Nurse-Family Partnership (NFP)®

Model effectiveness research report last updated: 2024

Effects shown in research

Child health

Findings rated high

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.

NFP with Paraprofessional Home Visitors

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
5-minute Apgar	FavorableUnfavorable or ambiguousNo Effect	Birth	Full, (Memphis)	1082 children	Adjusted mean = 8.60	Adjusted mean = 8.70	Mean difference = -0.10	Not available	Not statistically significant, p > 0.05
Birth weight, grams	FavorableUnfavorable or ambiguousNo Effect	Birth	Full (Memphis)	1082 children	Adjusted mean = 3032.20	Adjusted mean = 3050.40	Mean difference = -18.20	Not available	Not statistically significant, p > 0.05
Breastfeeding attempted, percentage	FavorableUnfavorable or ambiguousNo Effect	2 years postnatal	Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis)	671 children	% (adjusted) = 26.00	Adjusted mean % = 16.00	OR = 1.90	HomVEE calculated = 0.37	Statistically significant, p < 0.01	Submitted by user on Fri, 03/15/2019 - 14:29 The odds ratio compares the nurse-visited group to the comparison.
Gestational age, weeks	FavorableUnfavorable or ambiguousNo Effect	Birth	Full, (Memphis)	1082 children	Adjusted mean = 39.00	Adjusted mean = 39.00	Mean difference = 0.00	Not available	Not statistically significant, p > 0.05
Immunizations up to date, percentage	FavorableUnfavorable or ambiguousNo Effect	2 years postnatal	Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis)	671 children	% (adjusted) = 70.00	Adjusted mean % = 68.00	OR = 1.10	HomVEE calculated = 0.06	Not statistically significant, p > 0.05	Submitted by user on Fri, 03/15/2019 - 14:29 The odds ratio compares the nurse-visited group to the comparison.
Indicated preterm delivery (percentage)	FavorableUnfavorable or ambiguousNo Effect	Birth	Full, (Memphis)	1082 children	% (adjusted) = 3.00	Adjusted mean % = 3.00	OR = 1.00	HomVEE calculated = 0.00	Not statistically significant, p > 0.05	Submitted by user on Fri, 03/15/2019 - 14:29 Statistical significance reported on authors’ calculations of the odds ratio. Submitted by user on Fri, 03/15/2019 - 14:29 The odds ratio compares the nurse-visited group to the comparison.
Intrauterine growth restriction (percentage)	FavorableUnfavorable or ambiguousNo Effect	Birth	Full, (Memphis)	1082 children	% (adjusted) = 9.00	Adjusted mean % = 9.00	OR = 1.00	HomVEE calculated = 0.00	Not statistically significant, p > 0.05	Submitted by user on Fri, 03/15/2019 - 14:29 Statistical significance reported on authors’ calculations of the odds ratio. Submitted by user on Fri, 03/15/2019 - 14:29 The odds ratio compares the nurse-visited group to the comparison.
Low birth weight (percentage < 2500 g)	FavorableUnfavorable or ambiguousNo Effect	Birth	Full, (Memphis)	1082 children	% (adjusted) = 15.00	Adjusted mean % = 14.00	OR = 1.10	HomVEE calculated = 0.05	Not statistically significant, p > 0.05	Submitted by user on Fri, 03/15/2019 - 14:29 Statistical significance reported on authors’ calculations of the odds ratio. Submitted by user on Fri, 03/15/2019 - 14:29 The odds ratio compares the nurse-visited group to the comparison.
Number of well-child visits	FavorableUnfavorable or ambiguousNo Effect	2 years postnatal	Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis)	671 children	Adjusted mean = 4.60	Adjusted mean = 4.80	Mean difference = -0.20	Not available	Not statistically significant, p > 0.05
Preterm (less than 37 weeks, percentage)	FavorableUnfavorable or ambiguousNo Effect	Birth	Full, (Memphis)	1082 children	% (adjusted) = 11.00	Adjusted mean % = 13.00	OR = 0.80	HomVEE calculated = -0.12	Not statistically significant, p > 0.05	Submitted by user on Fri, 03/15/2019 - 14:29 Statistical significance reported on authors’ calculations of the odds ratio. Submitted by user on Fri, 03/15/2019 - 14:29 The odds ratio compares the nurse-visited group to the comparison.
Spontaneous preterm delivery, percentage	FavorableUnfavorable or ambiguousNo Effect	Birth	Full, (Memphis)	1082 children	% (adjusted) = 8.00	Adjusted mean % = 9.00	OR = 0.80	HomVEE calculated = -0.08	Not statistically significant, p > 0.05	Submitted by user on Fri, 03/15/2019 - 14:29 Statistical significance reported on authors’ calculations of the odds ratio. Submitted by user on Fri, 03/15/2019 - 14:29 The odds ratio compares the nurse-visited group to the comparison.

