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.
Model(s) Reviewed:
Nurse-Family Partnership (NFP)®
| Screening decision | Screening conclusion | HomVEE procedures and standards version |
|---|---|---|
| Passes screens | Eligible for review | Version 1 |
| Rating | Design | Attrition | Baseline equivalence | Compromised randomization | Confounding factors | Valid, reliable measure(s) |
|---|---|---|---|---|---|---|
| High | Randomized controlled trial | Low | Difference in SES, but controlled in analysis. | None | None | Not assessed in manuscripts reviewed before 2021 |
Notes:
In 2020, HomVEE updated this review in two ways. First, HomVEE removed findings related to remove mother's partnership status/family structure findings from the Family Economic Self-Sufficiency domain because ACF determined that mother's partnership status is ineligible for review by HomVEE. second, HomVEE removed two partner SES variables from the Family Economic Self-Sufficiency domain because partner SES is not eligible for review unless the same SES variable is measured for the mother, and the partner is coresident with the mother.
The effect sizes in this table for Olds, Kitzman, Hanks, Cole, Anson, Sidora-Arcoleo, et al. (2007) are those reported in the study, and could not be confirmed by HomVEE calculations. In addition, p-values and statistical significance determinations are based on the author’s likelihood ratio tests. The sample size was received through communication with the author.
| Study participants | The sample included pregnant, first-time mothers who were less than 29 weeks pregnant. Women were recruited through an obstetrical clinic if they had no previous live births, no chronic illnesses linked to fetal growth retardation or preterm delivery, and at least two of the following sociodemographic characteristics: unmarried, less than 12 years of education, and unemployed. From June 1990 through August 1991, 1,290 women were invited to participate and 1,139 consented and were randomly assigned. At enrollment, 92 percent of the women enrolled were African American, 98 percent were unmarried, and 64 percent were aged 18 years or younger. This study measured the sample when the children were 9 years old. The study sample included 627 women, 191 in the program group and 436 in the comparison group. |
|---|---|
| Setting | Memphis, Tennessee |
| Intervention services | The study included two treatment groups. The first treatment group received home visits from a nurse during pregnancy and two postpartum visits (one in the hospital prior to discharge and one in the home). The 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. On average, the nurses completed 7 home visits during pregnancy and 26 home visits postpartum. Nurses used a detailed protocol for each visit, which focused on health-related behaviors, parenting, education, and employment. The two treatment groups were combined for the prenatal analysis. Only the second treatment group was followed for postnatal outcomes. |
| Comparison conditions | The study included two comparison groups. The first comparison group received taxicab transportation for prenatal care appointments. The second comparison group received the transportation plus developmental screening and referral to services when the children were 6, 12, and 24 months old. The two comparison groups were combined for the prenatal analysis. Only the second group was followed for postnatal outcomes. |
| 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 | The National Institute of Mental Health (1-R01-MH61428-01); the National Institute of Child Health and Human Development (8R01 HD43492); and the Department of Justice (2005-MU-mu-001). |
| 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
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | GPA (reading and math, grades 1 – 3) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability | 9-year follow-up | 333 children | Adjusted mean = 2.68 | Adjusted mean = 2.44 | Mean difference = 0.24 | Study reported = 0.22 | Statistically significant, p = 0.02 |
|
| High | Achievement tests (reading and math, grades 1 – 3) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability | 9-year follow-up | 333 children | Adjusted mean = 44.89 | Adjusted mean = 35.72 | Mean difference = 9.17 | Study reported = 0.33 | Statistically significant, p < 0.01 |
|
| High | GPA (reading and math, grades 1–3) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 604 children | Adjusted mean = 2.69 | Adjusted mean = 2.59 | Mean difference = 0.10 | Study reported = 0.09 | Not statistically significant, p = 0.20 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Achievement tests (reading and math, grades 1–3) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 570 children | Adjusted mean = 44.61 | Adjusted mean = 41.63 | Mean difference = 2.98 | Study reported = 0.11 | Not statistically significant, p = 0.17 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Any academic failures (grades 1–3) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 604 children | = 0.07 | = 0.05 | Mean difference = 2.00 | HomVEE calculated = 0.20 | Not statistically significant, p = 0.37 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Conduct grades (grades 1–3 ) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 604 children | Adjusted mean = 2.71 | Adjusted mean = 2.68 | Mean difference = 0.03 | Study reported = 0.03 | Not statistically significant, p = 0.67 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Count of conduct failures, (grades 1–3) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 604 children | Adjusted mean = 0.06 | Adjusted mean = 0.10 | Mean difference = -0.04 | Not available | Not statistically significant, p = 0.09 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Count of depressive and anxiety disorders | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 604 children | Adjusted mean = 0.12 | Adjusted mean = 0.19 | Mean difference = -0.07 | Not available | Not statistically significant, p = 0.12 |
Statistical significance reported on authors’ calculation of incidence ratio.
