Kitzman, H., Olds, D. L., Sidora, K., Henderson, C. R., Hanks, C., Cole, R., et al. (2000). Enduring effects of nurse home visitation on maternal life course: A 3-year follow-up of a randomized trial. JAMA: The Journal of the American Medical Association, 283(15), 1983–1989.
| Screening decision | Screening conclusion |
|---|---|
| Passes screens | Eligible for review |
| Rating | Design | Attrition | Baseline equivalence | Reassignment | Confounding factors |
|---|---|---|---|---|---|
| High | Randomized controlled trial | Low | Difference in SES, but controlled in analysis. | None | None |
In 2020, HomVEE updated this review in two ways. First, HomVEE removed mother's partnership status/family structure findings from the Family Economic Self-Sufficiency domain because ACF determined that mother's partnership status is ineligible for review by HomVEE. Second, HomVEE removed the partner employment finding from the Family Economic Self-Sufficiency domain because partner SES is not eligible for review unless the same SES variable is measured for the mother, and the partner is coresident with the mother.
| Study participants | The sample included pregnant, first-time mothers who were less than 29 weeks pregnant. Women were recruited through an obstetrical clinic if they had no previous live births, no chronic illnesses linked to fetal growth retardation or preterm delivery, and at least two of the following sociodemographic characteristics: unmarried, less than 12 years of education, and unemployed. Between June 1990 and August 1991, 1,290 women were invited to participate and 1,139 consented and were randomly assigned. At enrollment, 92 percent of the women enrolled were African American, 98 percent were unmarried, and 64 percent were age 18 or younger. This study measured the sample when the children were 3 to 5 years old. The study sample included 646 women, 203 in the program group and 443 in the comparison group. |
|---|---|
| Setting | Memphis, Tennessee |
| Intervention services | The study included two treatment groups. The first treatment group received home visits from a nurse during pregnancy and two postpartum visits (one in the hospital prior to discharge and one in the home). 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. On average, the nurses completed 7 home visits during pregnancy and 26 home visits postpartum. Nurses used a detailed protocol for each visit, which focused on health-related behaviors, parenting, education, and employment. The two treatment groups were combined for the prenatal analysis. Only the second treatment group was followed for postnatal outcomes. |
| Comparison conditions | The study included two comparison groups. The first comparison group received taxicab transportation for prenatal care appointments. The second comparison group received the transportation plus developmental screening and referral to services when the children were 6, 12, and 24 months old. The two comparison groups were combined for the prenatal analysis. Only the second group was followed for postnatal outcomes. |
| Staff characteristics and training | All home visitors were nurses. No other information on training is provided. |
| Funding sources | Grant 90PD0215/01 from the Administration for Children and Families, Department of Health and Human Services; grant 9704-014 from the Carnegie Corporation of New York; grant 031052 from the Robert Wood Johnson Foundation; and a Senior Research Scientist Award (1-K05-MH01382-01) to Dr. Olds. |
| Author affiliation | David L. Olds, a study author, is a developer of this model. |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | Number of subsequent low birth weight newborns (< 2500 g) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 3-year follow-up | 646 mothers | Mean = 0.12 | Mean = 0.15 | Mean difference = -0.03 | Not available | Not statistically significant, p ≥ 0.05 |
footnote1Statistical significance reported on authors’ calculations of the log-incidence difference. |
| High | Number of subsequent neonatal intensive care unit or special care admissions | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 3-year follow-up | 646 mothers | Mean = 0.14 | Mean = 0.20 | Mean difference = -0.06 | Not available | Not statistically significant, p ≥ 0.05 |
footnote1Statistical significance reported on authors’ calculations of the log-incidence difference. footnote3Authors 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). |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | Current socioeconomic status (percentile ranked by U.S. occupational codes) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 3-year follow-up | 646 mothers | Adjusted mean = 15.62 | Adjusted mean = 13.73 | Mean difference = 1.89 | Not available | Not statistically significant, p ≥ 0.05 |
|
| High | Highest education level | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 3-year follow-up | 646 mothers | Adjusted mean = 11.61 | Adjusted mean = 11.67 | Mean difference = -0.06 | Not available | Not statistically significant, p ≥ 0.05 |
|
| High | Number of months mother or child received AFDC (0–60 months postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 3-year follow-up | 646 mothers | Adjusted mean = 32.55 | Adjusted mean = 36.19 | Mean difference = -3.64 | Not available | Statistically significant, p ≤ 0.01 |
|
| High | Number of months mother or child received food stamps (0–60 months postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 3-year follow-up | 646 mothers | Adjusted mean = 41.57 | Adjusted mean = 45.04 | Mean difference = -3.47 | Not available | Statistically significant, p ≤ 0.01 |
|
| High | Number of months received WIC (0–54 months postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 3-year follow-up | 646 mothers | Adjusted mean = 21.51 | Adjusted mean = 23.33 | Mean difference = -1.82 | Not available | Not statistically significant, p ≥ 0.05 |
|