Kitzman, H., Olds, D. L., Sidora, K., Henderson, C. R., Hanks, C., Cole, R., et al. (2000). Enduring effects of nurse home visitation on maternal life course: A 3-year follow-up of a randomized trial. JAMA: The Journal of the American Medical Association, 283(15), 1983–1989.

NFP with Paraprofessional Home Visitors

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Number of subsequent low birth weight newborns (< 2500 g)	FavorableUnfavorable or ambiguousNo Effect	3-year follow-up	Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis)	646 mothers	Mean = 0.12	Mean = 0.15	Mean difference = -0.03	Not available	Not statistically significant, p ≥ 0.05	Submitted by user on Fri, 03/15/2019 - 14:29 Statistical significance reported on authors’ calculations of the log-incidence difference.
Number of subsequent neonatal intensive care unit or special care admissions	FavorableUnfavorable or ambiguousNo Effect	3-year follow-up	Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis)	646 mothers	Mean = 0.14	Mean = 0.20	Mean difference = -0.06	Not available	Not statistically significant, p ≥ 0.05	Submitted by user on Fri, 03/15/2019 - 14:29 Statistical significance reported on authors’ calculations of the log-incidence difference. Submitted by user on Fri, 03/15/2019 - 14:29 Authors report the difference in this outcome to be statistically significant, p < 0.10, which is greater than the acceptable alpha for this review (α = 0.05).

Knox, V., & Michalopoulos, C. (2023). Mother and Infant Home Visiting Program Evaluation (MIHOPE), United States, 2012-2019. MIHOPE Model Results Documentation [Study 3-NFP contrast]. Inter-University Consortium for Political and Social Research. https://doi.org/10.3886/ICPSR37848.v3.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Any Medicaid-paid nonbirth hospitalizations	FavorableUnfavorable or ambiguousNo Effect	15-month follow-up	NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States,full sample	1105 children	Adjusted proportion = 0.14	Adjusted proportion = 0.20	Difference = -0.06	Study reported = -0.26	Not statistically significant, p ≥ 0.05	The statistical significance after adjusting for multiple comparisons is reported; precise p-values are not available. The study reported this finding was statistically significant (p = 0.01) prior to a multiple comparisons adjustment.
At risk of being overweight (%)	FavorableUnfavorable or ambiguousNo Effect	15-month follow-up	NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States,full sample	747 children	Adjusted proportion = 0.29	Adjusted proportion = 0.34	Difference = -0.05	Study reported = -0.13	Not statistically significant, p ≥ 0.05	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention. The statistical significance after adjusting for multiple comparisons is reported; precise p-values are not available.
Duration of breastfeeding	FavorableUnfavorable or ambiguousNo Effect	15-month follow-up	NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States,full sample	918 children	Adjusted mean = 4.40	Adjusted mean = 4.60	Difference = -0.20	Not available	Not statistically significant, p ≥ 0.05	The statistical significance after adjusting for multiple comparisons is reported; precise p-values are not available.
Normal weight (%)	FavorableUnfavorable or ambiguousNo Effect	15-month follow-up	NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States,full sample	747 children	Adjusted proportion = 0.59	Adjusted proportion = 0.54	Difference = 0.05	Study reported = 0.13	Not statistically significant, p ≥ 0.05	The statistical significance after adjusting for multiple comparisons is reported; precise p-values are not available.
Number of Medicaid-paid immunizations	FavorableUnfavorable or ambiguousNo Effect	15-month follow-up	NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States,full sample	895 children	Adjusted mean = 6.90	Adjusted mean = 7.50	Difference = -0.60	Not available	Not statistically significant, p ≥ 0.05	The statistical significance after adjusting for multiple comparisons is reported; precise p-values are not available.
Primary care provider for the child (%)	FavorableUnfavorable or ambiguousNo Effect	15-month follow-up	NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States,full sample	939 children	Adjusted proportion = 0.88	Adjusted proportion = 0.88	Difference = 0.00	Study reported = -0.02	Not statistically significant, p ≥ 0.05	The statistical significance after adjusting for multiple comparisons is reported; precise p-values are not available.
Underweight (%)	FavorableUnfavorable or ambiguousNo Effect	15-month follow-up	NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States,full sample	747 children	Adjusted proportion = 0.11	Adjusted proportion = 0.12	Difference = -0.01	Study reported = -0.04	Not statistically significant, p ≥ 0.05	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention. The statistical significance after adjusting for multiple comparisons is reported; precise p-values are not available.

