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Holmberg, John; Luckey, Dennis; Olds, David. (2011) Teacher data for the Denver Year-9 follow-up. Unpublished report submitted to the U.S. Department of Justice.

Model(s) Reviewed: Nurse-Family Partnership (NFP)® , NFP with Paraprofessional Home Visitors
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 None None
Notes:

footnote156

Submitted by user on Fri, 03/15/2019 - 14:29

This study received a mixed rating. Some outcomes rate high, others moderate, and still others low. For the low psychological resources subgroup, we were unable to determine attrition and if the baseline information provided corresponds to the analytic sample, so the outcomes for the low psychological resources subgroup rate low. For paraprofessional versus control comparison in the whole sample, the study rates high because there is low attrition and demonstration of baseline equivalence on race/ethnicity and socioeconomic status (SES). For the nurse versus control comparison in the whole sample, most of the outcomes had high attrition, but baseline equivalence was established on race/ethnicity and <abbr title="socioeconomic status">SES</abbr>, so these outcomes rate moderate. Within the nurse versus control comparison in the whole sample, there are two outcomes for which attrition is low, and these outcomes rate high.&nbsp;

Study characteristics
Study participants Women were recruited through 21 antepartum clinics that served low-income pregnant women. Recruitment focused on women who had no previous live births and either qualified for Medicaid or had no private health insurance. From March 1994 to June 1995, 1,178 women were invited to participate and 735 consented and were randomly assigned to one of three conditions: a control group, nurse home visiting, and paraprofessional home visiting. Randomization was conducted within strata based on maternal race (Hispanic, white, black, American Indian, or Asian); maternal gestational age (fewer than 32 weeks, 32 weeks or more); and geographic region. This study augments the data collection procedures of the Denver trial of the NFP . The authors conducted follow-up evaluations with interviews and direct tests of the children on 575 families.
Setting Denver, Colorado metropolitan area
Intervention services The study included two program groups: one serviced by paraprofessionals and one serviced by nurses. Women assigned to either group received developmental screening and referral services for their children and home visits during pregnancy and infancy (until the child was 2 years old). Both groups had the same goals: (1) to improve women’s health-related behaviors, (2) to support parents in providing competent care, and (3) to encourage planning future pregnancies and promote education and employment. Paraprofessionals conducted 6.3 home visits, on average, during pregnancy and 16 visits during infancy. Nurses conducted 6.5 home visits, on average, during pregnancy and 21 visits during infancy.
Comparison conditions Women in the comparison group received developmental screening and referral services for their children at 6, 12, 15, 21, and 24 months.
Staff characteristics and training Nurse home visitors were required to have a Bachelor's of Science in Nursing and experience in community or maternal and child health nursing. Paraprofessionals were required to have a high school education. Although those with college preparation in the “helping” professions were excluded, preference was given to paraprofessionals who had worked in human services. Both the nurse and paraprofessional home visitors received one month of training before working with families. Nurses and paraprofessionals had the same caseloads (approximately 25 families), but paraprofessionals had 2 supervisors for 10 visitors, compared with 1 supervisor for 10 nurse home visitors.
Funding sources Not specified.
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 Math Grades: Parent Report
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Nurse vs. Control Age 9 follow-up 374 mothers Unadjusted mean = 3.14 Unadjusted mean = 3.21 Mean difference = -0.07 Study reported = -0.11 p-value = 0.32
High Reading Grades: Parent Report
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Nurse vs. Control Age 9 follow-up 375 mothers Unadjusted mean = 3.14 Unadjusted mean = 3.18 Mean difference = -0.04 Study reported = -0.05 p-value = 0.62
High ASPD Total Score - borderline/clinical
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control Age 9 follow-up 328 mothers Unadjusted mean = 0.04 Unadjusted mean = 0.04 OR = 1.78 HomeVEE calculated = 0.37 p-value = 0.37

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High CBCL Externalizing - Dual Rater Clinical
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control Age 9 follow-up 320 mothers Unadjusted mean = 0.14 Unadjusted mean = 0.14 OR = 1.40 HomeVEE calculated = 0.20 p-value = 0.33

