Manuscript Detail | Home Visiting Evidence of Effectiveness

Holmberg, John; Luckey, Dennis; Olds, David. (2011) Teacher data for the Denver Year-9 follow-up. Unpublished report submitted to the U.S. Department of Justice.

Model(s) Reviewed: Nurse-Family Partnership (NFP)^® , NFP with Paraprofessional Home Visitors

Manuscript screening details
Screening decision	Screening conclusion	HomVEE procedures and standards version
Passes screens	Eligible for review	Version 1

Study design details
Rating	Design	Attrition	Baseline equivalence	Compromised randomization	Confounding factors	Valid, reliable measure(s)
High	Randomized controlled trial	Low	Established on race/ethnicity and SES	None	None	Not assessed in manuscripts reviewed before 2021

Notes:

This study received a mixed rating. Some outcomes rate high, others moderate, and still others low. For the low psychological resources subgroup, we were unable to determine attrition and if the baseline information provided corresponds to the analytic sample, so the outcomes for the low psychological resources subgroup rate low. For paraprofessional versus control comparison in the whole sample, the study rates high because there is low attrition and demonstration of baseline equivalence on race/ethnicity and socioeconomic status (SES). For the nurse versus control comparison in the whole sample, most of the outcomes had high attrition, but baseline equivalence was established on race/ethnicity and SES, so these outcomes rate moderate. Within the nurse versus control comparison in the whole sample, there are two outcomes for which attrition is low, and these outcomes rate high.

Study characteristics
Study participants	Women were recruited through 21 antepartum clinics that served low-income pregnant women. Recruitment focused on women who had no previous live births and either qualified for Medicaid or had no private health insurance. From March 1994 to June 1995, 1,178 women were invited to participate and 735 consented and were randomly assigned to one of three conditions: a control group, nurse home visiting, and paraprofessional home visiting. Randomization was conducted within strata based on maternal race (Hispanic, white, black, American Indian, or Asian); maternal gestational age (fewer than 32 weeks, 32 weeks or more); and geographic region. This study augments the data collection procedures of the Denver trial of the NFP . The authors conducted follow-up evaluations with interviews and direct tests of the children on 575 families.
Setting	Denver, Colorado metropolitan area
Intervention services	The study included two program groups: one serviced by paraprofessionals and one serviced by nurses. Women assigned to either group received developmental screening and referral services for their children and home visits during pregnancy and infancy (until the child was 2 years old). Both groups had the same goals: (1) to improve women’s health-related behaviors, (2) to support parents in providing competent care, and (3) to encourage planning future pregnancies and promote education and employment. Paraprofessionals conducted 6.3 home visits, on average, during pregnancy and 16 visits during infancy. Nurses conducted 6.5 home visits, on average, during pregnancy and 21 visits during infancy.
Comparison conditions	Women in the comparison group received developmental screening and referral services for their children at 6, 12, 15, 21, and 24 months.
Subgroups examined	This field lists subgroups examined in the manuscript (even if they were not replicated in other samples and not reported on the summary page for this model’s report). • Mother has psychological vulnerability (yes or no)
Funding sources	Not specified.
Author affiliation	David L. Olds, a study author, is a developer of this model.
Peer reviewed	Peer reviewed status is not listed for manuscripts reviewed before 2021.

