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Olds, D. L., Kitzman, H. J., Cole, R. E., Hanks, C. A., Arcoleo, K. J., Anson, E. A., Luckey, D. W., Knudtson, M. D., Henderson, C. R., Bondy, J., & Stevenson, A. J. (2010). Enduring effects of prenatal and infancy home visiting by nurses on maternal life course and government spending: Follow-up of a randomized trial among children at age 12 years. Archives of Pediatrics & Adolescent Medicine, 164(5), 419-424

Model(s) Reviewed: Nurse-Family Partnership (NFP)®
Manuscript screening details
Screening decision Screening conclusion
Passes screens Eligible for review
Study design details
Rating Design Attrition Baseline equivalence Reassignment Confounding factors
High Randomized controlled trial Low Established for race/ethnicity. Significant differences in SES, but controlled in analyses. None None
Notes:

In 2020, HomVEE updated this review to remove three 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. 

Study characteristics
Study participants The authors recruited women from the obstetric and pediatric care public system. A total of 743 pregnant women were enrolled and randomly assigned to treatment (228 women) or comparison (515 women). At the study’s onset, 92 percent of women in the sample were African American, 98.1 percent were unmarried, 64.1 percent were younger than 19 years, and 85 percent were living in households with incomes below the federal poverty threshold. For the 12-year follow-up, 594 women were interviewed. This sample is the same as that described in Kitzman et al. (2010) and reports on different outcomes from those described in that study.
Setting Memphis, TN
Intervention services Mothers in the nurse-visited condition were provided home visiting from pregnancy through their child’s second birthday, and the same assessment and referrals and transportation services provided to those in the comparison group.
Comparison conditions Mothers in the comparison group were provided developmental screening and referral services for their child at age 6, 12, and 24 months, and free transportation for scheduled prenatal care.
Staff characteristics and training All home visitors were nurses. No other information on training is provided.
Funding sources This project was supported by grant 1R01MH68790-01 from the National Institute of Mental Health, National Institutes of Health, and by grant 2004-52854-CO-JS0 from the Office of Juvenile Justice and Delinquency Prevention.
Author affiliation David L. Olds, a study author, is a developer of this model.

Findings details

Family economic self-sufficiency
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High Use of AFDC-TANF
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy and infancy and development screening comparison (Memphis 0 to 12 years 594 mothers Adjusted mean = 4.97 Adjusted mean = 5.47 Mean difference = -0.50 HomeVEE calculated = -3.03 Statistically significant, p < .05
High Time employed, in months
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy and infancy and development screening comparison (Memphis) 10 to 12 years 594 mothers Adjusted mean = 7.10 Adjusted mean = 7.77 Mean difference = -0.67 HomeVEE calculated = -2.62 Not statistically significant, p ≥ 0.05
High Time employed, in months
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy and infancy and development screening comparison (Memphis) 2 to 12 years 594 mothers Adjusted mean = 4.50 Adjusted mean = 4.64 Mean difference = -0.14 HomeVEE calculated = -0.99 Not statistically significant, p ≥ 0.05
High Use of AFDC-TANF
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy and infancy and development screening comparison (Memphis) 10 to 12 years 594 mothers Adjusted mean = 3.75 Adjusted mean = 3.97 Mean difference = -0.22 HomeVEE calculated = -13.10 Not statistically significant, p ≥ 0.05
High Use of food stamps
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy and infancy and development screening comparison (Memphis) 0 to 12 years 594 mothers Adjusted mean = 6.27 Adjusted mean = 6.86 Mean difference = -0.59 HomeVEE calculated = -3.90 Statistically significant, p < .05
High Use of food stamps
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy and infancy and development screening comparison (Memphis) 10 to 12 years 594 mothers Adjusted mean = 4.46 Adjusted mean = 5.06 Mean difference = -0.60 HomeVEE calculated = -2.65 Not statistically significant, p ≥ 0.05
High Use of Medicaid
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy and infancy and development screening comparison (Memphis) 0 to 12 years 594 mothers Adjusted mean = 8.08 Adjusted mean = 8.39 Mean difference = -0.31 HomeVEE calculated = -1.88 Not statistically significant, p ≥ 0.05
High Use of Medicaid
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy and infancy and development screening comparison (Memphis) 10 to 12 years 594 mothers Adjusted mean = 6.02 Adjusted mean = 6.23 Mean difference = -0.21 HomeVEE calculated = -0.81 Not statistically significant, p ≥ 0.05
Maternal health
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High Pearlin Mastery Scale
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and development screening comparison (Memphis) 6 months to 12 years 594 mothers Adjusted mean = 101.04 Adjusted mean = 99.60 Mean difference = 1.44 HomeVEE calculated = 4.30 Statistically significant, p < .05
High Pearlin Mastery Scale
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and development screening comparison (Memphis) 12-year follow-up 594 mothers Adjusted mean = 101.07 Adjusted mean = 99.56 Mean difference = 1.51 HomeVEE calculated = 2.80 Not statistically significant, p ≥ 0.05
High Alcohol or other drug use
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy and infancy and development screening comparison (Memphis) 12-year follow-up 594 mothers %(adjusted) = 10.00 Adjusted mean % = 10.00 OR = 0.91 HomeVEE calculated = -0.05 Not statistically significant, p ≥ 0.05
High Cumulative subsequent births
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy and infancy and development screening comparison (Memphis) 0 to 12 years 594 mothers Adjusted mean = 1.07 Adjusted mean = 1.15 Mean difference = -0.08 HomeVEE calculated = -1.69 Not statistically significant, p ≥ 0.05
High Cumulative subsequent births
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy and infancy and development screening comparison (Memphis) 10 to 12 years 594 mothers Adjusted mean = 1.80 Adjusted mean = 1.83 Mean difference = -0.03 HomeVEE calculated = -0.42 Not statistically significant, p ≥ 0.05
High Role impairment due to alcohol or drug use
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy and infancy and development screening comparison (Memphis) 12-year follow-up 594 mothers %(adjusted) = 0.00 Adjusted mean % = 3.00 Difference = -0.03 Not available Statistically significant, p < .05
High Symptoms of psychological distress (borderline/clinical vs. normal)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy and infancy and development screening comparison (Memphis) 12-year follow-up 594 mothers %(adjusted) = 18.00 Adjusted mean % = 17.00 OR = 1.09 HomeVEE calculated = 0.05 Not statistically significant, p ≥ 0.05
Reductions in child maltreatment
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High Child foster care placements
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy and infancy and development screening comparison (Memphis) 0 to 12 years 594 mothers %(adjusted) = 12.00 Adjusted mean % = 4.00 OR = 3.33 HomeVEE calculated = 0.72 Not statistically significant, p ≥ 0.05
Reductions in juvenile delinquency, family violence, and crime
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High Intimate partner violence
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy and infancy and development screening comparison (Memphis) 12-year follow-up 594 mothers %(adjusted) = 22.00 Adjusted mean % = 21.00 OR = 1.06 HomeVEE calculated = 0.03 Not statistically significant, p ≥ 0.05
High Maternal arrests
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy and infancy and development screening comparison (Memphis) 0 to 12 years 594 mothers %(adjusted) = 49.00 Adjusted mean % = 36.00 OR = 1.36 HomeVEE calculated = 0.32 Not statistically significant, p ≥ 0.05
High Mother jailed
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy and infancy and development screening comparison (Memphis) 12-year follow-up 594 mothers % (adjusted) = 13.00 Adjusted mean % = 13.00 OR = 0.97 HomeVEE calculated = -0.02 Not statistically significant, p ≥ 0.05

