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
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 remove seven 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. In addition, in the Child Development and School Readiness domain, the review was updated to clarify that the direction for "child attended Head Start, preschool, day care, or early intervention, age 24-54 months" is ambiguous, rather than favorable. 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.
Except for the Achenbach Child Behavioral Problems Checklist, for which HomVEE calculated the effect size, the effect sizes in this table for Olds, Kitzman, Cole, Robinson, Sidora, Luckey, et al. (2004) are those reported in the study, and could not be confirmed by HomVEE calculations. 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. Between June 1990 and 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 age 18 or younger. This study measured the sample when the children were 6 years old. The study sample included 641 women, 197 in the program group and 444 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 Administration for Children and Families, Department of Health and Human Services (grant 90PD0215/01); the Hearst Foundation; the Robert Wood Johnson Foundation (grant 027901); and a Senior Research Scientist Award (1-K05-MH01382-01) to D.L.O. |
| 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 | CBCL (externalizing problems) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 615 children | % (adjusted) = 17.40 | Adjusted mean % = 20.20 | OR = 0.83 | HomVEE calculated = -0.11 | Not statistically significant, p = 0.43 | |
| High | CBCL (internalizing problems) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 615 children | % (adjusted) = 12.60 | Adjusted mean % = 14.70 | OR = 0.84 | HomVEE calculated = -0.11 | Not statistically significant, p = 0.50 | |
| High | CBCL (total problems) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 615 children | % (adjusted) = 2.00 | Adjusted mean % = 5.00 | OR = 0.32 | HomVEE calculated = -0.37 | Statistically significant, p = 0.04 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | HTC Rating Scale (classroom social skills) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 615 children | Adjusted mean = 24.93 | Adjusted mean = 24.53 | Mean difference = 0.40 | Study reported = 0.03 | Not statistically significant, p = 0.71 |
|
| High | HTC Rating Scale(academic engagement) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 615 children | Adjusted mean = 6.16 | Adjusted mean = 6.86 | Mean difference = -0.70 | Study reported = -0.03 | Not statistically significant, p = 0.72 |
|
| High | KABC arithmetic achievement | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 615 children | Adjusted mean = 89.75 | Adjusted mean = 88.61 | Mean difference = 1.14 | Study reported = 0.09 | Not statistically significant, p = 0.30 | |
| High | KABC mental processing composite (arithmetic and reading) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 615 children | Adjusted mean = 92.34 | Adjusted mean = 90.24 | Mean difference = 2.10 | Study reported = 0.18 | Statistically significant, p = 0.03 |
|
| High | KABC reading achievement | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 615 children | Adjusted mean = 93.79 | Adjusted mean = 93.56 | Mean difference = 0.23 | Study reported = 0.02 | Not statistically significant, p = 0.84 | |
| High | MSSB (dysregulated aggression index) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 615 children | Adjusted mean = 99.24 | Adjusted mean = 100.26 | Mean difference = -1.02 | Study reported = -0.10 | Not statistically significant, p = 0.26 |
|
| High | MSSB (percentage incoherent stories) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 615 children | Adjusted mean = 21.15 | Adjusted mean = 25.22 | Mean difference = -4.07 | Study reported = -0.16 | Not statistically significant, p = 0.07 |
|
| High | MSSB (warmth/empathy index) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 615 children | Adjusted mean = 100.86 | Adjusted mean = 99.51 | Mean difference = 1.35 | Study reported = 0.14 | Not statistically significant, p = 0.13 |
|
| High | PPVT-III receptive vocabulary | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 615 children | Adjusted mean = 84.32 | Adjusted mean = 82.13 | Mean difference = 2.19 | Study reported = 0.17 | Statistically significant, p = 0.04 |
|
