Kitzman, H. J., Olds, D. L., Cole, R. E., Hanks, C. A., Anson, E. A., Arcoleo, K. J., Luckey, D. W., Knudtson, M. D., Henderson, C. R., & Holmberg, J. R. (2010). Enduring effects of prenatal and infancy home visiting by nurses on children: Follow-up of a randomized trial among children at age 12 years. Archives of Pediatrics & Adolescent Medicine, 164(5), 412–418.
From June 1, 1990 through August 31, 1991, the study enrolled primarily African American women at fewer than 29 weeks of gestation, with no previous live births, and with at least 2 of the following sociodemographic risk characteristics:unmarried, fewer than 12 years of education, and unemployed. Of the 1,290 eligible women, 1,139 consented and were randomly assigned. A subset of 743 women were involved in the postnatal aspect of the trial. Of the women enrolled, 92.1% were African American, 98.1% were unmarried, 64.1% were 18 years or younger at registration, and 85.1% came from households with annual incomes below the U.S. federal poverty guidelines. This study focused on the 12-year follow up; 594 women completed a maternal interview and 578 children completed an interview.
Women in the nurse-visited group were provided the same services as those in the comparison group, plus home visitation from pregnancy through the child’s second birthday. The nurses were provided detailed guidelines for each visit but allowed to adapt them to the needs of individual families. The nurses also linked families to other health and human services and tried to involve the children’s fathers and grandmothers in the pregnancy and care of the child. Each nurse visited a maximum of 25 families.
The program is intended to provide 62 home visits for women who enroll at 16 weeks gestation. In this study, the nurses completed a mean of 7 home visits (range of 0 to 18) during pregnancy and 26 home visits (range of 0 to 71) during the first 2 years after birth. Generally the difference between the recommended and actual number of visits was the result of participants dropping out of the program.
Women in the comparison group were provided developmental screening and referrals for the child at 6, 12, and 24 months of age, and free transportation for scheduled prenatal care.
All home visitors were nurses. No other information on training is provided.
This project was supported by National Institutes of Health research grant 1R01MH68790-01 funded by the National Institute of Mental Health and the Office of Juvenile Justice and Delinquency Prevention grant 2004-52854-CO-JS0. The earlier phases of this study were supported by several federal agencies: the National Institute of Mental Health (grant R01-MH61428- 01), the National Institute of Child Health and Human Development (grant R01-HD-043492), 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 (grants 90PJ0003 and 90PD0215/01), the Office of the Assistant Secretary for Planning and Evaluation (Department of Health and Human Services), and the National Center for Child Abuse and Neglect through a transfer of funds to the National Institute of Nursing Research (grant R01NR01691). The earlier phases of this research also were supported by 5 private foundations: the Robert Wood Johnson Foundation (grants 017934 and 11084), the Carnegie Corporation of New York (grant B 5492), the Pew Charitable Trusts (grants 88-0211-000 and 93-02363-000), the William T. Grant Foundation (grants 88-1246-88 and 91-1246-88), and the Hearst Foundation, as well as a Senior Research Scientist Award from the National Institutes of Health (1-K05-MH01382-01) (Dr Olds).