J., & Olds, D. (2010). Long-term effects of prenatal and infancy nurse home visitation on the life course of youths: 19-year follow-up of a randomized trial. Archives of Pediatrics & Adolescent Medicine, 164(1), 9-15.
Manuscript Detail
Model(s) Reviewed:
Nurse-Family Partnership (NFP)®
| Screening decision | Screening conclusion | HomVEE procedures and standards version |
|---|---|---|
| Passes screens | Eligible for review | Version 1 |
| Rating | Design | Attrition | Baseline equivalence | Compromised randomization | Confounding factors | Valid, reliable measure(s) |
|---|---|---|---|---|---|---|
| High | Randomized controlled trial | Low | Established on SES; Not established on maternal race, but analysis controlled for child race. | None | None | Not assessed in manuscripts reviewed before 2021 |
Notes:
In 2020, HomVEE updated this review to move the 14 findings related to the child's sexual behavior, pregnancy, and use of alcohol or drugs from the Child Health domain to the Child Development and School Readiness domain because ACF determined that all measures of child behavioral health, including children's risky behaviors, belong in HomVEE's Child Development and School Readiness domain.
| Study participants | The authors actively recruited pregnant, first-time mothers who were fewer than 25 weeks pregnant, were younger 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 to one of four conditions (two treatment and two comparison groups). This study measured the sample when the children were 19 years old. The sample included 310 youth (170 in the treatment groups and 140 in the comparison groups). |
|---|---|
| Setting | Elmira, NY |
| Intervention services | The study included two treatment groups. Families in the first treatment group were provided nurse home visits through the mother’s pregnancy;, sensory and developmental screening for the child at 12 and 24 months of age; referrals for clinical evaluation and treatment, as needed; and free transportation for prenatal and well -child care through the child’s second birthday. Families in the second treatment group were provided the same services as the first treatment group except that the nurse continued visits through the child’s second birthday. |
| Comparison conditions | The study included two comparison groups, which were combined for the analyses. Families in the first group were provided the same sensory and developmental screening for the child at 12 and 24 months of age as the treatment groups. Based on the results of these screenings, the children were referred for clinical evaluation and treatment when needed. Families in the second group were provided these same screening services plus free transportation for prenatal and well-child care through the child’s second birthday. There were no differences between in the groups in their use of prenatal and well-child care. |
| Subgroups examined |
This field lists subgroups examined in the manuscript (even if they were not replicated in other samples and not reported on the summary page for this model’s report). • Child gender (boy or girl) • Subgroups defined by combinations of maternal characteristics (unmarried and low income) |
| Funding sources | This research was supported by grant 801-099 from the Smith Richardson Foundation. Support for earlier phases of this trial was provided by a Senior Research Scientist Award (Dr Olds) and by grants from the Prevention Research and Behavioral Medicine Branch of the National Institute of Mental Health, the Assistant Secretary for Planning and Evaluation, Health and Human Services, the Bureau of Maternal and Child Health (Department of Health and Human Services), the Robert Wood Johnson Foundation, the W.T. Grant Foundation, the Ford Foundation, and the Commonwealth Fund. Dr Olds’ Research Center at the University of Colorado has a contract with the NFP National Service Office to conduct research on improving the NFP model. |
| Author affiliation | David L. Olds, a study author, is a developer of this model. |
| Peer reviewed | Peer reviewed status is not listed for manuscripts reviewed before 2021. |
Findings that rate moderate or high
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | Ever been pregnant/made a girl pregnant | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and comparison (Elmira) | 19-year follow-up | 231 children | % (adjusted) = 32.40 | Adjusted mean % = 31.60 | Difference = 0.80 | HomVEE calculated = 0.02 | Not statistically significant, p ≥ 0.05 | |
