WWHV003348

Olds, D. L., Henderson Jr., C. R., Tatelbaum, R., & Chamberlin, R. (1986). Improving the delivery of prenatal care and outcomes of pregnancy: A randomized trial of nurse home visitation. Pediatrics, 77(1), 16.

Citation Year
1986
Rating
Used in Implementation Reports
On
Study Participants

The sample included pregnant, first-time mothers who were less than 30 weeks pregnant. Women were recruited through health and human services agencies, including health clinics, Planned Parenthood, and public schools. In these locations, pregnant women who were less than 19 years old, were single parents, or had low socioeconomic status were actively recruited for the study. Between April 1978 and September 1980, 500 women were interviewed and 400 were randomly assigned. For this study, 46 nonwhite women were excluded from the sample. At enrollment, on average, the women were about 19 years old, 17 weeks pregnant, and had approximately 11 years of education. Roughly 42 percent of the sample was married. This study measured the sample in the 32nd week of pregnancy and the time of birth. The study sample included 354 women, 189 in the program group and 165 in the comparison group.

Setting

The study was conducted in Elmira, a metropolitan area within a semi-rural county in the Appalachian region of New York that has approximately 100,000 residents.

Home Visiting Services

The study included two treatment groups, which were combined for the analyses. The first treatment group received home visits from a nurse during pregnancy. The nurse visited the family every other week and made nine visits, on average, which lasted one hour and 15 minutes. This 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. Home visits were weekly for the first month after delivery, decreasing over time to once every 6 weeks when the child was 18-24 months. Home visits focused on parent education, enhancing the women’s support systems, and linkages to community services.

Comparison Conditions

The study included two comparison groups, which were combined for the analyses. The first comparison group did not receive any services during pregnancy. When the children were 12 and 24 months old, they were screened for sensory and developmental problems and referred to other specialists, as appropriate. The second treatment group received free transportation (through a contract with a local taxi company) for prenatal and well-child care at local clinics and doctors’ offices. The second comparison group also received the 12- and 24-month developmental screening.

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

Bureau of Community Health Services (HHS-MCR-360403-06), the Robert Wood Johnson Foundation (grant 5263), and the W. T. Grant Foundation (grant 0723-80). The serum cotinine assays were carried out in the laboratories of Dr. Helen Van Vunakis at Brandeis University and were partially supported by grant DA 2407 from the Department of Health and Human Services.

Sample
Elmira, New York Sample
Attrition
Low
Reassignment
None
Citation short
Olds, D. L., Henderson Jr., C. R., Tatelbaum, R., & Chamberlin, R. (1986)
Confounding Factors
None
Baseline Equivalence
Established on race and SES.
Disposition
Not applicable
Screening Decision
Passes screens
Design Detail
Randomized controlled trial