Outcome measure summary

Family economic self-sufficiency
Outcome measure Description of measure Data collection method Properties of measure

Time employed, in months

Count of the number of months the mother was employed from child age 2 to 12 years Parent/caregiver report

Not applicable 

Use of AFDC-TANF

Count of the number of months per year the mother Aid to Families with Dependent Children and Temporary Assistance for Needy Families from birth through child age 12 years Review of state records supplemented by parent/caregiver report

Not applicable 

Use of food stamps

Count of the number of months per year the mother received food stamps from birth through child age 12 years Review of state records supplemented by parent/caregiver report

Not applicable 

Use of Medicaid

Count of the number of months per year the mother received Medicaid from birth through age child age 12 years Review of state records supplemented by parent/caregiver report

Not applicable 

Maternal health
Outcome measure Description of measure Data collection method Properties of measure

Alcohol or other drug use

Percentage of mothers that had consumed 3 or more alcoholic drinks 3 or more times per month in the last year or used marijuana or cocaine since the last interview at age 9 years of the child Parent/caregiver report

Not applicable

Cumulative subsequent births

An index that reflects the number and timing of subsequent births Parent/caregiver report

Not reported by author

Pearlin Mastery Scale

Mother’s sense of mastery reported from child age 6 months to 12 years. The Pearlin Mastery Scale assesses the degree to which a person has a sense of mastery or control over their life. Parent/caregiver report

Not applicable

Role impairment due to alcohol or drug use

Percentage of mothers that experienced any impairment in role functioning (at work, with friends, or with family members) due to use of alcohol and other drugs since the last interview at child age 9 years Parent/caregiver report

Not applicable 

Symptoms of psychological distress (borderline/clinical vs. normal)

Mother’s symptoms of psychological distress (borderline or clinical vs. normal) Parent/caregiver report

Not applicable 

Reductions in child maltreatment
Outcome measure Description of measure Data collection method Properties of measure

Child foster care placements

Count of the number of the mother’s children that had been placed in foster care Parent/caregiver report

Not applicable

Reductions in juvenile delinquency, family violence, and crime
Outcome measure Description of measure Data collection method Properties of measure

Intimate partner violence

Percentage of mothers that had experienced any physical intimate partner violence between the child’s 9th-year and 12th-year interviews Parent/caregiver report

Not applicable

Maternal arrests

Count of the number of times the mother had been arrested from birth through child age 12 years Parent/caregiver report

Not applicable

Mother jailed

Percentage of mothers that had been jailed through child age 12 Parent/caregiver report

Not applicable