Nurse-Family Partnership (NFP)®

Model effectiveness research report last updated: 2024

Effects shown in research

Positive parenting practices

Findings rated high

Izzo, C., Eckenrode, J., Smith, E., Henderson, C., Cole, R., Kitzman, H., & Olds, D. L. (2005). Reducing the impact of uncontrollable stressful life events through a program of nurse home visitation for new parents. Prevention Science, 6(4), 269–274.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Parenting practices - Hostility: Child Report of Parental Behavior Inventory (CRPBI)	FavorableUnfavorable or ambiguousNo Effect	15 years	Nurse-visited group 4 vs. comparison groups 1 and 2, Elmira sample	300 children	Unadjusted mean = 1.38	Unadjusted mean = 1.99	MD = -0.61	HomVEE calculated = -1.22	Statistically significant, p = 0.00	Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations. Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
Parenting practices - Inconsistent discipline: Child Report of Parental Behavior Inventory (CRPBI)	FavorableUnfavorable or ambiguousNo Effect	15 years	Nurse-visited group 4 vs. comparison groups 1 and 2, Elmira sample	300 children	Unadjusted mean = 1.90	Unadjusted mean = 1.99	MD = -0.09	HomVEE calculated = -0.16	Not statistically significant, p = 0.23	Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Parenting practices - Parent involvement: Child Report of Parental Behavior Inventory (CRPBI)	FavorableUnfavorable or ambiguousNo Effect	15 years	Nurse-visited group 4 vs. comparison groups 1 and 2, Elmira sample	300 children	Unadjusted mean = 3.34	Unadjusted mean = 3.33	MD = 0.01	HomVEE calculated = 0.02	Not statistically significant, p = 0.89	Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Parenting practices - Supervision: Parenting Style Index measure by Steinberg et al. (1993)	FavorableUnfavorable or ambiguousNo Effect	15 years	Nurse-visited group 4 vs. comparison groups 1 and 2, Elmira sample	300 children	Unadjusted mean = 0.86	Unadjusted mean = 0.89	MD = -0.03	HomVEE calculated = -0.26	Not statistically significant, p = 0.05	Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Parenting practices - Warmth: Child Report of Parental Behavior Inventory (CRPBI)	FavorableUnfavorable or ambiguousNo Effect	15 years	Nurse-visited group 4 vs. comparison groups 1 and 2, Elmira sample	300 children	Unadjusted mean = 3.65	Unadjusted mean = 3.67	MD = -0.02	HomVEE calculated = -0.04	Not statistically significant, p = 0.76	Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.

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.

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
HOME (emotional/ cognitive stimulation)	FavorableUnfavorable or ambiguousNo Effect	2 years postpartum	Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis)	675 mothers	Adjusted mean = 32.30	Adjusted mean = 30.90	Mean difference = 1.40	Not available	Statistically significant, p < 0.01
NCAST Child Responsiveness (total score)	FavorableUnfavorable or ambiguousNo Effect	2 years postnatal	Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis)	1082 children	Adjusted mean = 17.70	Adjusted mean = 17.40	Mean difference = 0.30	Not available	Not statistically significant, p > 0.05
NCAST Maternal Teaching (total score)	FavorableUnfavorable or ambiguousNo Effect	2 years postpartum	Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis)	675 mothers	Adjusted mean = 36.70	Adjusted mean = 36.50	Mean difference = 0.20	Not available	Not statistically significant, p > 0.05
Beliefs associated with child abuse (AAPI total score)	FavorableUnfavorable or ambiguousNo Effect	2 years postpartum	Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis)	672 mothers	Adjusted mean = 98.70	Adjusted mean = 100.50	Mean difference = -1.80	Not available	Statistically significant, p < 0.01

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
Three-Bag Task composite score of parental supportiveness (fixed effect random slope analysis)	FavorableUnfavorable or ambiguousNo Effect	15 months old	NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample	723 mothers	Not reported	Not reported	Not reported	Study reported = 0.08	Not statistically significant, p= 0.40
Three-Bag Task composite score of parental supportiveness (restricted maximum likelihood analysis)	FavorableUnfavorable or ambiguousNo Effect	15 months old	NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample	723 mothers	Not reported	Not reported	Not reported	Study reported = 0.08	Not statistically significant, p= 0.41
Three-Bag Task composite score of parental supportiveness (split-sample analysis)	FavorableUnfavorable or ambiguousNo Effect	15 months old	NFP vs. Resource referral RCT (MIHOPE), 2012-2015, United States, full sample	723 mothers	Not reported	Not reported	Difference = 0.14	Study reported = 0.14	Statistically significant, p= 0.04