| High | Ever fathered a child/given birth | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and comparison (Elmira) | 19-year follow-up | 231 children | %(adjusted) = 21.20 | Adjusted mean % = 20.70 | Difference = 0.50 | HomVEE calculated = 0.02 | Not statistically significant, p ≥ 0.05 | |
| High | Frequency of birth control use | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and comparison (Elmira) | 19-year follow-up | 231 children | Adjusted mean = 4.70 | Adjusted mean = 4.60 | Mean difference = 0.10 | Not available | Not statistically significant, p ≥ 0.05 | |
| High | Frequency of condom use | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and comparison (Elmira) | 19-year follow-up | 231 children | Adjusted mean = 3.90 | Adjusted mean = 3.30 | Mean difference = 0.60 | Not available | Not statistically significant, p ≥ 0.05 | |
| High | Number of sex partners, past year | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and comparison (Elmira) | 19-year follow-up | 231 children | Adjusted mean = 1.73 | Adjusted mean = 1.55 | Mean difference = 0.18 | Not available | Not statistically significant, p ≥ 0.05 | |
| High | Binge drinking | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | %(adjusted) = 36.00 | Adjusted mean % = 32.00 | Difference = 0.04 | HomVEE calculated = 0.11 | Not statistically significant, p ≥ 0.05 | |
| High | Ever been pregnant/made a girl pregnant | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | %(adjusted) = 32.40 | Adjusted mean % = 30.90 | Difference = 1.50 | HomVEE calculated = 0.04 | Not statistically significant, p ≥ 0.05 | |
| High | Ever fathered a child/given birth | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | %(adjusted) = 18.10 | Adjusted mean % = 20.70 | Difference = -2.60 | HomVEE calculated = -0.10 | Not statistically significant, p ≥ 0.05 | |
| High | Frequency of birth control use | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | Adjusted mean = 4.90 | Adjusted mean = 4.60 | Mean difference = 0.30 | Not available | Not statistically significant, p ≥ 0.05 | |
| High | Frequency of condom use | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | Adjusted mean = 3.70 | Adjusted mean = 3.30 | Mean difference = 0.40 | Not available | Not statistically significant, p ≥ 0.05 | |
| High | Graduated from high school | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | %(adjusted) = 81.60 | Adjusted mean % = 74.50 | Difference = 7.10 | HomVEE calculated = 0.25 | Not statistically significant, p ≥ 0.05 | |
| High | Illicit drug use | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | %(adjusted) = 53.00 | Adjusted mean % = 52.00 | Difference = 0.01 | HomVEE calculated = 0.02 | Not statistically significant, p ≥ 0.05 | |
| High | Number of sex partners, past year | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | Adjusted mean = 1.68 | Adjusted mean = 1.55 | Mean difference = 0.13 | Not available | Not statistically significant, p ≥ 0.05 | |
| High | Binge drinking | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and infancy and comparison (Elmira) | 19-year follow-up | 231 children | %(adjusted) = 28.00 | Adjusted mean % = 32.00 | Difference = -0.03 | HomVEE calculated = -0.10 | Not statistically significant, p ≥ 0.05 | |
| High | Graduated from high school | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and infancy and comparison (Elmira) | 19-year follow-up | 231 children | %(adjusted) = 70.60 | Adjusted mean % = 74.50 | Difference = -3.90 | HomVEE calculated = -0.12 | Not statistically significant, p ≥ 0.05 | |
| High | Illicit drug use | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and infancy and comparison (Elmira) | 19-year follow-up | 231 children | %(adjusted) = 49.00 | Adjusted mean % = 52.00 | Difference = -0.03 | HomVEE calculated = -0.08 | Not statistically significant, p ≥ 0.05 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | Economically productive | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | %(adjusted) = 73.00 | Adjusted mean % = 68.00 | Difference = 0.04 | HomVEE calculated = 0.13 | Not statistically significant, p ≥ 0.05 | |
| High | Ever used AFDC | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | %(adjusted) = 6.00 | Adjusted mean % = 2.00 | Difference = 0.04 | HomVEE calculated = -0.68 | Statistically significant, p < 0.05 | |
| High | Ever used food stamps | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | %(adjusted) = 7.00 | Adjusted mean % = 6.00 | Difference = 0.01 | HomVEE calculated = 0.06 | Not statistically significant, p ≥ 0.05 | |
