Hanks, Carole, Luckey, Dennis, Knudtson, Michael, Kitzman, Harriet, Anson, Elizabeth, Arcoleo, Kimberly, & Olds, David. (2011) Neighborhood context and the Nurse-Family Partnership. Unpublished report submitted to the U.S. Department of Justice.
| Screening decision | Screening conclusion |
|---|---|
| Passes screens | Eligible for review |
| Rating | Design | Attrition | Baseline equivalence | Reassignment | Confounding factors |
|---|---|---|---|---|---|
| Moderate | Randomized controlled trial | Low | Not established on race/ethnicity or SES | None | None |
Because baseline equivalence is not established on race/ethnicity and <abbr title="socioeconomic status">SES</abbr>, we cannot determine if there were significant differences for which authors should have controlled in analyses. Thus the highest rating possible for the study is moderate.
| Study participants | Since 1977, the authors have conducted three randomized controlled trials of NFP in trials in Elmira, New York, with a sample of primarily white families in a semi-rural community (N = 400); Memphis, Tennessee, with a sample of primarily African American families (N = 743); and Denver, Colorado, with a sample that is largely Hispanic (46 percent; N = 735). The Denver trial included a treatment arm in which NFP was delivered by paraprofessionals rather than nurses, but this study focuses on nurse-visited women. For this study, the authors obtained U.S. Bureau of Census tract and block group numbers for the addresses of participants in the Elmira, Memphis, and Denver NFP trials. The authors created a neighborhood disadvantage index in order to answer three research questions: (1) Did nurse-visited families move to less disadvantaged neighborhoods over time compared with their control-group counterparts? (2) If nurse-visited women moved to better neighborhoods, to what extent did their living in better neighborhoods account for their improvements in maternal and child health compared with control group women and children? (3) To what extent did the NFP program attenuate the risk for poor maternal and child health associated with concentrated neighborhood social disadvantage? |
|---|---|
| Setting | Elmira, NY; Memphis, TN; Denver, CO |
| Intervention services | See descriptions for site-specific trials. |
| Comparison conditions | See descriptions for site-specific trials. |
| Staff characteristics and training | See descriptions for site-specific trials. |
| Funding sources | Not specified. |
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Neighborhood Disadvantage index | FavorableUnfavorable or ambiguousNo Effect |
Denver, CO- Nurse Family Partnership (NFP) | 4 years | 414 mothers | Unadjusted mean = 0.10 | Unadjusted mean = 0.06 | Mean difference = 0.04 | Study reported = 0.04 | p = 0.72 | footnote163Positive value is favorable to the comparison group. |
| Moderate | Neighborhood Disadvantage index | FavorableUnfavorable or ambiguousNo Effect |
Denver, CO- Nurse Family Partnership (NFP) | 6 years | 394 mothers | Unadjusted mean = -0.01 | Unadjusted mean = -0.08 | Mean difference = 0.07 | Study reported = 0.12 | p = 0.34 | footnote163Positive value is favorable to the comparison group. |
| Moderate | Neighborhood Disadvantage index | FavorableUnfavorable or ambiguousNo Effect |
Denver, CO- Nurse Family Partnership (NFP) | 9 years | 357 mothers | Unadjusted mean = -0.15 | Unadjusted mean = -0.17 | Mean difference = 0.02 | Study reported = 0.03 | p = 0.84 | footnote163Positive value is favorable to the comparison group. |
| Moderate | Neighborhood Disadvantage index | FavorableUnfavorable or ambiguousNo Effect |
Denver, CONurseFamily Partnership (NFP) - low psychological resources | 4 years | 152 mothers | Unadjusted mean = 0.18 | Unadjusted mean = 0.40 | Mean difference = -0.22 | Study reported = -0.23 | p = 0.16 | footnote162Negative value is favorable to the intervention. |
| Moderate | Neighborhood Disadvantage index | FavorableUnfavorable or ambiguousNo Effect |
Elmira, NY- Nurse Family Partnership (NFP) | 24 months | 205 mothers | Unadjusted mean = 0.32 | Unadjusted mean = 0.45 | Mean difference = -0.13 | Study reported = -0.12 | p = 0.54 | footnote162Negative value is favorable to the intervention. |
| Moderate | Neighborhood Disadvantage index | FavorableUnfavorable or ambiguousNo Effect |
Elmira, NY- Nurse Family Partnership (NFP) | 4 years | 214 mothers | Unadjusted mean = 0.36 | Unadjusted mean = 0.44 | Mean difference = -0.08 | Study reported = -0.07 | p = 0.72 | footnote162Negative value is favorable to the intervention. |
| Moderate | Neighborhood Disadvantage index | FavorableUnfavorable or ambiguousNo Effect |
Elmira, NY- Nurse Family Partnership (NFP) | 15 years | 183 mothers | Unadjusted mean = 0.48 | Unadjusted mean = 0.06 | Mean difference = 0.42 | Study reported = 0.42 | p = 0.03 | footnote163Positive value is favorable to the comparison group. |
| Moderate | Neighborhood Disadvantage index | FavorableUnfavorable or ambiguousNo Effect |
