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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 Unpublished report submitted to the U.S. Department of Justice.

Model(s) Reviewed: Nurse-Family Partnership (NFP)® , NFP with Nurse Home Visitors - Mothers with low psychological resources subgroup
Manuscript screening details
Screening decision Screening conclusion
Passes screens Eligible for review
Study design details
Rating Design Attrition Baseline equivalence Reassignment Confounding factors
Moderate Randomized controlled trial Low Not established on race/ethnicity or SES None None
Notes:

footnote159

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

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 characteristics
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.

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
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

footnote163

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

Positive 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

footnote163

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

Positive 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

footnote163

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

Positive 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

footnote162

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

Negative 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

footnote162

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

Negative 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

footnote162

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

Negative 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

footnote163

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

Positive 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

footnote162

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

Negative 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

footnote163

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

Positive value is favorable to the comparison group.

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

footnote163

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

Positive 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

footnote163

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

Positive 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

footnote162

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

Negative 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

footnote163

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

Positive 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

footnote162

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

Negative value is favorable to the intervention.

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

footnote162

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

Negative 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

footnote162

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

Negative 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

footnote163

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

Positive 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

footnote163

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

Positive value is favorable to the comparison group.

Outcome measure summary

Family economic self-sufficiency
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