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High CBCL Internalizing - Dual Rater Clinical
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control Age 9 follow-up 317 mothers Unadjusted mean = 0.08 Unadjusted mean = 0.08 OR = 0.95 HomeVEE calculated = -0.03 p-value = 0.9

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High CBCL Total - Dual Rater Clinical
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control Age 9 follow-up 317 mothers Unadjusted mean = 0.10 Unadjusted mean = 0.10 OR = 0.97 HomeVEE calculated = -0.01 p-value = 0.94

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High Current grade placement
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control Age 9 follow-up 321 mothers Unadjusted mean = 4.45 Unadjusted mean = 4.45 Mean difference = 0.12 Study reported = 0.16 p-value = 0.13
High Learning support services: hrs/week
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control Age 9 follow-up 309 mothers Unadjusted mean = 1.22 Unadjusted mean = 1.22 Mean difference = -0.42 Study reported = -0.09 p-value = 0.4

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High Math Grades: Parent Report
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control Age 9 follow-up 391 mothers Unadjusted mean = 3.11 Unadjusted mean = 3.11 Mean difference = -0.10 Study reported = -0.15 p-value = 0.16
High Math Grades: School Report
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control Age 9 follow-up 305 mothers Unadjusted mean = 2.51 Unadjusted mean = 2.51 Mean difference = -0.17 Study reported = -0.15 p-value = 0.15
High Reading Grades: Parent Report
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control Age 9 follow-up 391 mothers Unadjusted mean = 3.12 Unadjusted mean = 3.12 Mean difference = -0.06 Study reported = -0.07 p-value = 0.47
High Reading Grades: School Report
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control Age 9 follow-up 307 mothers Unadjusted mean = 2.32 Unadjusted mean = 2.32 Mean difference = -0.17 Study reported = -0.16 p-value = 0.14
High Special Education school report
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control Age 9 follow-up 308 mothers Unadjusted mean = 0.16 Unadjusted mean = 0.16 OR = 1.01 HomeVEE calculated = 0.01 p-value = 0.98

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

High Times sent to Principal"s office
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control Age 9 follow-up 326 mothers Unadjusted mean = 1.44 Unadjusted mean = 1.44 Mean difference = 0.14 Study reported = 0.15 p-value = 0.18

footnote163

Submitted by user on Fri, 03/15/2019 - 14:29

Positive value is favorable to the comparison group.

Moderate ASPD Total Score - borderline/clinical
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Nurse vs. Control Age 9 follow-up 310 mothers Unadjusted mean = 0.01 Unadjusted mean = 0.02 OR = 0.62 HomeVEE calculated = -0.26 p-value = 0.59

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

Moderate CBCL Externalizing - Dual Rater Clinical
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Nurse vs. Control Age 9 follow-up 303 mothers Unadjusted mean = 0.07 Unadjusted mean = 0.10 OR = 0.62 HomeVEE calculated = -0.29 p-value = 0.26

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

Moderate CBCL Internalizing - Dual Rater Clinical
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Nurse vs. Control Age 9 follow-up 302 mothers Unadjusted mean = 0.04 Unadjusted mean = 0.08 OR = 0.41 HomeVEE calculated = -0.53 p-value = 0.1

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

Moderate CBCL Total - Dual Rater Clinical
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Nurse vs. Control Age 9 follow-up 302 mothers Unadjusted mean = 0.07 Unadjusted mean = 0.10 OR = 0.74 HomeVEE calculated = -0.18 p-value = 0.47

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

Moderate Current grade placement
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Nurse vs. Control Age 9 follow-up 304 mothers Unadjusted mean = 4.35 Unadjusted mean = 4.33 Mean difference = 0.02 Study reported = 0.06 p-value = 0.57
Moderate Learning support services: hrs/week
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Nurse vs. Control Age 9 follow-up 294 mothers Unadjusted mean = 1.53 Unadjusted mean = 1.64 Mean difference = -0.11 Study reported = -0.02 p-value = 0.83

