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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.

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 SES; Not established on maternal race, but analysis controlled for child race. None None
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 characteristics
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.
Staff characteristics and training All home visitors were nurses. No other information on training is provided.
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.

Findings details

Child development and school readiness
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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE calculated = -0.08 Not statistically significant, p ≥ 0.05
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 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE calculated = -0.06 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 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE calculated = -0.06 Not statistically significant, p ≥ 0.05

Outcome measure summary

Child development and school readiness
Outcome measure Description of measure Data collection method Properties of measure

Binge drinking

Percentage of youth that had engaged in binge drinking (greater than 4 drinks in a row) during the previous six months

Adolescent report

Not applicable

Ever been pregnant/made a girl pregnant

Percentage of youth that had become or made a girl pregnant or become a parent

Adolescent report

Not applicable

Ever fathered a child/given birth

Percentage of youth that had fathered a child or given birth

Adolescent report

Not applicable

Frequency of birth control use

A scale indicating the frequency of birth control use ranging from 1 (never) to 7(always)

Adolescent report

Not applicable

Frequency of condom use

A scale indicating the frequency of condom use ranging from 1 (never) to 7(always)

Adolescent report

Not applicable

Graduated from high school

Percentage of youth that had graduated from high school Adolescent report

Not applicable

Illicit drug use

Percentage of youth that had used illegal drugs in the past year.

Adolescent report

Not applicable

Number of sex partners, past year

Count of the study child’s number of sexual partners during the 12 month period prior to the interview.

Adolescent report

Not applicable

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

Economically productive

Percentage of youth engaging in economically productive activities such as whether the youth was in school, the military, or job training or working full time at the time of the interview Adolescent report

Not applicable

Ever used AFDC

Percentage of youth that had received AFDC Adolescent report

Not applicable

Ever used food stamps

Percentage of youth that had received food stamps Adolescent report

Not applicable

Ever used Medicaid

Percentage of youth that had received Medicaid Adolescent report

Not applicable

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

Arrested, lifetime

Percentage of youth that had been arrested at least once during their lifetime Adolescent report

Not applicable

Arrested, past year

Percentage of youth that had been arrested at least once during the past year Adolescent report

Not applicable

Convicted, lifetime

Percentage of youth that had been convicted of a crime during their lifetime Adolescent report

Not applicable

Convicted, past year

Percentage of youth that had been convicted of a crime during the past year Adolescent report

Not applicable

Felony assault

Percentage of youth that had engaged in felony assault during the past year, including aggravated assault, sexual assault, or gang fights Adolescent report

Not applicable

Fraud

Percentage of youth that had engaged in fraud during the past year Adolescent report

Not applicable

Illegal services

Percentage of youth that had engaged in illegal services during the past year, including prostitution or selling marijuana or other drugs Adolescent report

Not applicable

Minor assault

Percentage of youth that had engaged in minor assault during the past year, including hitting parents, teachers, or students Adolescent report

Not applicable

Minor theft

Percentage of youth that had engaged in minor assault during the past year, including stealing something worth less than $50 or joyriding Adolescent report

Not applicable

Number of arrests, lifetime

Count of the number of times the adolescent had been arrested during their lifetime Adolescent report

Not applicable

Number of arrests, past year

Count of the number of times the adolescent had been arrested during the past year Adolescent report

Not applicable

Number of convictions, lifetime

Count of the number of times the adolescent had been convicted of a crime during their lifetime Adolescent report

Not applicable

Number of convictions, past year

Count of the number of sexual partners the adolescent had during the past year Adolescent report

Not applicable

Number of convictions, past year

Count of the number of times the adolescent had been convicted of a crime during the past year Adolescent report

Not applicable

Public disorder

Percentage of youth that had engaged in public disorder during the past year, including panhandling or been loud, rowdy, or drunk in public Adolescent report

Not applicable

Vandalism

Percentage of youth that had engaged in vandalism or destruction of property during the past year Adolescent report

Not applicable