White
89.00%
Source
Olds, D. L., Henderson, C. R., Cole, R., Eckenrode, J., Kitzman, H., Luckey, D., et al. (1998). Long-term effects of nurse home visitation on children’s criminal and antisocial behavior: 15-year follow-up of a randomized controlled trial. JAMA: The Journal of the American Medical Association, 280(14), 1238–1244.
Model(s) Reviewed
Funding Sources
Senior Research Scientist Award 1-K05-MH01382-01 (Dr. Olds); the Prevention Research and Behavioral Medicine Branch of the National Institute of Mental Health (R01-MH49381) and the Assistant Secretary for Planning and Evaluation, Department of Health and Human Services (grant 96ASPE278A).
Study Design
| Design | Attrition | Baseline equivalence | Confounding factors | Valid, reliable measures? |
|---|---|---|---|---|
| Randomized controlled trial | Low | Established on race and SES. | None |
Notes
In 2020, HomVEE updated this review in several ways. First, HomVEE removed two findings entitled "Ever stopped by police" from the Reductions in Juvenile Delinquency, Family Violence, and Crime domain because ACF determined that this outcome is ineligible for review by HomVEE. Second, HomVEE moved eight findings about the child running away, number of minor antisocial acts, acting out problems, and externalizing problems from the Reductions in Juvenile Delinquency, Family Violence, and Crime domain to the Child Development and School Readiness domain because ACF determined that running away and other behavior and behavioral health outcomes belong in HomVEE's Child Development and School Readiness domain along with other behavior and behavioral health outcomes. Finally, HomVEE moved 15 findings related to measures of sexual behavior, pregnancy, alcohol, and drugs from the Child Health domain to the Child Development and School Readiness because ACF determined that all measures of child behavioral health belong in HomVEE's Child Development and School Readiness domain.
The Elmira sample included two deviations from the randomization procedure. First, six housemates of women already randomly assigned and enrolled in the study were assigned to the same treatment as the women already enrolled. Second, the probability of being assigned to one of the treatment groups was increased in the last 6 months of the 30 month enrollment period. The first issue suggests a mismatch between the unit of assignment (adult in the household) and the unit of analysis, which may lead to overstating the precision of the standard errors. The second issue should lead to a weighting strategy in the analysis, so that those who were enrolled later receive less weight in the analysis. Weighting, however, was not used in these studies.
Study Participants
The sample included pregnant, first-time mothers who were less than 30 weeks pregnant. The study actively recruited and included pregnant, first-time mothers who were less than 25 weeks pregnant, were less than 19 years old, were single parents, or had low socioeconomic status. Between April 1978 and September 1980, 500 women were interviewed and 400 were randomly assigned. This study is a longitudinal follow-up at 15 years for the women originally enrolled in the study and their children. At this follow-up, the study included data on 330 of the original mothers (177 in the program group and 152 in the comparison group) and 315 children of the original mothers (171 in the program group and 144 in the comparison group). At enrollment, on average, the women included in this study were about 19 years old and had approximately 11 years of education. Roughly 40 percent of the sample was married.
Setting
The study was conducted in Elmira, a metropolitan area within a semi-rural county in the Appalachian region of New York that has approximately 100,000 residents (information obtained from other studies using the Elmira sample).
Home Visiting Services
The study included two treatment groups, which were combined for the analyses. The first treatment group received home visits from a nurse during pregnancy. The nurse visited the family every other week and made nine visits, on average, which lasted one hour and 15 minutes. 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. Home visits were once a week for the first month after delivery, decreasing over time to once every 6 weeks when the child was 18-24 months. Home visits focused on parent education, enhancing the women’s support systems, and linkages to community services.
Comparison Conditions
The study included two comparison groups, which were combined for the analyses. The first comparison group did not receive any services during pregnancy. When the children were 12 and 24 months old, they were screened for sensory and developmental problems and referred to other specialists, as appropriate. The second treatment group received free transportation (through a contract with a local taxi company) for prenatal and well-child care at local clinics and doctors’ offices. The second comparison group also received the 12- and 24-month developmental screening.
