WWHV003621

Kitzman, H., Olds, D. L., Henderson, C. R., Hanks, C., Cole, R., Tatelbaum, R., et al. (1997). Effect of prenatal and infancy home visitation by nurses on pregnancy outcomes, childhood injuries, and repeated childbearing. A randomized controlled trial. JAMA: The Journal of the American Medical Association, 278(8), 644–652.

Citation Year
1997
Rating
Used in Implementation Reports
On
Study Participants

The sample included pregnant, first-time mothers who were less than 29 weeks pregnant. Women were recruited through an obstetrical clinic if they had no previous live births, no chronic illnesses linked to fetal growth retardation or preterm delivery, and at least two of the following sociodemographic characteristics: unmarried, less than 12 years of education, and unemployed. From June 1990 through August 1991, 1,290 women were invited to participate and 1,139 consented and were randomly assigned. At enrollment, 92 percent of the women enrolled were African American, 98 percent were unmarried, and 64 percent were age 18 or younger. This study measured the sample up through the child’s 24th month. At the 24-month follow-up, the sample included 675 women, 208 in the program group and 467 in the comparison group.

Setting

Memphis, Tennessee

Home Visiting Services

The study included two treatment groups. The first treatment group received home visits from a nurse during pregnancy and two postpartum visits (one in the hospital prior to discharge and one in the home). The treatment group also received the screening and transportation services described below for the comparison groups. The second treatment group received the same services as the first treatment group, but the home visiting continued until the child was 2 years old. On average, the nurses completed 7 home visits during pregnancy and 26 home visits postpartum. Nurses used a detailed protocol for each visit, which focused on health-related behaviors, parenting, education, and employment. The two treatment groups were combined for the prenatal analysis. Only the second treatment group was followed for postnatal outcomes.

Comparison Conditions

The study included two comparison groups. The first comparison group received taxicab transportation for prenatal care appointments. The second comparison group received the transportation plus developmental screening and referral to services when the children were 6, 12, and 24 months old. The two comparison groups were combined for the prenatal analysis. Only the second group was followed for postnatal outcomes.

Staff Characteristics and Training

All home visitors were nurses. No other information on training is provided.

Author Affiliation

David L. Olds, a study author, is a developer of this model.

Funding Sources

Five federal agencies: the National Institute of Nursing Research (grant NR01-01691-05); the Bureau of Maternal and Child Health (grant MCJ 360579); the Administration for Children and Families (grant 90PJ0003); the Office of the Assistant Secretary for Planning and Evaluation; and the National Center for Child Abuse and Neglect, through a transfer of funds to the National Institute of Nursing Research. Four private foundations: the Robert Wood Johnson Foundation, Princeton, NJ (grants 017934 and 11084); the Carnegie Corporation of New York, New York, NY (grant 5492); the Pew Charitable Trusts, Philadelphia, Pa (grants 88-0211-000 and 93-02363-000); and the William T. Grant Foundation, New York, NY (grants 88-1246-88 and 91-1246-88), including a William T. Grant Faculty Scholars Award 86108086) and a Senior Research Scientist Award (1-K05-MH01382-01) to Dr. Olds.

Sample
Memphis, Tennessee Sample
Attrition
Low
Reassignment
None
Citation short
Kitzman, H., Olds, D. L., Henderson, C. R., Hanks, C., Cole, R., Tatelbaum, R., et al. (1997)
Confounding Factors
None
Baseline Equivalence
Difference in SES, but controlled in analysis.
Disposition
Not applicable
Screening Decision
Passes screens
Design Detail
Randomized controlled trial