|
| High | Count of disruptive behavior disorders (with impairment) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 604 children | Adjusted mean = 0.36 | Adjusted mean = 0.31 | Mean difference = -0.05 | Not available | Not statistically significant, p = 0.42 |
Statistical significance reported on authors’ calculation of incidence ratio.
|
| High | Ever placed in special education (grades 1–3) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 604 children | = 0.02 | = 0.02 | Mean difference = 0.00 | HomVEE calculated = -0.03 | Not statistically significant, p = 0.97 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Ever retained (grades 1–3) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 604 children | = 0.16 | = 0.12 | Mean difference = 4.00 | HomVEE calculated = 0.18 | Not statistically significant, p = 0.25 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Teacher reported peer affiliation (grade 3) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 558 children | Adjusted mean = 100.35 | Adjusted mean = 99.92 | Mean difference = 0.43 | Study reported = 0.04 | Not statistically significant, p = 0.64 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Teacher-reported academically focused behavior (grade 3) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 558 children | Adjusted mean = 100.10 | Adjusted mean = 100.08 | Mean difference = 0.02 | Study reported = 0.00 | Not statistically significant, p = 0.98 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Teacher-reported antisocial behavior (grade 3) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 558 children | Adjusted mean = 99.77 | Adjusted mean = 100.08 | Mean difference = -0.31 | Study reported = -0.03 | Not statistically significant, p = 0.74 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Conduct grades (grades 1 – 3) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability | 9-year follow-up | 333 children | Adjusted mean = 2.68 | Adjusted mean = 2.65 | Mean difference = 0.03 | Study reported = 0.03 | Not statistically significant, p = 0.75 |
|
| High | Teacher-reported academically focused behavior (grade 3) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability | 9-year follow-up | 333 children | Adjusted mean = 99.59 | Adjusted mean = 98.70 | Mean difference = 0.89 | Study reported = 0.09 | Not statistically significant, p = 0.47 |
|
| High | Teacher-reported antisocial behavior (grade 3) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability | 9-year follow-up | 333 children | Adjusted mean = 100.18 | Adjusted mean = 100.17 | Mean difference = 0.01 | Study reported = 0.00 | Not statistically significant, p = 0.99 |
|
| High | Teacher-reported peer affiliation (grade 3) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability | 9 year follow-up | 333 children | Adjusted mean = 99.56 | Adjusted mean = 99.37 | Mean difference = 0.19 | Study reported = 0.02 | Not statistically significant, p = 0.88 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | Number of infant and childhood deaths among firstborn children (birth–9 years) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | per 1,000 = 4.50 | per 1,000 = 20.08 | OR = 0.22 | Not available | Not statistically significant, p = 0.80 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Number of subsequent low birth weight newborns (0–9 years postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | Adjusted mean = 0.18 | Adjusted mean = 0.27 | Mean difference = -0.09 | Not available | Not statistically significant, p = 0.07 |
Statistical significance reported on authors’ calculation of incidence ratio.