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
HOME (avoidance of restriction and punishment)	FavorableUnfavorable or ambiguousNo Effect	10 months	Nurse visited during pregnancy and comparison (Elmira)	184 mothers	Adjusted mean = 5.77	Adjusted mean = 5.60	Mean difference = 0.17	Not available	Statistical significance not reported
HOME (avoidance of restriction and punishment)	FavorableUnfavorable or ambiguousNo Effect	10 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	191 mothers	Adjusted mean = 5.40	Adjusted mean = 5.60	Mean difference = -0.20	Not available	Not statistically significant, p ≥ 0.05
HOME (avoidance of restriction and punishment)	FavorableUnfavorable or ambiguousNo Effect	22 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	180 mothers	Adjusted mean = 5.82	Adjusted mean = 6.28	Mean difference = -0.46	Not available	Not statistically significant, p ≥ 0.05
HOME (avoidance of restriction and punishment)	FavorableUnfavorable or ambiguousNo Effect	22 months	Nurse visited during pregnancy and comparison (Elmira)	171 mothers	Adjusted mean = 5.53	Adjusted mean = 6.28	Mean difference = -0.75	Not available	Statistical significance not reported
HOME (provision of appropriate play materials)	FavorableUnfavorable or ambiguousNo Effect	10 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	201 mothers	Adjusted mean = 7.36	Adjusted mean = 7.26	Mean difference = 0.10	Not available	Not statistically significant, p ≥ 0.05
HOME (provision of appropriate play materials)	FavorableUnfavorable or ambiguousNo Effect	10 months	Nurse visited during pregnancy and comparison (Elmira)	195 mothers	Adjusted mean = 7.45	Adjusted mean = 7.26	Mean difference = 0.19	Not available	Statistical significance not reported
HOME (provision of appropriate play materials)	FavorableUnfavorable or ambiguousNo Effect	22 months	Nurse visited during pregnancy and comparison (Elmira)	190 mothers	Adjusted mean = 8.66	Adjusted mean = 8.65	Mean difference = 0.01	Not available	Statistical significance not reported
HOME (provision of appropriate play materials)	FavorableUnfavorable or ambiguousNo Effect	22 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	198 mothers	Adjusted mean = 8.68	Adjusted mean = 8.65	Mean difference = 0.03	Not available	Not statistically significant, p ≥ 0.05
Conflict	FavorableUnfavorable or ambiguousNo Effect	6 months	Nurse visited during pregnancy and comparison (Elmira)	164 mothers	Adjusted mean = 0.27	Adjusted mean = 0.25	Mean difference = 0.02	Not available	Statistical significance not reported
Conflict	FavorableUnfavorable or ambiguousNo Effect	6 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	163 mothers	Adjusted mean = 0.29	Adjusted mean = 0.25	Mean difference = 0.04	Not available	Not statistically significant, p ≥ 0.05
Spank or hit (number of times last 2 weeks)	FavorableUnfavorable or ambiguousNo Effect	6 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	159 mothers	Adjusted mean = 0.19	Adjusted mean = 1.09	Mean difference = -0.90	Not available	Not statistically significant, p ≥ 0.05
Spank or hit (number of times last 2 weeks)	FavorableUnfavorable or ambiguousNo Effect	6 months	Nurse visited during pregnancy and comparison (Elmira)	151 mothers	Adjusted mean = 1.71	Adjusted mean = 1.09	Mean difference = 0.62	Not available	Statistical significance not reported
Worry or concern (Sum of positive responses for behavioral problems)	FavorableUnfavorable or ambiguousNo Effect	6 months	Nurse visited during pregnancy and comparison (Elmira)	164 mothers	Adjusted mean = 0.61	Adjusted mean = 0.54	Mean difference = 0.07	Not available	Statistical significance not reported
Worry or concern (Sum of positive responses for behavioral problems)	FavorableUnfavorable or ambiguousNo Effect	6 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	163 mothers	Adjusted mean = 0.83	Adjusted mean = 0.54	Mean difference = 0.29	Not available	Statistically significant, p < 0.05
Yell or scold (number of times last 2 weeks)	FavorableUnfavorable or ambiguousNo Effect	6 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	159 mothers	Adjusted mean = 3.99	Adjusted mean = 7.90	Mean difference = -3.91	Not available	Not statistically significant, p ≥ 0.05
Yell or scold (number of times last 2 weeks)	FavorableUnfavorable or ambiguousNo Effect	6 months	Nurse visited during pregnancy and comparison (Elmira)	151 mothers	Adjusted mean = 7.56	Adjusted mean = 7.90	Mean difference = -0.34	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
HOME inventory (total score)	FavorableUnfavorable or ambiguousNo Effect	34 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	238 mothers	Adjusted mean = 39.08	Adjusted mean = 39.03	Mean difference = 0.05	Not available	Not statistically significant, p ≥ 0.05
HOME inventory (total score)	FavorableUnfavorable or ambiguousNo Effect	34 months	Nurse visited during pregnancy and comparison (Elmira)	227 mothers	Adjusted mean = 38.45	Adjusted mean = 39.03	Mean difference = -0.58	Not available	Statistical significance not reported
HOME inventory (total score)	FavorableUnfavorable or ambiguousNo Effect	46 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	238 mothers	Adjusted mean = 39.66	Adjusted mean = 39.67	Mean difference = -0.01	Not available	Not statistically significant, p ≥ 0.05
HOME inventory (total score)	FavorableUnfavorable or ambiguousNo Effect	46 months	Nurse visited during pregnancy and comparison (Elmira)	227 mothers	Adjusted mean = 40.18	Adjusted mean = 39.67	Mean difference = 0.51	Not available	Statistical significance not reported
Hazardous exposures observed in home	FavorableUnfavorable or ambiguousNo Effect	34 months	Nurse visited during pregnancy and comparison (Elmira)	202 mothers	Adjusted mean = 0.23	Adjusted mean = 0.38	Mean difference = -0.15	Not available	Statistical significance not reported
Hazardous exposures observed in home	FavorableUnfavorable or ambiguousNo Effect	34 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	209 mothers	Adjusted mean = 0.22	Adjusted mean = 0.38	Mean difference = -0.16	Not available	Statistically significant, p < 0.05	Submitted by user on Fri, 03/15/2019 - 14:29 Statistical significance reported on authors’ calculation of incidence ratio.
Hazardous exposures observed in home	FavorableUnfavorable or ambiguousNo Effect	46 months	Nurse visited during pregnancy + infancy and comparison (Elmira)	209 mothers	Adjusted mean = 0.21	Adjusted mean = 0.46	Mean difference = -0.25	Not available	Statistically significant, p < 0.01	Submitted by user on Fri, 03/15/2019 - 14:29 Statistical significance reported on authors’ calculation of incidence ratio.
Hazardous exposures observed in home	FavorableUnfavorable or ambiguousNo Effect	46 months	Nurse visited during pregnancy and comparison (Elmira)	202 mothers	Adjusted mean = 0.31	Adjusted mean = 0.46	Mean difference = -0.15	Not available	Statistical significance not reported