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

Moderate Math Grades: Parent Report
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Nurse vs. Control Age 9 follow-up 374 mothers Unadjusted mean = 3.14 Unadjusted mean = 3.21 Mean difference = -0.07 Study reported = -0.11 p-value = 0.32
Moderate Math Grades: School Report
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Nurse vs. Control Age 9 follow-up 295 mothers Unadjusted mean = 2.54 Unadjusted mean = 2.68 Mean difference = -0.14 Study reported = -0.12 p-value = 0.24
Moderate Reading Grades: School Report
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Nurse vs. Control Age 9 follow-up 294 mothers Unadjusted mean = 2.47 Unadjusted mean = 2.49 Mean difference = -0.02 Study reported = -0.03 p-value = 0.8
Moderate Special Education school report
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Nurse vs. Control Age 9 follow-up 294 mothers Unadjusted mean = 0.12 Unadjusted mean = 0.16 OR = 0.76 HomeVEE calculated = -0.17 p-value = 0.42

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

Moderate Times sent to Principal's office
FavorableUnfavorable or ambiguousNo Effect
Denver Nurse Family Partnership (NFP) - Nurse vs. Control Age 9 follow-up 308 mothers Unadjusted mean = 1.32 Unadjusted mean = 1.30 Mean difference = 0.02 Study reported = 0.02 p-value = 0.85

footnote163

Submitted by user on Fri, 03/15/2019 - 14:29

Positive value is favorable to the comparison group.

Outcome measure summary

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

ASPD Total Score - borderline/clinical

Antisocial ProcessScreening Device (ASPD) assessment detects antisocial processes in youth ages 6 through 13 years.

Teacher report

Not reported by author

CBCL Externalizing - Dual Rater Clinical

Percentage of children rated as having externalizing problems on Achenbach’s Child Behavior Checklist (CBCL)

Parent/caregiver report and teacher report

Not reported by authors

CBCL Internalizing - Dual Rater Clinical

Percentage of children rated as having internalizing problems on Achenbach’s Child Behavior Checklist (CBCL)

Parent/caregiver report and teacher report

Not reported by authors

CBCL Total - Dual Rater Clinical

Percentage of children rated as having total behavioral problems on Achenbach’s Child Behavior Checklist (CBCL)

Parent/caregiver report and teacher report

Not reported by authors

Current grade placement

Mean current grade placement

Not reported by authors

Not applicable

Learning support services: hrs/week

Mean hours per week in learning support services

Not reported by authors

Not applicable

Math Grades: Parent Report

Mean third-grade math grade point average

Parent/caregiver report

Not applicable

Math Grades: School Report

Mean third-grade math grade point average

Teacher report

Not applicable

Reading Grades: Parent Report

Mean third-grade reading grade point average

Parent/caregiver report

Not applicable

Reading Grades: School Report

Mean third-grade reading grade point average

Teacher report

Not applicable

Special Education school report

Not reported by authors

Not reported by authors

Not applicable

Times sent to Principal's office

Mean number of times sent to principal's office

Not reported by authors

Not applicable

CBCL Externalizing - Dual Rater Clinical

No description provided Teacher report

Not reported by author

CBCL Internalizing - Dual Rater Clinical

No description provided Teacher report

Not reported by author

CBCL Total - Dual Rater Clinical

No description provided Teacher report

Not reported by author

ASPD Total Score - borderline/clinical
No description provided

Teacher report

Current grade placement

No description provided Not reported by author

Not applicable

Learning support services: hrs/week

No description provided Not reported by author

Not applicable

Math Grades: Parent Report

No description provided Parent report

Not applicable

Math Grades: School Report

Mean third-grade math grade point average Teacher report

Not applicable

Reading Grades: Parent Report

No description provided Parent report

Not applicable

Reading Grades: School Report

Mean third-grade reading grade point average Teacher report

Not applicable

Special Education school report

No description provided Teacher report

Not applicable

Times sent to Principal's office

No description provided Teacher report

Not applicable