WWHV038783

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?