Lee, H., Crowne S., Estarziau M., Kranker K., Michalopoulos C., Warren A., Mijanovich T., Filene J. H., Duggan A., and Knox V. (2019). The Effects of Home Visiting on Prenatal Health, Birth Outcomes, and Health Care Use in the First Year of Life, Final Implementation and Impact Findings from the Mother and Infant Home Visiting Program Evaluation-Strong Start (OPRE Report, 2019-08). [Study 3-NFP contrast]. Washington, DC, Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. https://www.acf.hhs.gov/sites/default/files/documents/opre/mihope_stron…

NFP with Paraprofessional Home Visitors

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Admitted to neonatal intensive care unit (%)	FavorableUnfavorable or ambiguousNo Effect	Birth	NFP vs. Resource referral RCT (MIHOPE-Strong Start), 2012-2015, United States, full sample	1854 infants	Not reported	Not reported	Difference = 0.01	Not available	Not statistically significant, p= 0.68
Any emergency department visits (%)	FavorableUnfavorable or ambiguousNo Effect	12 months old	NFP vs. Resource referral RCT (MIHOPE-Strong Start), 2012-2015, United States, full sample	1854 infants	Not reported	Not reported	Difference = 0.00	Not available	Not statistically significant, p= 0.90
Any nonbirth hospitalizations (%)	FavorableUnfavorable or ambiguousNo Effect	12 months old	NFP vs. Resource referral RCT (MIHOPE-Strong Start), 2012-2015, United States, full sample	1854 infants	Not reported	Not reported	Difference = -0.01	Not available	Not statistically significant, p= 0.52
Average number of well-child office visits	FavorableUnfavorable or ambiguousNo Effect	12 months old	NFP vs. Resource referral RCT (MIHOPE-Strong Start), 2012-2015, United States, full sample	1854 infants	Not reported	Not reported	Difference = -0.16	Not available	Not statistically significant, p= 0.37
Low birth weight (< 2,500 grams; %)	FavorableUnfavorable or ambiguousNo Effect	Birth	NFP vs. Resource referral RCT (MIHOPE-Strong Start), 2012-2015, United States, full sample	1714 infants	Not reported	Not reported	Difference = 0.00	Not available	Not statistically significant, p= 0.87	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
Preterm birth (< 37 weeks; %)	FavorableUnfavorable or ambiguousNo Effect	Birth	NFP vs. Resource referral RCT (MIHOPE-Strong Start), 2012-2015, United States, full sample	1715 infants	Not reported	Not reported	Difference = 0.02	Not available	Not statistically significant, p= 0.24

McConnell, M. A., Rokicki, S., Ayers, S., Allouch, F., Perreault, N., Gourevitch, R. A., Martin, M. W., Zhou, R., A., Zera, C., Hacker, M. R., Chien, A., Bates, M. A., & Baicker, K. (2022). Effect of an intensive nurse home visiting program on adverse birth outcomes in a Medicaid-eligible population: A randomized clinical trial. JAMA, 328(1), 27–37. https://doi.org/10.1001/jama.2022.9703