| High | Child attended Head Start, preschool, day care, or early intervention, age 24–54 months | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 641 mothers | % (adjusted) = 82.00 | Adjusted mean % = 75.00 | OR = 1.53 | HomVEE calculated = 0.26 | Statistically significant, p = 0.05 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | CBCL (externalizing problems) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability | 6-year follow-up | 335 children | % (adjusted) = 22.00 | Adjusted mean % = 24.00 | OR = 0.87 | HomVEE calculated = -0.09 | Not statistically significant, p = 0.63 |
|
| High | CBCL (internalizing problems) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability | 6-year follow-up | 335 children | % (adjusted) = 20.00 | Adjusted mean % = 17.00 | OR = 1.30 | HomVEE calculated = 0.16 | Not statistically significant, p = 0.40 |
|
| High | CBCL (total problems, percentage) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability | 6-year follow-up | 335 children | Adjusted mean % = 3.70 | Adjusted mean % = 6.60 | Difference = -2.90 | Study reported = -0.37 | Not statistically significant, p = 0.31 |
|
| High | HTC Rating Scale(academic engagement) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability | 6-year follow-up | 335 children | Adjusted mean = 4.74 | Adjusted mean = 4.23 | Mean difference = 0.51 | Study reported = 0.02 | Not statistically significant, p = 0.86 |
|
| High | HTC Rating Scale(classroom social skills) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability | 6-year follow-up | 335 children | Adjusted mean = 24.54 | Adjusted mean = 22.92 | Mean difference = 1.62 | Study reported = 0.14 | Not statistically significant, p = 0.27 |
|
| High | KABC arithmetic achievement | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability | 6-year follow-up | 335 children | Adjusted mean = 88.61 | Adjusted mean = 85.42 | Mean difference = 3.19 | Study reported = 0.25 | Statistically significant, p = 0.04 |
|
| High | KABC mental processing composite (arithmetic and reading) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability | 6-year follow-up | 335 children | Adjusted mean = 90.49 | Adjusted mean = 87.64 | Mean difference = 2.85 | Study reported = 0.25 | Statistically significant, p = 0.03 |
|
| High | KABC reading achievement | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability | 6-year follow-up | 335 children | Adjusted mean = 92.07 | Adjusted mean = 90.87 | Mean difference = 1.20 | Study reported = 0.09 | Not statistically significant, p = 0.44 |
|
| High | MSSB (dysregulated aggression index) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability | 6-year follow-up | 335 children | Adjusted mean = 98.58 | Adjusted mean = 101.10 | Mean difference = -2.52 | Study reported = -0.25 | Statistically significant, p = 0.04 |
|
| High | MSSB (percentage incoherent stories) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability | 6-year follow-up | 335 children | Adjusted mean = 20.90 | Adjusted mean = 29.84 | Mean difference = -8.94 | Study reported = -0.34 | Statistically significant, p < 0.01 |
|
| High | MSSB (warmth/ empathy index) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability | 6-year follow-up | 335 children | Adjusted mean = 100.30 | Adjusted mean = 98.98 | Mean difference = 1.32 | Study reported = 0.13 | Not statistically significant, p = 0.27 |
|
| High | PPVT-III receptive vocabulary | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability | 6-year follow-up | 335 children | Adjusted mean = 81.75 | Adjusted mean = 79.08 | Mean difference = 2.67 | Study reported = 0.21 | Not statistically significant, p = 0.07 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | Subsequent NICU/special care admission (rate per subsequent birth) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 641 mothers | % (adjusted) = 18.00 | Adjusted mean % = 23.00 | OR = -0.72 | HomVEE calculated = -0.20 | Not statistically significant, p = 0.14 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Subsequent low birth weight newborn (rate per subsequent birth) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 641 mothers | % (adjusted) = 11.00 | Adjusted mean % = 16.00 | OR = -0.69 | HomVEE calculated = -0.22 | Not statistically significant, p = 0.16 |
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 | SES of current job (mother) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 641 mothers | Adjusted mean = 14.01 | Adjusted mean = 13.06 | Mean difference = 0.95 | Study reported = 0.05 | Not statistically significant, p = 0.56 | |