| High | Ever used Medicaid | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | %(adjusted) = 20.00 | Adjusted mean % = 12.00 | Difference = 0.07 | HomVEE calculated = 0.34 | Not statistically significant, p ≥ 0.05 | |
| High | Economically productive | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and infancy and comparison (Elmira) | 19-year follow-up | 231 children | % (adjusted) = 71.00 | Adjusted mean % = 68.00 | Difference = 0.03 | HomVEE calculated = 0.09 | Not statistically significant, p ≥ 0.05 | |
| High | Ever used AFDC | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and infancy and comparison (Elmira) | 19-year follow-up | 231 children | % (adjusted) = 3.00 | Adjusted mean % = 2.00 | Difference = 0.01 | HomVEE calculated = 0.26 | Not statistically significant, p ≥ 0.05 | |
| High | Ever used food stamps | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and infancy and comparison (Elmira) | 19-year follow-up | 231 children | %(adjusted) = 6.00 | Adjusted mean % = 6.00 | Difference = 0.00 | HomVEE calculated = 0.02 | Not statistically significant, p ≥ 0.05 | |
| High | Ever used Medicaid | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and infancy and comparison (Elmira) | 19-year follow-up | 231 children | %(adjusted) = 11.00 | Adjusted mean % = 12.00 | Difference = -0.01 | HomVEE calculated = -0.06 | Not statistically significant, p ≥ 0.05 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | Arrested, lifetime | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | %(adjusted) = 30.00 | Adjusted mean % = 37.00 | Difference = -0.07 | HomVEE calculated = -0.20 | Not statistically significant, p ≥ 0.05 | |
| High | Arrested, past year | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | %(adjusted) = 12.00 | Adjusted mean % = 6.00 | Difference = 0.06 | HomVEE calculated = 0.49 | Not statistically significant, p ≥ 0.05 | |
| High | Convicted, lifetime | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | %(adjusted) = 23.00 | Adjusted mean % = 28.00 | Difference = -0.05 | HomVEE calculated = -0.16 | Not statistically significant, p ≥ 0.05 | |
| High | Convicted, past year | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | %(adjusted) = 10.00 | Adjusted mean % = 4.00 | Difference = 0.06 | HomVEE calculated = 0.56 | Not statistically significant, p ≥ 0.05 | |
| High | Felony assault | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | %(adjusted) = 3.00 | Adjusted mean % = 7.00 | Difference = -0.04 | HomVEE calculated = -0.52 | Not statistically significant, p ≥ 0.05 | |
| High | Fraud | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | %(adjusted) = 5.00 | Adjusted mean % = 4.00 | Difference = 0.01 | HomVEE calculated = 0.09 | Not statistically significant, p ≥ 0.05 | |
| High | Illegal services | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | %(adjusted) = 6.00 | Adjusted mean % = 7.00 | Difference = -0.01 | HomVEE calculated = -0.07 | Not statistically significant, p ≥ 0.05 | |
| High | Minor assault | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | %(adjusted) = 27.00 | Adjusted mean % = 26.00 | Difference = 0.01 | HomVEE calculated = 0.03 | Not statistically significant, p ≥ 0.05 | |
| High | Minor theft | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | %(adjusted) = 9.00 | Adjusted mean % = 11.00 | Difference = -0.02 | HomVEE calculated = -0.14 | Not statistically significant, p ≥ 0.05 | |
| High | Number of arrests, lifetime | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | Adjusted mean = 0.52 | Adjusted mean = 0.86 | Mean difference = -0.34 | Not available | Not statistically significant, p ≥ 0.05 | |
| High | Number of arrests, past year | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | Adjusted mean = 0.11 | Adjusted mean = 0.06 | Mean difference = 0.05 | Not available | Not statistically significant, p ≥ 0.05 | |
| High | Number of convictions, lifetime | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | Adjusted mean = 0.33 | Adjusted mean = 0.58 | Mean difference = -0.25 | Not available | Not statistically significant, p ≥ 0.05 | |
| High | Number of convictions, past year | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | Adjusted mean = 0.10 | Adjusted mean = 0.05 | Mean difference = 0.05 | Not available | Not statistically significant, p ≥ 0.05 | |
| High | Public disorder | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | %(adjusted) = 30.00 | Adjusted mean % = 26.00 | Difference = 0.04 | HomVEE calculated = 0.13 | Not statistically significant, p ≥ 0.05 | |