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Adverse birth outcome composite	FavorableUnfavorable or ambiguousNo Effect	Child's birth	NFP vs. usual care RCT, South Carolina 2016-2021, full sample	4966 children	Adjusted proportion = 0.27 Infants	Adjusted proportion = 0.26 Infants	Mean difference = 0.01	Study reported = 0.02	Not statistically significant, p= ≥0.05	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
Extremely preterm birth	FavorableUnfavorable or ambiguousNo Effect	Child's birth	NFP vs. usual care RCT, South Carolina 2016-2021, full sample	4932 children	Adjusted proportion = 0.01 Infants	Adjusted proportion = 0.01 Infants	Mean difference = 0.00	Study reported = 0.00	Not statistically significant, p= ≥0.05	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
Large for gestational age	FavorableUnfavorable or ambiguousNo Effect	Child's birth	NFP vs. usual care RCT, South Carolina 2016-2021, full sample	4932 children	Adjusted proportion = 0.05 Infants	Adjusted proportion = 0.06 Infants	Mean difference = -0.01	Study reported = -0.11	Not statistically significant, p= ≥0.05
Mean birth weight (in grams)	FavorableUnfavorable or ambiguousNo Effect	Child's birth	NFP vs. usual care RCT, South Carolina 2016-2021, full sample	4932 children	Adjusted mean = 3086.10 Infants	Adjusted mean = 3093.90 Infants	Mean difference = -7.80	HomVEE calculated = -0.01	Not statistically significant, p = 0.67	Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Mean gestational age (in weeks)	FavorableUnfavorable or ambiguousNo Effect	Child's birth	NFP vs. usual care RCT, South Carolina 2016-2021, full sample	4932 children	Adjusted mean = 38.20 Infants	Adjusted mean = 38.10 Infants	Mean difference = 0.10	HomVEE calculated = 0.04	Not statistically significant, p = 0.15	Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Neonatal morbidity	FavorableUnfavorable or ambiguousNo Effect	Child's birth	NFP vs. usual care RCT, South Carolina 2016-2021, full sample	4932 children	Unadjusted proportion = 0.10 Infants	Unadjusted proportion = 0.09 Infants	Mean difference = 0.01	Study reported = 0.09	Not statistically significant, p= ≥0.05	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
Overnight NICU stay	FavorableUnfavorable or ambiguousNo Effect	Child's birth	NFP vs. usual care RCT, South Carolina 2016-2021, full sample	4543 children	Adjusted proportion = 0.08 Infants	Adjusted proportion = 0.09 Infants	Mean difference = -0.01	Study reported = -0.06	Not statistically significant, p= ≥0.05	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
Very low birth weight	FavorableUnfavorable or ambiguousNo Effect	Child's birth	NFP vs. usual care RCT, South Carolina 2016-2021, full sample	4932 children	Adjusted proportion = 0.02 Infants	Adjusted proportion = 0.03 Infants	Mean difference = -0.01	Study reported = -0.17	Not statistically significant, p= ≥0.05	Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.

Michalopoulos, C., Faucetta, K., Hill, C. J., Portilla, X., Burrell, L., Lee, H., Duggan, A., & Knox, V. (2019). Impacts on family outcomes of evidence-based early childhood home visiting: Results from the Mother and Infant Home Visiting Program Evaluation (OPRE Report 2019-07). [Study 3-NFP contrast]. U.S. Department of Health and Human Services, Administration for Children and Families, Office of Planning, Research, and Evaluation. https://www.acf.hhs.gov/sites/default/files/documents/opre/mihope_impac….

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
Number of Medicaid-paid child emergency department visits (fixed effect random slope analysis)	FavorableUnfavorable or ambiguousNo Effect	15 months old	NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample	895 children	Not reported	Not reported	Difference = -0.50	Not available	Statistically significant, p= 0.02
Number of Medicaid-paid child emergency department visits (restricted maximum likelihood analysis)	FavorableUnfavorable or ambiguousNo Effect	15 months old	NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample	895 children	Not reported	Not reported	Difference = -0.50	Not available	Statistically significant, p= 0.03
Number of Medicaid-paid child emergency department visits (split-sample analysis)	FavorableUnfavorable or ambiguousNo Effect	15 months old	NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample	895 children	Not reported	Not reported	Difference = -0.50	Not available	Statistically significant, p= 0.01
Number of Medicaid-paid well-child visits (fixed effect random slope analysis)	FavorableUnfavorable or ambiguousNo Effect	15 months old	NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample	895 children	Not reported	Not reported	Difference = -0.30	Not available	Not statistically significant, p= 0.43
Number of Medicaid-paid well-child visits (restricted maximum likelihood analysis)	FavorableUnfavorable or ambiguousNo Effect	15 months old	NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample	895 children	Not reported	Not reported	Difference = -0.20	Not available	Not statistically significant, p= 0.45
Number of Medicaid-paid well-child visits (split-sample analysis)	FavorableUnfavorable or ambiguousNo Effect	15 months old	NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample	895 children	Not reported	Not reported	Difference = -0.30	Not available	Not statistically significant, p= 0.10