Subgroups examined
• Subgroups defined by combinations of maternal characteristics (unmarried and low income)
Findings that rate moderate or high in this manuscript
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Ever had sexual intercourse | 15-year follow-up | High | 0.00 | Not statistically significant, p = 1.00 |
227 adolescents | Nurse visited during pregnancy and comparison (Elmira) | ||
| Ever pregnant or made someone pregnant | 15-year follow-up | High | -0.25 | Not statistically significant, p = 0.97 |
227 adolescents | Nurse visited during pregnancy and comparison (Elmira) | ||
| Incidence of sex partners (number) | 15-year follow-up | High | Not statistically significant, p = 0.48 |
227 adolescents | Nurse visited during pregnancy and comparison (Elmira) | |||
| Incidence–cigarettes smoked per day | 15-year follow-up | High | Not statistically significant, p = 0.49 |
227 adolescents | Nurse visited during pregnancy and comparison (Elmira) | |||
| Incidence–days drank alcohol | 15-year follow-up | High | Not statistically significant, p = 0.97 |
227 adolescents | Nurse visited during pregnancy and comparison (Elmira) | |||
| Incidence–days used drugs | 15-year follow-up | High | Not statistically significant, p = 0.49 |
227 adolescents | Nurse visited during pregnancy and comparison (Elmira) | |||
| Ever pregnant or made someone pregnant | 15-year follow-up | High | 0.18 | Not statistically significant, p = 1.00 |
245 adolescents | Nurse visited during pregnancy + infancy and comparison (Elmira) | ||
| Incidence of sex partners (number) | 15-year follow-up | High | Not statistically significant, p = 0.90 |
245 adolescents | Nurse visited during pregnancy + infancy and comparison (Elmira) | |||
| Incidence–cigarettes smoked per day | 15-year follow-up | High | Not statistically significant, p = 0.76 |
245 adolescents | Nurse visited during pregnancy + infancy and comparison (Elmira) | |||
| Incidence–days drank alcohol | 15-year follow-up | High | Not statistically significant, p = 0.96 |
245 adolescents | Nurse visited during pregnancy + infancy and comparison (Elmira) | |||
| Incidence–days used drugs | 15-year follow-up | High | Not statistically significant, p = 0.54 |
245 adolescents | Nurse visited during pregnancy + infancy and comparison (Elmira) | |||
| Number of internalizing problems | 15-year follow-up | High | Not statistically significant, p = 0.46 |
227 adolescents | Nurse visited during pregnancy and comparison (Elmira) | |||
| Number of internalizing problems | 15-year follow-up | High | Not statistically significant, p = 0.19 |
245 adolescents | Nurse visited during pregnancy + infancy and comparison (Elmira) | |||
| Incidence–times ran away (self-report) | 15-year follow-up | High | Not statistically significant, p = 0.83 |
227 adolescents | Nurse visited during pregnancy and comparison (Elmira) | |||
| Number of minor antisocial acts (self-report) | 15-year follow-up | High | Not statistically significant, p = 0.50 |
227 adolescents | Nurse visited during pregnancy and comparison (Elmira) | |||
| Number of externalizing problems (self-report and mother report) | 15-year follow-up | High | Not statistically significant, p = 0.95 |
227 adolescents | Nurse visited during pregnancy and comparison (Elmira) | |||
| Number of acting out problems (teacher report) | 15-year follow-up | High | Not statistically significant, p = 0.41 |
227 adolescents | Nurse visited during pregnancy and comparison (Elmira) | |||
| Alcohol impairment (self-report) | 15-year follow-up | High | Not statistically significant, p = 0.95 |
227 adolescents | Nurse visited during pregnancy and comparison (Elmira) | |||
| Alcohol and drug impairment (mother report) | 15-year follow-up | High | Not statistically significant, p = 0.96 |
277 adolescents | Nurse visited during pregnancy and comparison (Elmira) | |||
| Incidence–times ran away (self report) | 15-year follow-up | High | Not statistically significant, p = 0.07 |