Elmira, NYNurseFamily Partnership (NFP) - high risk (unmarried, low SES) | 4 years | 100 mothers | Unadjusted mean = 0.83 | Unadjusted mean = 0.91 | Mean difference = -0.08 | Study reported = -0.06 | p = 0.79 | footnote162Negative value is favorable to the intervention. |
| Moderate | Neighborhood Disadvantage index | FavorableUnfavorable or ambiguousNo Effect |
Elmira, NYNurseFamily Partnership (NFP) - high risk (unmarried, low SES) | 15 years | 78 mothers | Unadjusted mean = 0.57 | Unadjusted mean = 0.52 | Mean difference = 0.05 | Study reported = 0.04 | p = 0.86 | footnote163Positive value is favorable to the comparison group. |
| Moderate | Neighborhood Disadvantage index | FavorableUnfavorable or ambiguousNo Effect |
Memphis, TN - Nurse Family Partnership (NFP) | 6 years | 627 mothers | Unadjusted mean = 1.86 | Unadjusted mean = 2.04 | Mean difference = -0.18 | Study reported = -0.11 | p = 0.38 | footnote162Negative value is favorable to the intervention. |
| Moderate | Neighborhood Disadvantage index | FavorableUnfavorable or ambiguousNo Effect |
Memphis, TN - Nurse Family Partnership (NFP) | 9 years | 617 mothers | Unadjusted mean = 1.93 | Unadjusted mean = 1.93 | Mean difference = 0.00 | Study reported = 0.00 | p = 0.99 | footnote163Positive value is favorable to the comparison group. |
| Moderate | Neighborhood Disadvantage index | FavorableUnfavorable or ambiguousNo Effect |
Memphis, TN - Nurse Family Partnership (NFP) | 12 years | 569 mothers | Unadjusted mean = 1.54 | Unadjusted mean = 1.60 | Mean difference = -0.06 | Study reported = -0.04 | p = 0.78 | footnote162Negative value is favorable to the intervention. |
| Moderate | Neighborhood Disadvantage index | FavorableUnfavorable or ambiguousNo Effect |
Memphis, TN - Nurse Family Partnership (NFP) | 24 months | 657 mothers | Unadjusted mean = 2.30 | Unadjusted mean = 2.21 | Mean difference = 0.09 | Study reported = 0.05 | p = 0.7 | footnote163Positive value is favorable to the comparison group. |
| Moderate | Neighborhood Disadvantage index | FavorableUnfavorable or ambiguousNo Effect |
Memphis, TN - Nurse Family Partnership (NFP) | 54 months | 626 mothers | Unadjusted mean = 2.40 | Unadjusted mean = 2.28 | Mean difference = 0.12 | Study reported = 0.06 | p = 0.63 | footnote163Positive value is favorable to the comparison group. |
| Moderate | Neighborhood Disadvantage index | FavorableUnfavorable or ambiguousNo Effect |
Memphis, TN Nurse Family Partnership (NFP) - low psychological resources | 24 months | 338 mothers | Unadjusted mean = 2.48 | Unadjusted mean = 2.51 | Mean difference = -0.03 | Study reported = -0.02 | p = 0.88 | footnote162Negative value is favorable to the intervention. |
| Moderate | Neighborhood Disadvantage index | FavorableUnfavorable or ambiguousNo Effect |
Memphis, TN Nurse Family Partnership (NFP) - low psychological resources | 54 months | 325 mothers | Unadjusted mean = 2.52 | Unadjusted mean = 2.71 | Mean difference = -0.19 | Study reported = -0.11 | p = 0.35 | footnote162Negative value is favorable to the intervention. |
| Moderate | Neighborhood Disadvantage index | FavorableUnfavorable or ambiguousNo Effect |
Memphis, TN Nurse Family Partnership (NFP) - low psychological resources | 6 years | 332 mothers | Unadjusted mean = 2.84 | Unadjusted mean = 2.34 | Mean difference = 0.50 | Study reported = 0.30 | p = 0.01 | footnote163Positive value is favorable to the comparison group. |
| Moderate | Neighborhood Disadvantage index | FavorableUnfavorable or ambiguousNo Effect |
Memphis, TN Nurse Family Partnership (NFP) - low psychological resources | 12 years | 308 mothers | Unadjusted mean = 2.03 | Unadjusted mean = 1.74 | Mean difference = 0.29 | Study reported = 0.19 | p = 0.11 | footnote163Positive value is favorable to the comparison group. |
| Outcome measure | Description of measure | Data collection method | Properties of measure |
|---|---|---|---|
Neighborhood Disadvantage index |
Weighted average of the standardized values for the following percentages within Census tract and block group: (1) households below the federal poverty level (2) persons on public assistance (3) female-headed households with children (4) persons unemployed, and (5) share of population that is black. |
U.S. Census Bureau - 1980, 1990, and 2000 censuses |
Not reported by authors |
Neighborhood Disadvantage index |
An average of the standardized values for five elements in each Census tract and block group number: (1) percentage of households below the federal poverty level, (2) percentage of persons on public assistance, (3) percentage of female-headed households with children, (4) percentage of persons unemployed, (5) percentage of population that is black. This average was weighted by intervals between the Censuses when participant assessments were conducted. The weighted scores represent the degree of concentrated disadvantage in the neighborhood in terms of national averages, weighted by intervals to the Census. |
Author calculation from public data |
Not reported by author |