Olds, D. L., Henderson Jr., C. R., Chamberlin, R., & Tatelbaum, R. (1986). Preventing child abuse and neglect: A randomized trial of nurse home visitation. Pediatrics, 78, 65–78.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
Night awake (mother-reported number of episodes last 2 weeks	FavorableUnfavorable or ambiguousNo Effect	6 months	Nurse visited during pregnancy and comparison (Elmira)	164 children	Adjusted mean = 3.25	Adjusted mean = 2.83	Mean difference = 0.42	Not available	Statistical significance not reported
Night awake (mother-reported number of episodes last 2 weeks	FavorableUnfavorable or ambiguousNo Effect	6 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	163 children	Adjusted mean = 2.69	Adjusted mean = 2.83	Mean difference = -0.14	Not available	Not statistically significant, p > 0.05
Number of emergency room visits (first year of life)	FavorableUnfavorable or ambiguousNo Effect	1-year follow-up	Nurse visited during pregnancy and comparison (Elmira)	205 children	Adjusted mean = 1.12	Adjusted mean = 1.02	Mean difference = 0.10	Not available	Statistical significance not reported
Number of emergency room visits (first year of life)	FavorableUnfavorable or ambiguousNo Effect	1-year follow-up	Nurse visited during pregnancy + infancy and comparison (Elmira)	223 children	Adjusted mean = 0.74	Adjusted mean = 1.02	Mean difference = -0.28	Not available	Statistically significant, p < 0.05
Number of emergency room visits (second year of life)	FavorableUnfavorable or ambiguousNo Effect	2-year follow-up	Nurse visited during pregnancy + infancy and comparison (Elmira)	196 children	Adjusted mean = 0.74	Adjusted mean = 1.09	Mean difference = -0.35	Not available	Statistically significant, p < 0.01
Number of emergency room visits (second year of life)	FavorableUnfavorable or ambiguousNo Effect	2-year follow-up	Nurse visited during pregnancy and comparison (Elmira)	185 children	Adjusted mean = 1.04	Adjusted mean = 1.09	Mean difference = -0.05	Not available	Statistical significance not reported
Resist eating (mother-reported number of episodes last 2 weeks)	FavorableUnfavorable or ambiguousNo Effect	6 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	163 children	Adjusted mean = 2.29	Adjusted mean = 1.72	Mean difference = 0.57	Not available	Statistically significant, p < 0.01
Resist eating (mother-reported number of episodes last 2 weeks)	FavorableUnfavorable or ambiguousNo Effect	6 months	Nurse visited during pregnancy and comparison (Elmira)	164 children	Adjusted mean = 2.01	Adjusted mean = 1.72	Mean difference = 0.29	Not available	Statistical significance not reported