| High | Months mother employed (54–72 months postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 641 mothers | Adjusted mean = 9.96 | Adjusted mean = 9.99 | Mean difference = -0.03 | Study reported = 0.00 | Not statistically significant, p = 0.97 | |
| High | Months of AFDC (54–72 months postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 641 mothers | Adjusted mean = 7.21 | Adjusted mean = 8.96 | Mean difference = -1.75 | Study reported = -0.22 | Statistically significant, p = 0.01 | |
| High | Months of food stamps (54–72 months postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 641 mothers | Adjusted mean = 9.67 | Adjusted mean = 11.50 | Mean difference = -1.83 | Study reported = -0.24 | Statistically significant, p < 0.01 | |
| High | Months of Medicaid, (54–72 months postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 641 mothers | Adjusted mean = 11.98 | Adjusted mean = 13.08 | Mean difference = -1.10 | Study reported = -0.15 | Not statistically significant, p = 0.08 | |
| High | Mother graduated from high school/earned GED (percentage) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 641 mothers | % (adjusted) = 69.00 | Adjusted mean % = 66.00 | OR = 1.12 | Study reported = 0.07 | Not statistically significant, p = 0.54 |
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 | MHI | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 641 mothers | Adjusted mean = 100.18 | Adjusted mean = 99.92 | Mean difference = 0.26 | Study reported = 0.03 | Not statistically significant, p = 0.76 |
|
| High | Behavioral problems attributable to substance abuse | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 641 mothers | % (adjusted) = 4.00 | Adjusted mean % = 4.00 | OR = 0.94 | HomVEE calculated = -0.03 | Not statistically significant, p = 0.88 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Currently uses marijuana | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 641 mothers | % (adjusted) = 5.00 | Adjusted mean % = 3.00 | OR = 1.37 | HomVEE calculated = 0.19 | Not statistically significant, p = 0.47 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Moderate/heavy drinker (= 3 drinks = 3 times per month) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 641 mothers | % (adjusted) = 5.00 | Adjusted mean % = 3.00 | OR = 2.03 | HomVEE calculated = 0.44 | Not statistically significant, p = 0.11 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Months between births of first and second children | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 641 mothers | Adjusted mean = 34.38 | Adjusted mean = 30.23 | Mean difference = 4.15 | Study reported = 0.26 | Statistically significant, p = 0.01 |
|
| High | Number of subsequent children (birth to 72 months postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 641 mothers | Adjusted mean = 1.08 | Adjusted mean = 1.28 | Mean difference = -0.20 | Study reported = -0.22 | Statistically significant, p = 0.01 |
|
| High | Number of subsequent pregnancies (birth to 72 months postpartum) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 641 mothers | Adjusted mean = 1.16 | Adjusted mean = 1.38 | Mean difference = -0.22 | Study reported = -0.22 | Statistically significant, p = 0.01 |
|
| High | Pearlin Mastery Scale | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 641 mothers | Adjusted mean = 100.46 | Adjusted mean = 99.79 | Mean difference = 0.67 | Study reported = 0.07 | Not statistically significant, p = 0.43 |
|
| High | Subsequent abortion (rate per subsequent pregnancy) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 641 mothers | % (adjusted) = 4.00 | Adjusted mean % = 5.00 | OR = 0.70 | HomVEE calculated = -0.23 | Not statistically significant, p = 0.42 |
Statistical significance reported on authors’ calculations of the odds ratio.
|
| High | Subsequent miscarriage (rate per subsequent pregnancy) | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 641 mothers | % (adjusted) = 3.00 | Adjusted mean % = 5.00 | OR = 0.75 | HomVEE calculated = -0.27 | Not statistically significant, p = 0.50 |
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, birth to age 6 | FavorableUnfavorable or ambiguousNo Effect |
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | 6-year follow-up | 641 mothers | % (adjusted) = 39.00 | Adjusted mean % = 40.00 | OR = 0.97 | Study reported = -0.02 | Not statistically significant, p = 0.87 |
Statistical significance reported on authors’ calculations of the odds ratio.
|