| High | Vandalism | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and comparison (Elmira) | 19-year follow-up | 219 children | %(adjusted) = 5.00 | Adjusted mean % = 7.00 | Difference = -0.02 | HomVEE calculated = -0.24 | Not statistically significant, p ≥ 0.05 | |
| High | Arrested, lifetime | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and infancy and comparison (Elmira) | 19-year follow-up | 231 children | %(adjusted) = 21.00 | Adjusted mean % = 37.00 | Difference = -0.16 | HomVEE calculated = -0.48 | Statistically significant, p < 0.05 | |
| High | Arrested, past year | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and infancy and comparison (Elmira) | 19-year follow-up | 231 children | %(adjusted) = 8.00 | Adjusted mean % = 6.00 | Difference = 0.03 | HomVEE calculated = 0.03 | Not statistically significant, p ≥ 0.05 | |
| High | Convicted, lifetime | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and infancy and comparison (Elmira) | 19-year follow-up | 231 children | %(adjusted) = 12.00 | Adjusted mean % = 28.00 | Difference = -0.16 | HomVEE calculated = -0.64 | Statistically significant, p < 0.05 | |
| High | Convicted, past year | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and infancy and comparison (Elmira) | 19-year follow-up | 231 children | %(adjusted) = 8.00 | Adjusted mean % = 4.00 | Difference = 0.03 | HomVEE calculated = 0.34 | Not statistically significant, p ≥ 0.05 | |
| High | Felony assault | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and infancy and comparison (Elmira) | 19-year follow-up | 231 children | %(adjusted) = 3.00 | Adjusted mean % = 7.00 | Difference = -0.05 | HomVEE calculated = -0.64 | Not statistically significant, p ≥ 0.05 | |
| High | Fraud | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and infancy and comparison (Elmira) | 19-year follow-up | 231 children | %(adjusted) = 2.00 | Adjusted mean % = 4.00 | Difference = -0.03 | HomVEE calculated = -0.67 | Not statistically significant, p ≥ 0.05 | |
| High | Illegal services | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and infancy and comparison (Elmira) | 19-year follow-up | 231 children | %(adjusted) = 4.00 | Adjusted mean % = 7.00 | Difference = -0.03 | HomVEE calculated = -0.34 | Not statistically significant, p ≥ 0.05 | |
| High | Minor assault | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and infancy and comparison (Elmira) | 19-year follow-up | 231 children | %(adjusted) = 23.00 | Adjusted mean % = 26.00 | Difference = -0.03 | HomVEE calculated = -0.10 | Not statistically significant, p ≥ 0.05 | |
| High | Minor theft | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and infancy and comparison (Elmira) | 19-year follow-up | 231 children | %(adjusted) = 8.00 | Adjusted mean % = 11.00 | Difference = -0.03 | HomVEE calculated = -0.25 | Not statistically significant, p ≥ 0.05 | |
| High | Number of arrests, lifetime | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and infancy and comparison (Elmira) | 19-year follow-up | 231 children | Adjusted mean = 0.37 | Adjusted mean = 0.86 | Mean difference = -0.49 | Not available | Statistically significant, p < 0.05 | |
| High | Number of arrests, past year | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and infancy and comparison (Elmira) | 19-year follow-up | 231 children | Adjusted mean = 0.10 | Adjusted mean = 0.06 | Mean difference = 0.04 | Not available | Not statistically significant, p ≥ 0.05 | |
| High | Number of convictions, lifetime | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and infancy and comparison (Elmira) | 19-year follow-up | 231 children | Adjusted mean = 0.20 | Adjusted mean = 0.58 | Mean difference = -0.38 | Not available | Statistically significant, p < 0.05 | |
| High | Number of convictions, past year | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and infancy and comparison (Elmira) | 19-year follow-up | 231 children | Adjusted mean = 0.09 | Adjusted mean = 0.05 | Mean difference = 0.04 | Not available | Not statistically significant, p ≥ 0.05 | |
| High | Public disorder | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and infancy and comparison (Elmira) | 19-year follow-up | 231 children | %(adjusted) = 32.00 | Adjusted mean % = 26.00 | Difference = 0.06 | HomVEE calculated = 0.18 | Not statistically significant, p ≥ 0.05 | |
| High | Vandalism | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy and infancy and comparison (Elmira) | 19-year follow-up | 231 children | %(adjusted) = 7.00 | Adjusted mean % = 7.00 | Difference = -0.01 | HomVEE calculated = -0.06 | Not statistically significant, p ≥ 0.05 |