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Izzo, C., Eckenrode, J., Smith, E., Henderson, C., Cole, R., Kitzman, H., & Olds, D. L. (2005). Reducing the impact of uncontrollable stressful life events through a program of nurse home visitation for new parents. Prevention Science, 6(4), 269–274.

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 on race/ethnicity and SES; outcomes not feasible to assess at baseline None None
Notes:

In addition to the outcomes that received a high rating, substance use outcomes in the maternal health domain received a moderate rating because equivalence was not established on baseline measures of the outcomes.

Study characteristics
Study participants Participants were 324 mothers and 315 of their first-born children. The mothers and children all participated in an RCT examining the Nurse-Family Partnership model in Elmira, NY in 1978. At the time of recruitment, participants were pregnant, first-time mothers who were less than 25 weeks pregnant. All participants were all either under the age of 19; unmarried; or had low socioeconomic status, as indicated by their Medicaid eligibility.
Setting Elmira, NY, USA
Intervention services The treatment group received in-home nurse visits from pregnancy through 24 months after birth, in addition to the same services as the comparison group.
Comparison conditions Mothers in the comparison group received developmental and sensory screening for their children, clinical referrals, and transportation to prenatal and postnatal care.
Staff characteristics and training Services were provided by registered nurses.
Funding sources This study was supported with grants from the Prevention Research Branch of the National Institutes of Mental Health (R01-MH49381); the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services (96ASPE278A); the Children's Bureau, U.S. Department of Health and Human Services (90-CA-1631). The research was also supported by an NIH Senior Research Scientist Award.
Author affiliation David L. Olds, one of the study authors, is also the model developer.
Study Registration:

Clinicaltrials.gov Identifier: None found. Study registration was assessed by HomVEE beginning with the 2014 review.

Findings details

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

Mental health - Anxiety: Mental Health Inventory (MHI)

FavorableUnfavorable or ambiguousNo Effect

Nurse-visited group 4 vs. comparison groups 1 and 2, Elmira sample

15 years

300 mothers Unadjusted mean = 2.56 Unadjusted mean = 2.56 MD = 0.00 HomeVEE calculated = 0.00

Not statistically significant, p = 1.00

High

Mental health - Depression: Mental Health Inventory (MHI)

FavorableUnfavorable or ambiguousNo Effect

Nurse-visited group 4 vs. comparison groups 1 and 2, Elmira sample

15 years

300 mothers Unadjusted mean = 2.01 Unadjusted mean = 2.02 MD = -0.01 HomeVEE calculated = -0.01

Not statistically significant, p = 0.95

High

Mental health - Emotional stability: Mental Health Inventory (MHI)

FavorableUnfavorable or ambiguousNo Effect

Nurse-visited group 4 vs. comparison groups 1 and 2, Elmira sample

15 years

300 mothers Unadjusted mean = 3.75 Unadjusted mean = 3.74 MD = 0.01 HomeVEE calculated = 0.02

Not statistically significant, p = 0.90

High

Mental health - Positive well-being: Mental Health Inventory (MHI)

FavorableUnfavorable or ambiguousNo Effect

Nurse-visited group 4 vs. comparison groups 1 and 2, Elmira sample

15 years

300 mothers Unadjusted mean = 3.78 Unadjusted mean = 3.79 MD = -0.01 HomeVEE calculated = -0.02

Not statistically significant, p = 0.90

Moderate Alcohol impairment score
FavorableUnfavorable or ambiguousNo Effect
Nurse-visited group 4 vs. comparison groups 1 and 2, Elmira sample 15 years 300 mothers Unadjusted mean = 0.35 Unadjusted mean = 0.37 MD = -0.02 HomeVEE calculated = -0.02 Not statistically significant, p = 0.87
Moderate Substance use - # cigarettes smoked per day
FavorableUnfavorable or ambiguousNo Effect
Nurse-visited group 4 vs. comparison groups 1 and 2, Elmira sample 15 years 300 mothers Unadjusted mean = 8.32 Unadjusted mean = 10.56 MD = -2.24 HomeVEE calculated = -0.21 Not statistically significant, p = 0.11
Moderate Substance use - binge drinking: # days had 5+ drinks in the past year
FavorableUnfavorable or ambiguousNo Effect
Nurse-visited group 4 vs. comparison groups 1 and 2, Elmira sample 15 years 300 mothers Unadjusted mean = 11.70 Unadjusted mean = 9.27 MD = 2.43 HomeVEE calculated = 0.06 Not statistically significant, p = 0.65
Positive parenting practices
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High

Parenting practices - Hostility: Child Report of Parental Behavior Inventory (CRPBI)