Olds, D. L., Henderson, C. R., & Kitzman, H. (1994). Does prenatal and infancy nurse home visitation have enduring effects on qualities of parental caregiving and child health at 25 to 50 months of life? Pediatrics, 93(1), 89–98.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Number of days hospitalized (25 to 50 months)	FavorableUnfavorable or ambiguousNo Effect	50 months	Nurse visited during pregnancy and comparison (Elmira)	209 children	Adjusted mean = 0.43	Adjusted mean = 0.31	Mean difference = 0.12	Not available	Statistical significance not reported
Number of days hospitalized (25 to 50 months)	FavorableUnfavorable or ambiguousNo Effect	50 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	221 children	Adjusted mean = 0.49	Adjusted mean = 0.31	Mean difference = 0.18	Not available	Statistically significant, p ≤ 0.05	Submitted by user on Fri, 03/15/2019 - 14:29 Statistical significance reported on authors’ calculations of the log-incidence difference.
Number of emergency department visits (25 to 50 months)	FavorableUnfavorable or ambiguousNo Effect	50 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	221 children	Adjusted mean = 1.00	Adjusted mean = 1.53	Mean difference = -0.53	Not available	Statistically significant, p ≤ .01	Submitted by user on Fri, 03/15/2019 - 14:29 Statistical significance reported on authors’ calculations of the log-incidence difference.
Number of emergency department visits (25 to 50 months)	FavorableUnfavorable or ambiguousNo Effect	50 months	Nurse visited during pregnancy and comparison (Elmira)	209 children	Adjusted mean = 1.24	Adjusted mean = 1.53	Mean difference = -0.29	Not available	Statistical significance not reported
Number of hospital admissions (25 to 50 months)	FavorableUnfavorable or ambiguousNo Effect	50 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	221 children	Adjusted mean = 0.14	Adjusted mean = 0.11	Mean difference = 0.03	Not available	Not statistically significant, p > 0.05	Submitted by user on Fri, 03/15/2019 - 14:29 Statistical significance reported on authors’ calculations of the log-incidence difference.
Number of hospital admissions (25 to 50 months)	FavorableUnfavorable or ambiguousNo Effect	50 months	Nurse visited during pregnancy and comparison (Elmira)	209 children	Adjusted mean = 0.11	Adjusted mean = 0.11	Mean difference = 0.00	Not available	Statistical significance not reported
Number of scheduled health supervision visits (25 to 50 months)	FavorableUnfavorable or ambiguousNo Effect	50 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	221 children	Adjusted mean = 1.26	Adjusted mean = 1.56	Mean difference = -0.30	Not available	Not statistically significant, p > 0.05
Number of scheduled health supervision visits (25 to 50 months)	FavorableUnfavorable or ambiguousNo Effect	50 months	Nurse visited during pregnancy and comparison (Elmira)	209 children	Adjusted mean = 1.27	Adjusted mean = 1.56	Mean difference = -0.29	Not available	Statistical significance not reported
Number of scheduled health supervision visits with problems (25 to 50 months)	FavorableUnfavorable or ambiguousNo Effect	50 months	Nurse visited during pregnancy and comparison (Elmira)	209 children	Adjusted mean = 5.18	Adjusted mean = 6.72	Mean difference = -1.54	Not available	Statistical significance not reported
Number of scheduled health supervision visits with problems (25 to 50 months)	FavorableUnfavorable or ambiguousNo Effect	50 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	221 children	Adjusted mean = 6.24	Adjusted mean = 6.72	Mean difference = -0.48	Not available	Not statistically significant, p > 0.05

Olds, D. L., Kitzman, H., Cole, R., Robinson, J., Sidora, K., Luckey, D. W., et al. (2004). Effects of nurse home-visiting on maternal life course and child development: Age 6 follow-up results of a randomized trial. Pediatrics, 114(6), 1550–1559

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Subsequent NICU/special care admission (rate per subsequent birth)	FavorableUnfavorable or ambiguousNo Effect	6-year follow-up	Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis)	641 mothers	% (adjusted) = 18.00	Adjusted mean % = 23.00	OR = -0.72	HomVEE calculated = -0.20	Not statistically significant, p = 0.14	Submitted by user on Fri, 03/15/2019 - 14:29 Statistical significance reported on authors’ calculations of the odds ratio.
Subsequent low birth weight newborn (rate per subsequent birth)	FavorableUnfavorable or ambiguousNo Effect	6-year follow-up	Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis)	641 mothers	% (adjusted) = 11.00	Adjusted mean % = 16.00	OR = -0.69	HomVEE calculated = -0.22	Not statistically significant, p = 0.16	Submitted by user on Fri, 03/15/2019 - 14:29 Statistical significance reported on authors’ calculations of the odds ratio.

