Black or African American
93%
Source
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
Note: Navigate to model page for more information about the home visiting model. See the study manuscript for more information about how the model was implemented in this study.
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.
Study Design
| Design | Attrition | Baseline equivalence | Confounding factors | Valid, reliable measures? |
|---|---|---|---|---|
| Randomized controlled trial | Low | Difference in SES, but controlled in analysis. |
None |
Not assessed in manuscripts reviewed under Handbook of Procedures and Standards, Version 1 |
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
Home Visiting 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.
Model(s) Reviewed
Note: Navigate to model page for more information about the home visiting model. See the study manuscript for more information about how the model was implemented in this study.
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.
Were any subgroups examined?
Yes
Subgroups examined
• Mother has psychological vulnerability (yes or no)
Findings that rate moderate or high in this manuscript
Maternal health
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Number of subsequent pregnancies (birth to 72 months postpartum) |
6-year follow-up |
High | 0.22 | Statistically significant, |
641 mothers | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
Number of subsequent children (birth to 72 months postpartum) |
6-year follow-up |
High | 0.22 | Statistically significant, |
641 mothers | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
Months between births of first and second children |
6-year follow-up |
High | 0.26 | Statistically significant, |
641 mothers | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
Subsequent miscarriage (rate per subsequent pregnancy) |
6-year follow-up |
High | 0.27 | Not statistically significant, |
641 mothers | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
Subsequent abortion (rate per subsequent pregnancy) |
6-year follow-up |
High | 0.23 | Not statistically significant, |
641 mothers | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
Currently uses marijuana |
6-year follow-up |
High | 0.19 | Not statistically significant, |
641 mothers | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
Moderate/heavy drinker (= 3 drinks = 3 times per month) |
6-year follow-up |
High | 0.44 | Not statistically significant, |
641 mothers | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
Behavioral problems attributable to substance abuse |
6-year follow-up |
High | 0.03 | Not statistically significant, |
641 mothers | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
Pearlin Mastery Scale |
6-year follow-up |
High | 0.07 | Not statistically significant, |
641 mothers | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
MHI |
6-year follow-up |
High | 0.03 | Not statistically significant, |
641 mothers | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
Child health
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Subsequent low birth weight newborn (rate per subsequent birth) |
6-year follow-up |
High | 0.22 | Not statistically significant, |
641 mothers | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
Subsequent NICU/special care admission (rate per subsequent birth) |
6-year follow-up |
High | 0.20 | Not statistically significant, |
641 mothers | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
Child development and school readiness
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Child attended Head Start, preschool, day care, or early intervention, age 24–54 months |
6-year follow-up |
High | 0.26 | Statistically significant, |
641 mothers | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
HTC Rating Scale(academic engagement) |
6-year follow-up |
High | 0.03 | Not statistically significant, |
615 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
HTC Rating Scale (classroom social skills) |
6-year follow-up |
High | 0.03 | Not statistically significant, |
615 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
MSSB (dysregulated aggression index) |
6-year follow-up |
High | 0.10 | Not statistically significant, |
615 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
MSSB (warmth/empathy index) |
6-year follow-up |
High | 0.14 | Not statistically significant, |
615 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
MSSB (percentage incoherent stories) |
6-year follow-up |
High | 0.16 | Not statistically significant, |
615 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
KABC mental processing composite (arithmetic and reading) |
6-year follow-up |
High | 0.18 | Statistically significant, |
615 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
PPVT-III receptive vocabulary |
6-year follow-up |
High | 0.17 | Statistically significant, |
615 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
CBCL (total problems) |
6-year follow-up |
High | 0.37 | Statistically significant, |
615 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
KABC arithmetic achievement |
6-year follow-up |
High | 0.09 | Not statistically significant, p = 0.30 |
615 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
KABC reading achievement |
6-year follow-up |
High | 0.02 | Not statistically significant, p = 0.84 |
615 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
CBCL (internalizing problems) |
6-year follow-up |
High | 0.11 | Not statistically significant, p = 0.50 |
615 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
CBCL (externalizing problems) |
6-year follow-up |
High | 0.11 | Not statistically significant, p = 0.43 |
615 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
MSSB (dysregulated aggression index) |
6-year follow-up |
High | 0.25 | Statistically significant, |
335 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability |
||
MSSB (warmth/ empathy index) |
6-year follow-up |
High | 0.13 | Not statistically significant, |
335 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability |
||
HTC Rating Scale(academic engagement) |
6-year follow-up |
High | 0.02 | Not statistically significant, |
335 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability |
||
HTC Rating Scale(classroom social skills) |
6-year follow-up |
High | 0.14 | Not statistically significant, |
335 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability |
||
MSSB (percentage incoherent stories) |
6-year follow-up |
High | 0.34 | Statistically significant, |
335 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability |
||
KABC mental processing composite (arithmetic and reading) |
6-year follow-up |
High | 0.25 | Statistically significant, |
335 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability |
||
PPVT-III receptive vocabulary |
6-year follow-up |
High | 0.21 | Not statistically significant, |
335 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability |
||
CBCL (total problems, percentage) |
6-year follow-up |
High | 0.37 | Not statistically significant, |
335 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability |
||
KABC arithmetic achievement |
6-year follow-up |
High | 0.25 | Statistically significant, |
335 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability |
||
KABC reading achievement |
6-year follow-up |
High | 0.09 | Not statistically significant, |
335 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability |
||
CBCL (internalizing problems) |
6-year follow-up |
High | 0.16 | Not statistically significant, |
335 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability |
||
CBCL (externalizing problems) |
6-year follow-up |
High | 0.09 | Not statistically significant, |
335 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis); Subgroup: Mother has psychological vulnerability |
Reductions in juvenile delinquency, family violence, and crime
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Any domestic violence, birth to age 6 |
6-year follow-up |
High | 0.02 | Not statistically significant, |
641 mothers | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
Family economic self-sufficiency
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Months mother employed (54–72 months postpartum) |
6-year follow-up |
High | 0.00 | Not statistically significant, p = 0.97 |
641 mothers | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
SES of current job (mother) |
6-year follow-up |
High | 0.05 | Not statistically significant, p = 0.56 |
641 mothers | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
Months of AFDC (54–72 months postpartum) |
6-year follow-up |
High | 0.22 | Statistically significant, p = 0.01 |
641 mothers | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
Months of food stamps (54–72 months postpartum) |
6-year follow-up |
High | 0.24 | Statistically significant, p < 0.01 |
641 mothers | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
Months of Medicaid, (54–72 months postpartum) |
6-year follow-up |
High | 0.15 | Not statistically significant, p = 0.08 |
641 mothers | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
||
Mother graduated from high school/earned GED (percentage) |
6-year follow-up |
High | 0.07 | Not statistically significant, |
641 mothers | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) |
This study included participants with the following characteristics at enrollment:
Race/Ethnicity
Maternal Education
Other Characteristics
This study included participants from the following locations:
- Tennessee