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
HOME total score	FavorableUnfavorable or ambiguousNo Effect	4-year follow-up	Nurse home visitor and comparison (Denver)	408 mothers	Adjusted mean = 25.32	Adjusted mean = 25.09	Mean difference = 0.23	Study reported = 0.07	Not statistically significant, p = 0.47
Sensitive/responsive interaction	FavorableUnfavorable or ambiguousNo Effect	4-year follow-up	Nurse home visitor and comparison (Denver)	408 mothers	Adjusted mean = 100.51	Adjusted mean = 98.66	Mean difference = 1.85	Study reported = 0.18	Not statistically significant, p = 0.06

Olds, D. L., Robinson, J., O’Brien, R., Luckey, D. W., Pettitt, L. M., Henderson, C. R., et al. (2002). Home visiting by paraprofessionals and by nurses: A randomized, controlled trial. Pediatrics, 110(3), 486.

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
HOME environment score	FavorableUnfavorable or ambiguousNo Effect	21 months	Paraprofessional home visitor and comparison (Denver)	420 mothers	Adjusted mean = 37.40	Adjusted mean = 37.10	Mean difference = 0.30	Not available	Not statistically significant, p > 0.05
Mother-infant responsive interaction	FavorableUnfavorable or ambiguousNo Effect	24 months	Paraprofessional home visitor and comparison (Denver)	392 mothers	Adjusted mean = 100.15	Adjusted mean = 98.99	Mean difference = 1.16	Not available	Not statistically significant, p ≥ 0.05

Findings rated moderate

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
HOME environment score	FavorableUnfavorable or ambiguousNo Effect	Unknown	Nurse home visitor and comparison (Denver)	406 mothers	Adjusted mean = 37.79	Adjusted mean = 37.10	Mean difference = 0.69	Not available	Not statistically significant, p > 0.05	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).
Mother-infant responsive interaction	FavorableUnfavorable or ambiguousNo Effect	Unknown	Nurse home visitor and comparison (Denver)	372 mothers	Adjusted mean = 100.31	Adjusted mean = 98.99	Mean difference = 1.32	Not available	Statistically significant, p ≤ 0.05	Submitted by user on Fri, 03/15/2019 - 14:29 The study indicates home environments were rated at 12 and 21 months, however, only one result is presented in the article and the timing is not labeled.

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
HOME total score	FavorableUnfavorable or ambiguousNo Effect	4-year follow-up	Paraprofessional home visitor and comparison (Denver)	412 mothers	Adjusted mean = 25.08	Adjusted mean = 25.09	Mean difference = -0.01	Study reported = 0.00	Not statistically significant, p = 0.96
Sensitive/responsive interaction	FavorableUnfavorable or ambiguousNo Effect	4-year follow-up	Paraprofessional home visitor and comparison (Denver)	412 mothers	Adjusted mean = 100.92	Adjusted mean = 98.66	Mean difference = 2.26	Study reported = 0.23	Statistically significant, p = 0.03

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