| High | Number of months received Medicaid (0–54 months postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 3-year follow-up | 646 mothers | Adjusted mean = 39.59 | Adjusted mean = 41.08 | Mean difference = -1.49 | Not available | Not statistically significant, p ≥ 0.05 |
|
| High | Number of months worked (0–54 months postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 3-year follow-up | 646 mothers | Adjusted mean = 19.89 | Adjusted mean = 18.84 | Mean difference = 1.05 | Not available | 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 | Number of months between birth or first and second child | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 3-year follow-up | 646 mothers | Adjusted mean = 30.25 | Adjusted mean = 26.60 | Mean difference = 3.65 | Not available | Statistically significant, p ≤ 0.01 |
|
| High | Number of subsequent live births | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 3-year follow-up | 646 mothers | Adjusted mean = 0.85 | Adjusted mean = 0.96 | Mean difference = -0.11 | Not available | Not statistically significant, p ≥ 0.05 |
|
| High | Number of subsequent pregnancies | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 3-year follow-up | 646 mothers | Adjusted mean = 1.15 | Adjusted mean = 1.34 | Mean difference = -0.19 | Not available | Statistically significant, p < 0.05 |
|
| High | Number of subsequent pregnancies with short intervals (< 6 months from previous delivery or termination) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 3-year follow-up | 646 mothers | Adjusted mean = 0.22 | Adjusted mean = 0.32 | Mean difference = -0.10 | Not available | Statistically significant, p < 0.05 |
footnote1Statistical significance reported on authors’ calculations of the log-incidence difference. |
| High | Number of subsequent spontaneous abortions | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 3-year follow-up | 646 mothers | Adjusted mean = 0.10 | Adjusted mean = 0.12 | Mean difference = -0.12 | Not available | Not statistically significant, p ≥ 0.05 |
footnote1Statistical significance reported on authors’ calculations of the log-incidence difference. |
| High | Number of subsequent still births | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 3-year follow-up | 646 mothers | Adjusted mean = 0.01 | Adjusted mean = 0.02 | Mean difference = -0.01 | Not available | Not statistically significant p ≥ 0.05 |
footnote1Statistical significance reported on authors’ calculations of the log-incidence difference. |
| High | Number of subsequent therapeutic abortions | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 3-year follow-up | 646 mothers | Adjusted mean = 0.05 | Adjusted mean = 0.10 | Mean difference = -0.05 | Not available | Not statistically significant, p ≥ 0.05 |
footnote3Authors 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). |
| Outcome measure | Description of measure | Data collection method | Properties of measure |
|---|---|---|---|
Number of subsequent NICU or special care admissions |
Number of NICU or special care admissions episodes the mother experienced after the birth of the study’s focal child | Parent/caregiver report | Not applicable |
Number of subsequent low birth weight newborns (< 2,500 g) |
Number of low birth weight newborns the mother experienced after the birth of the study’s focal child | Parent/caregiver report | Not applicable |
| Outcome measure | Description of measure | Data collection method | Properties of measure |
|---|---|---|---|
Current SES |
Percentile rank of the mother’s occupation estimated by calculating percentile rank for each occupation using Census categories and the median income and educational achievement associated with each occupation | Parent/caregiver report | Not applicable |
Highest education level |
The highest year of school the mother had completed | Parent/caregiver report | Not applicable |
Number of months mother or child received AFDC |
Counts of the number of months the mother received AFDC | Review of Tennessee Department of Human Services records | Not applicable |
Number of months mother or child received food stamps |
Counts of the number of months the mother received food stamps. The outcome was measured for the period of 0 to 60 months postpartum. | Review of Tennessee Department of Human Services records | Not applicable |
Number of months received WIC |
Counts of the number of months the mother received WIC | Parent/caregiver report | Not applicable |
Number of months received Medicaid |
Counts of the number of months the mother received Medicaid | Parent/caregiver report | Not applicable |
Number of months worked |
Counts of the number of months the mother was employed | Parent/caregiver report | Not applicable |
| Outcome measure | Description of measure | Data collection method | Properties of measure |
|---|---|---|---|
Number of months between birth of first and second child |
Number of months that passed between the birth of the mother’s first and second child | Parent/caregiver report | Not applicable |
Number of subsequent live births |
The number of subsequent live births experienced by the mother | Parent/caregiver report | Not applicable |
Number of subsequent pregnancies |
The number of subsequent pregnancies experienced by the mother | Parent/caregiver report | Not applicable |
Number of subsequent pregnancies with short intervals |
The number of pregnancies where conception occurred less than 6 months from the previous delivery or termination | Parent/caregiver report | Not applicable |
Number of subsequent spontaneous abortions |
Number of subsequent spontaneous abortions experienced by the mother | Parent/caregiver report | Not applicable |
Number of subsequent stillbirths |
Number of subsequent stillbirths experienced by the mother | Parent/caregiver report | Not applicable |
Number of subsequent therapeutic abortions |
Number of subsequent therapeutic abortions experienced by the mother | Parent/caregiver report | Not applicable |