FavorableUnfavorable or ambiguousNo Effect

Nurse-visited group 4 vs. comparison groups 1 and 2, Elmira sample

15 years

300 children Unadjusted mean = 1.38 Unadjusted mean = 1.99 MD = -0.61 HomeVEE calculated = -1.22

Statistically significant, p = 0.00

High

Parenting practices - Inconsistent discipline: Child Report of Parental Behavior Inventory (CRPBI)

FavorableUnfavorable or ambiguousNo Effect

Nurse-visited group 4 vs. comparison groups 1 and 2, Elmira sample

15 years

300 children Unadjusted mean = 1.90 Unadjusted mean = 1.99 MD = -0.09 HomeVEE calculated = -0.16

Not statistically significant, p = 0.23

High

Parenting practices - Parent involvement: Child Report of Parental Behavior Inventory (CRPBI)

FavorableUnfavorable or ambiguousNo Effect

Nurse-visited group 4 vs. comparison groups 1 and 2, Elmira sample

15 years

300 children Unadjusted mean = 3.34 Unadjusted mean = 3.33 MD = 0.01 HomeVEE calculated = 0.02

Not statistically significant, p = 0.89

High

Parenting practices - Supervision: Parenting Style Index measure by Steinberg et al. (1993)

FavorableUnfavorable or ambiguousNo Effect

Nurse-visited group 4 vs. comparison groups 1 and 2, Elmira sample

15 years

300 children Unadjusted mean = 0.86 Unadjusted mean = 0.89 MD = -0.03 HomeVEE calculated = -0.26

Not statistically significant, p = 0.05

High

Parenting practices - Warmth: Child Report of Parental Behavior Inventory (CRPBI)

FavorableUnfavorable or ambiguousNo Effect

Nurse-visited group 4 vs. comparison groups 1 and 2, Elmira sample

15 years

300 children Unadjusted mean = 3.65 Unadjusted mean = 3.67 MD = -0.02 HomeVEE calculated = -0.04

Not statistically significant, p = 0.76

Outcome measure summary

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

Mental health - Anxiety: Mental Health Inventory (MHI)

The RAND Mental Health Inventory (MHI) Survey consists of 37 measures of respondent core functioning and well-being.

Parent report

Properties not reported by author.

Mental health - Depression: Mental Health Inventory (MHI)

The RAND Mental Health Inventory (MHI) Survey consists of 37 measures of respondent core functioning and well-being.

Parent report

Properties not reported by author.

Mental health - Emotional stability: Mental Health Inventory (MHI)

The RAND Mental Health Inventory (MHI) Survey consists of 37 measures of respondent core functioning and well-being.

Parent report

Properties not reported by author.

Mental health - Positive well-being: Mental Health Inventory (MHI)

The RAND Mental Health Inventory (MHI) Survey consists of 37 measures of respondent core functioning and well-being.

Parent report

Properties not reported by author.

Alcohol impairment score

Not reported

Not reported

Properties not reported by author.

Substance use - # cigarettes smoked per day

Mothers in the study were asked to report the number of cigarettes they smoked per day in the past year.

Parent report

Properties not reported by author.

Substance use - binge drinking: # days had 5+ drinks in the past year

Mothers in the study were asked to report how many times in the past year they'd consumed at least five drinks in a single drinking episode.

Parent report

Properties not reported by author.

Positive parenting practices
Outcome measure Description of measure Data collection method Properties of measure

Parenting practices - Hostility: Child Report of Parental Behavior Inventory (CRPBI)

The Child Report of Parental Behavior Inventory (CRPBI) is designed to assess parenting behavior based on child and parent reports.

Child report

Properties not reported by author.

Parenting practices - Inconsistent discipline: Child Report of Parental Behavior Inventory (CRPBI)

The Child Report of Parental Behavior Inventory (CRPBI) is designed to assess parenting behavior based on child and parent reports.

Child report

Properties not reported by author.

Parenting practices - Parent involvement: Child Report of Parental Behavior Inventory (CRPBI)

The Child Report of Parental Behavior Inventory (CRPBI) is designed to assess parenting behavior based on child reports.

Child report

Properties not reported by author.

Parenting practices - Supervision: Parenting Style Index measure by Steinberg et al. (1993)

The Parenting Style Index is a measure developed by Steinberg and colleagues in 1993, in part to assess personal communication between parents and children.

Child report

Properties not reported by author.

Parenting practices - Warmth: Child Report of Parental Behavior Inventory (CRPBI)

The Child Report of Parental Behavior Inventory (CRPBI) is designed to assess parenting behavior based on child and parent reports, using psychometric measures.

Child report

Properties not reported by author.