Findings that rate moderate or high

Child development and school readiness
Rating	Outcome measure	Effect	Sample	Timing of follow-up	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
High	Math Grades: Parent Report	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Nurse vs. Control	Age 9 follow-up	374 mothers	Unadjusted mean = 3.14	Unadjusted mean = 3.21	Mean difference = -0.07	Study reported = -0.11	p-value = 0.32
High	Reading Grades: Parent Report	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Nurse vs. Control	Age 9 follow-up	375 mothers	Unadjusted mean = 3.14	Unadjusted mean = 3.18	Mean difference = -0.04	Study reported = -0.05	p-value = 0.62
High	ASPD Total Score - borderline/clinical	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control	Age 9 follow-up	328 mothers	Unadjusted mean = 0.04	Unadjusted mean = 0.04	OR = 1.78	HomVEE calculated = 0.37	p-value = 0.37	Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.
High	CBCL Externalizing - Dual Rater Clinical	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control	Age 9 follow-up	320 mothers	Unadjusted mean = 0.14	Unadjusted mean = 0.14	OR = 1.40	HomVEE calculated = 0.20	p-value = 0.33	Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.
High	CBCL Internalizing - Dual Rater Clinical	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control	Age 9 follow-up	317 mothers	Unadjusted mean = 0.08	Unadjusted mean = 0.08	OR = 0.95	HomVEE calculated = -0.03	p-value = 0.9	Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.
High	CBCL Total - Dual Rater Clinical	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control	Age 9 follow-up	317 mothers	Unadjusted mean = 0.10	Unadjusted mean = 0.10	OR = 0.97	HomVEE calculated = -0.01	p-value = 0.94	Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.
High	Current grade placement	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control	Age 9 follow-up	321 mothers	Unadjusted mean = 4.45	Unadjusted mean = 4.45	Mean difference = 0.12	Study reported = 0.16	p-value = 0.13
High	Learning support services: hrs/week	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control	Age 9 follow-up	309 mothers	Unadjusted mean = 1.22	Unadjusted mean = 1.22	Mean difference = -0.42	Study reported = -0.09	p-value = 0.4	Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.
High	Math Grades: Parent Report	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control	Age 9 follow-up	391 mothers	Unadjusted mean = 3.11	Unadjusted mean = 3.11	Mean difference = -0.10	Study reported = -0.15	p-value = 0.16
High	Math Grades: School Report	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control	Age 9 follow-up	305 mothers	Unadjusted mean = 2.51	Unadjusted mean = 2.51	Mean difference = -0.17	Study reported = -0.15	p-value = 0.15
High	Reading Grades: Parent Report	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control	Age 9 follow-up	391 mothers	Unadjusted mean = 3.12	Unadjusted mean = 3.12	Mean difference = -0.06	Study reported = -0.07	p-value = 0.47
High	Reading Grades: School Report	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control	Age 9 follow-up	307 mothers	Unadjusted mean = 2.32	Unadjusted mean = 2.32	Mean difference = -0.17	Study reported = -0.16	p-value = 0.14
High	Special Education school report	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control	Age 9 follow-up	308 mothers	Unadjusted mean = 0.16	Unadjusted mean = 0.16	OR = 1.01	HomVEE calculated = 0.01	p-value = 0.98	Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.
High	Times sent to Principal"s office	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control	Age 9 follow-up	326 mothers	Unadjusted mean = 1.44	Unadjusted mean = 1.44	Mean difference = 0.14	Study reported = 0.15	p-value = 0.18	Submitted by user on Fri, 03/15/2019 - 14:29 Positive value is favorable to the comparison group.
Moderate	ASPD Total Score - borderline/clinical	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Nurse vs. Control	Age 9 follow-up	310 mothers	Unadjusted mean = 0.01	Unadjusted mean = 0.02	OR = 0.62	HomVEE calculated = -0.26	p-value = 0.59	Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.
Moderate	CBCL Externalizing - Dual Rater Clinical	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Nurse vs. Control	Age 9 follow-up	303 mothers	Unadjusted mean = 0.07	Unadjusted mean = 0.10	OR = 0.62	HomVEE calculated = -0.29	p-value = 0.26	Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.
Moderate	CBCL Internalizing - Dual Rater Clinical	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Nurse vs. Control	Age 9 follow-up	302 mothers	Unadjusted mean = 0.04	Unadjusted mean = 0.08	OR = 0.41	HomVEE calculated = -0.53	p-value = 0.1	Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.
Moderate	CBCL Total - Dual Rater Clinical	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Nurse vs. Control	Age 9 follow-up	302 mothers	Unadjusted mean = 0.07	Unadjusted mean = 0.10	OR = 0.74	HomVEE calculated = -0.18	p-value = 0.47	Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.
Moderate	Current grade placement	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Nurse vs. Control	Age 9 follow-up	304 mothers	Unadjusted mean = 4.35	Unadjusted mean = 4.33	Mean difference = 0.02	Study reported = 0.06	p-value = 0.57
Moderate	Learning support services: hrs/week	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Nurse vs. Control	Age 9 follow-up	294 mothers	Unadjusted mean = 1.53	Unadjusted mean = 1.64	Mean difference = -0.11	Study reported = -0.02	p-value = 0.83	Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.
Moderate	Math Grades: Parent Report	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Nurse vs. Control	Age 9 follow-up	374 mothers	Unadjusted mean = 3.14	Unadjusted mean = 3.21	Mean difference = -0.07	Study reported = -0.11	p-value = 0.32
Moderate	Math Grades: School Report	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Nurse vs. Control	Age 9 follow-up	295 mothers	Unadjusted mean = 2.54	Unadjusted mean = 2.68	Mean difference = -0.14	Study reported = -0.12	p-value = 0.24
Moderate	Reading Grades: School Report	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Nurse vs. Control	Age 9 follow-up	294 mothers	Unadjusted mean = 2.47	Unadjusted mean = 2.49	Mean difference = -0.02	Study reported = -0.03	p-value = 0.8
Moderate	Special Education school report	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Nurse vs. Control	Age 9 follow-up	294 mothers	Unadjusted mean = 0.12	Unadjusted mean = 0.16	OR = 0.76	HomVEE calculated = -0.17	p-value = 0.42	Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.
Moderate	Times sent to Principal's office	FavorableUnfavorable or ambiguousNo Effect	Denver Nurse Family Partnership (NFP) - Nurse vs. Control	Age 9 follow-up	308 mothers	Unadjusted mean = 1.32	Unadjusted mean = 1.30	Mean difference = 0.02	Study reported = 0.02	p-value = 0.85	Submitted by user on Fri, 03/15/2019 - 14:29 Positive value is favorable to the comparison group.