Olds, D. L., Kitzman, H., Hanks, C., Cole, R., Anson, E., Sidora-Arcoleo, K., et al. (2007). Effects of nurse home visiting on maternal and child functioning: Age-9 follow-up of a randomized trial. Pediatrics, 120(4), e832–e845.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Number of infant and childhood deaths among firstborn children (birth–9 years)	FavorableUnfavorable or ambiguousNo Effect	9-year follow-up	Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis)	627 mothers	per 1,000 = 4.50 per 1,000	per 1,000 = 20.08 per 1,000	OR = 0.22	Not available	Not statistically significant, p = 0.80	Submitted by user on Fri, 03/15/2019 - 14:29 Statistical significance reported on authors’ calculations of the odds ratio.
Number of subsequent low birth weight newborns (0–9 years postpartum)	FavorableUnfavorable or ambiguousNo Effect	9-year follow-up	Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis)	627 mothers	Adjusted mean = 0.18	Adjusted mean = 0.27	Mean difference = -0.09	Not available	Not statistically significant, p = 0.07	Submitted by user on Fri, 03/15/2019 - 14:29 Statistical significance reported on authors’ calculation of incidence ratio.

Olds, D. L., Robinson, J., Pettitt, L., Luckey, D. W., Holmberg, J., Ng, R. K., et al. (2004). Effects of home visits by paraprofessionals and by nurses: Age 4 follow-up results of a randomized trial. Pediatrics, 114(6), 1560-1568.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
Subsequent low birth weight newborns	FavorableUnfavorable or ambiguousNo Effect	4-year follow-up	Nurse home visitor and comparison (Denver)	424 mothers	= 0.06	= 0.08	OR = 0.75	HomVEE calculated = -0.17	Not statistically significant, p = 0.45
Subsequent special care admissions	FavorableUnfavorable or ambiguousNo Effect	4-year follow-up	Nurse home visitor and comparison (Denver)	424 mothers	= 0.06	= 0.08	OR = 0.66	HomVEE calculated = -0.26	Not statistically significant, p = 0.27

Findings rated moderate

Nguyen, J. D., Carson, M. L., Parris, K. M., & Place, P. (2003). A comparison pilot study of public health field nursing home visitation program interventions for pregnant Hispanic adolescents. Public Health Nursing, 20(5), 412. doi:10.1046/j.1525-1446.2003.20509.x

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
Birth weight (grams)	FavorableUnfavorable or ambiguousNo Effect	Birth	NFP-trained nurse visitors and comparison nurse visitors	156 children	Mean = 3.00	Mean = 3.00	Mean difference = 164.26	HomVEE calculated = 0.29	Not reported
Gestational age (months)	FavorableUnfavorable or ambiguousNo Effect	Birth	NFP-trained nurse visitors and comparison nurse visitors	154 children	Mean = 38.88	Mean = 38.92	Mean difference = -0.04	HomVEE calculated = -0.02	Not reported

Olds, D. L., Kitzman, H., Knudtson, M. D., Anson, E., Smith, J. A., & Cole, R. (2014). Effect of home visiting by nurses on maternal and child mortality: Results of a 2-decade follow-up of a randomized clinical trial. JAMA Pediatrics, 168(9), 800-806.

NFP with Paraprofessional Home Visitors

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
20 year child mortality rate - all causes (Nurse home visits during pregnancy and infancy vs. developmental screening comparison)	FavorableUnfavorable or ambiguousNo Effect	20 years	Nurse home visits during pregnancy and infancy vs. developmental screening comparison (Memphis)	708 mother/child dyads	Unadjusted mean = 0.01	Unadjusted mean = 0.03	Mean difference = -0.02	HomVEE calculated = -0.68	Not statistically significant, p = 0.11	Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.
20 year child mortality rate - preventable cause (Nurse home visits during pregnancy and infancy vs. developmental screening comparison)	FavorableUnfavorable or ambiguousNo Effect	20 years	Nurse home visits during pregnancy and infancy vs. developmental screening comparison (Memphis)	708 mother/child dyads	Unadjusted mean = 0.00	Unadjusted mean = 0.02	Mean difference = -0.02	Not available	Statistically significant, p = 0.04	Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.

NFP with Paraprofessional Home Visitors

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
Subsequent low birth weight newborns	FavorableUnfavorable or ambiguousNo Effect	4-year follow-up	Paraprofessional. home visitor and comparison (Denver)	431 mothers	= 0.03	= 0.08	OR = 0.34	HomVEE calculated = -0.64	Statistically significant, p = 0.03
Subsequent special care admissions	FavorableUnfavorable or ambiguousNo Effect	4-year follow-up	Paraprofessional home visitor and comparison (Denver)	431 mothers	= 0.05	= 0.08	OR = 0.54	HomVEE calculated = -0.38	Not statistically significant, p = 0.13

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