245 adolescents | Nurse visited during pregnancy + infancy and comparison (Elmira) | |||
| Number of minor antisocial acts (self-report) | 15-year follow-up | High | Not statistically significant, p = 0.86 |
245 adolescents | Nurse visited during pregnancy + infancy and comparison (Elmira) | |||
| Number of externalizing problems (self-report and mother report) | 15-year follow-up | High | Not statistically significant, p = 0.89 |
245 adolescents | Nurse visited during pregnancy + infancy and comparison (Elmira) | |||
| Number of acting out problems (teacher report) | 15-year follow-up | High | Not statistically significant, p = 0.85 |
245 adolescents | Nurse visited during pregnancy + infancy and comparison (Elmira) | |||
| Alcohol impairment (self-report) | 15-year follow-up | High | Not statistically significant, p = 0.35 |
245 adolescents | Nurse visited during pregnancy + infancy and comparison (Elmira) | |||
| Alcohol and drug impairment (mother report) | 15 year follow-up | High | Not statistically significant, p = 0.68 |
245 adolescents | Nurse visited during pregnancy + infancy and comparison (Elmira) |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Incidence–short-term school suspensions | 15-year follow-up | High | Not statistically significant, p = 0.97 |
245 adolescents | Nurse visited during pregnancy + infancy and comparison (Elmira) | |||
| Incidence–long-term school suspensions | 15-year follow-up | High | Not statistically significant, p = 1.00 |
245 adolescents | Nurse visited during pregnancy + infancy and comparison (Elmira) | |||
| Ever was person inneed of supervision (PINS; self-report) | 15-year follow-up | High | -0.12 | Not statistically significant, p = 0.75 |
227 adolescents | Nurse visited during pregnancy and comparison (Elmira) | ||
| Incidence–arrests (self-report) | 15-year follow-up | High | Statistically significant, p < 0.01 |
227 adolescents | Nurse visited during pregnancy and comparison (Elmira) | |||
| Incidence–convictions and probation violations (self-report) | 15-year follow-up | High | Statistically significant, p < 0.01 |
227 adolescents | Nurse visited during pregnancy and comparison (Elmira) | |||
| Incidence–sent to youth corrections (self-report) | 15-year follow-up | High | Not statistically significant, p = 0.98 |
227 adolescents | Nurse visited during pregnancy and comparison (Elmira) | |||
| Incidence of arrests (mother report) | 15-year follow-up | High | Not statistically significant, p = 0.73 |
277 adolescents | Nurse visited during pregnancy and comparison (Elmira) | |||
| Number of major delinquent acts (self-report) | 15-year follow-up | High | Not statistically significant, p = 0.93 |
227 adolescents | Nurse visited during pregnancy and comparison (Elmira) | |||
| Ever was person inneed of supervision (PINS; self-report) | 15-year follow-up | High | -0.33 | Not statistically significant, p = 0.33 |
Nurse visited during pregnancy + infancy and comparison (Elmira) | |||
| Incidence–convictions and probation violations (self-report) | 15-year follow-up | High | Statistically significant, p < 0.01 |
245 adolescents | Nurse visited during pregnancy + infancy and comparison (Elmira) | |||
| Incidence–sent to youth corrections (self-report) | 15-year follow-up | High | Not statistically significant, p = 0.98 |
245 adolescents | Nurse visited during pregnancy + infancy and comparison (Elmira) | |||
| Incidence of arrests (mother report) | 15-year follow-up | High | Not statistically significant, p = 0.37 |
245 adolescents | Nurse visited during pregnancy + infancy and comparison (Elmira) | |||
| Number of major delinquent acts (self-report) | 15-year follow-up | High | Not statistically significant, p = 0.48 |
245 adolescents | Nurse visited during pregnancy + infancy and comparison (Elmira) |
This study included participants with the following characteristics at enrollment:
Race/Ethnicity
Maternal Education
Other Characteristics
This study included participants from the following locations:
- New York