|
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | Number of months employed per year (2–9 years postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | Adjusted mean = 3.84 | Adjusted mean = 3.86 | Mean difference = -0.02 | Study reported = -0.01 | Not statistically significant, p = 0.93 |
|
| High | Number of months employed per year (6–9 years postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | Adjusted mean = 6.86 | Adjusted mean = 7.39 | Mean difference = -0.53 | Study reported = -0.15 | Not statistically significant, p = 0.13 |
|
| High | Number of months on TANF(6–9 years postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | Adjusted mean = 3.39 | Adjusted mean = 4.01 | Mean difference = -0.62 | Study reported = -0.12 | Not statistically significant, p = 0.12 |
|
| High | Number of months on Aid to Families with Dependent Children, Temporary Assistance for Needy Families (TANF) per year (0–9 years postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | Adjusted mean = 5.21 | Adjusted mean = 5.92 | Mean difference = -0.71 | Study reported = -0.14 | Statistically significant, p < 0.01 |
|
| High | Number of months on food stamps per year (0–9 years postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | Adjusted mean = 6.98 | Adjusted mean = 7.80 | Mean difference = -0.82 | Study reported = -0.17 | Statistically significant, p < 0.01 |
|
| High | Number of months on food stamps per year (6–9 years postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | Adjusted mean = 4.89 | Adjusted mean = 5.92 | Mean difference = -1.03 | Study reported = -0.21 | Statistically significant, p = 0.02 |
|
| High | Number of months on Medicaid per year (0–9 years postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | Adjusted mean = 9.71 | Adjusted mean = 10.07 | Mean difference = -0.36 | Study reported = -0.09 | Not statistically significant, p = 0.12 |
|
| High | Number of months on Medicaid per year (6–9 years postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | Adjusted mean = 8.79 | Adjusted mean = 8.74 | Mean difference = 0.05 | Study reported = 0.01 | Not statistically significant, p = 0.89 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | Cumulative subsequent live births per year (0–9 yr postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | Adjusted mean = 0.81 | Adjusted mean = 0.93 | Mean difference = -0.12 | Study reported = -0.14 | Statistically significant, p < 0.05 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Maternal depression (CES-D) (9 years postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | Adjusted mean = 1.71 | Adjusted mean = 1.72 | Mean difference = 0.01 | Study reported = -0.01 | Not statistically significant, p = 0.87 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Number of months between birth of first and second child | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | Adjusted mean = 40.73 | Adjusted mean = 34.09 | Mean difference = 6.64 | Study reported = 0.29 | Statistically significant, p < 0.01 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Number of subsequent abortions | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | Adjusted mean = 0.14 | Adjusted mean = 0.20 | Mean difference = -0.06 | Not available | Not statistically significant, p = 0.15 |
Statistical significance reported on authors’ calculation of incidence ratio.
|
| High | Number of subsequent miscarriages (0–9 years postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | Adjusted mean = 0.24 | Adjusted mean = 0.24 | Mean difference = 0.00 | Not available | Not statistically significant, p = 1.00 |
Statistical significance reported on authors’ calculation of incidence ratio.
|
| High | Number of substances used (moderate/heavy alcohol, marijuana, cocaine) since last interview | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | Adjusted mean = 0.10 | Adjusted mean = 0.17 | Mean difference = -0.07 | Not available | Not statistically significant, p = 0.08 |
Statistical significance reported on authors’ calculation of incidence ratio.
|
| High | Pearlin Mastery Scale (9 years postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | Adjusted mean = 100.79 | Adjusted mean = 99.75 | Mean difference = 1.04 | Study reported = 0.10 | Not statistically significant, p = 0.20 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Pearlin Mastery Scale (6 months–9 years postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | Adjusted mean = 101.00 | Adjusted mean = 99.50 | Mean difference = 1.53 | Study reported = 0.15 | Statistically significant, p < 0.01 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Subsequent still birth (0–9 years postpartum), percentage | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | % (adjusted) = 1.00 | Adjusted mean % = 2.00 | Mean difference = -1.00 | Study reported = 1.00 | Not statistically significant, p = 0.36 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Cumulative subsequent live birth per year (6–9 years postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy during infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | Adjusted mean = 1.40 | Adjusted mean = 1.53 | Mean difference = -0.13 | Study reported = -0.16 | Not statistically significant, p = 0.17 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | Any domestic violence (6–9 years postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | = 0.21 | = 0.24 | OR = 0.81 | HomVEE calculated = -0.11 | Not statistically significant, p = 0.37 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Mother jailed (6–9 years postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | = 0.04 | = 0.03 | OR = 1.46 | HomVEE calculated = 0.25 | Not statistically significant, p = 0.46 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Number of maternal arrests (6–9 years postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 9-year follow-up | 627 mothers | Mean = 0.41 | Mean = 0.30 | Mean difference = 0.11 | Study reported = 1.35 | Not statistically significant, p = 0.16 |