Black or African American
93.50%
Source
Kitzman, H. J., Olds, D. L., Cole, R. E., Hanks, C. A., Anson, E. A., Arcoleo, K. J., Luckey, D. W., Knudtson, M. D., Henderson, C. R., & Holmberg, J. R. (2010). Enduring effects of prenatal and infancy home visiting by nurses on children: Follow-up of a randomized trial among children at age 12 years. Archives of Pediatrics & Adolescent Medicine, 164(5), 412–418.
Model(s) Reviewed
Funding Sources
This project was supported by National Institutes of Health research grant 1R01MH68790-01 funded by the National Institute of Mental Health and the Office of Juvenile Justice and Delinquency Prevention grant 2004-52854-CO-JS0. The earlier phases of this study were supported by several federal agencies: the National Institute of Mental Health (grant R01-MH61428- 01), the National Institute of Child Health and Human Development (grant R01-HD-043492), the National Institute of Nursing Research (grant NR01-01691-05), the Bureau of Maternal and Child Health (grant MCJ 360579), the Administration for Children and Families (grants 90PJ0003 and 90PD0215/01), the Office of the Assistant Secretary for Planning and Evaluation (Department of Health and Human Services), and the National Center for Child Abuse and Neglect through a transfer of funds to the National Institute of Nursing Research (grant R01NR01691). The earlier phases of this research also were supported by 5 private foundations: the Robert Wood Johnson Foundation (grants 017934 and 11084), the Carnegie Corporation of New York (grant B 5492), the Pew Charitable Trusts (grants 88-0211-000 and 93-02363-000), the William T. Grant Foundation (grants 88-1246-88 and 91-1246-88), and the Hearst Foundation, as well as a Senior Research Scientist Award from the National Institutes of Health (1-K05-MH01382-01) (Dr Olds).
Study Design
| Design | Attrition | Baseline equivalence | Confounding factors | Valid, reliable measures? |
|---|---|---|---|---|
| Randomized controlled trial | Low | Established for race/ethnicity. Significant differences in SES, but controlled in analyses. | None |
Notes
In 2020, HomVEE updated this review in two ways. First, HomVEE moved six findings on externalizing disorders, internalizing disorders, and total problems from the Reductions in Juvenile Delinquency, Family Violence, and Crime domain to the Child Development and School Readiness domain. Second, HomVEE moved the findings on whether the child used cigarettes, alcohol, or marijuana in the past 30 days from the Child Health domain to the Child Development and School Readiness domain. These changes are because ACF determined that all measures of child behavioral health, including internalizing and externalizing behaviors and children's risky behaviors, belong in HomVEE's Child Development and School Readiness domain.
Study Participants
From June 1, 1990 through August 31, 1991, the study enrolled primarily African American women at fewer than 29 weeks of gestation, with no previous live births, and with at least 2 of the following sociodemographic risk characteristics:unmarried, fewer than 12 years of education, and unemployed. Of the 1,290 eligible women, 1,139 consented and were randomly assigned. A subset of 743 women were involved in the postnatal aspect of the trial. Of the women enrolled, 92.1% were African American, 98.1% were unmarried, 64.1% were 18 years or younger at registration, and 85.1% came from households with annual incomes below the U.S. federal poverty guidelines. This study focused on the 12-year follow up; 594 women completed a maternal interview and 578 children completed an interview.
Setting
Memphis, TN
Home Visiting Services
Women in the nurse-visited group were provided the same services as those in the comparison group, plus home visitation from pregnancy through the child’s second birthday. The nurses were provided detailed guidelines for each visit but allowed to adapt them to the needs of individual families. The nurses also linked families to other health and human services and tried to involve the children’s fathers and grandmothers in the pregnancy and care of the child. Each nurse visited a maximum of 25 families.
The program is intended to provide 62 home visits for women who enroll at 16 weeks gestation. In this study, the nurses completed a mean of 7 home visits (range of 0 to 18) during pregnancy and 26 home visits (range of 0 to 71) during the first 2 years after birth. Generally the difference between the recommended and actual number of visits was the result of participants dropping out of the program.
Comparison Conditions
Women in the comparison group were provided developmental screening and referrals for the child at 6, 12, and 24 months of age, and free transportation for scheduled prenatal care.
Were any subgroups examined?
Yes
Subgroups examined
• Mother has psychological vulnerability (yes or no)
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 | |
|---|---|---|---|---|---|---|---|---|
| Conduct grades (grades 1–-6) | 12-year follow-up | High | 1.79 | Not statistically significant, p ≥ 0.05 | 635 children | Nurse visited during pregnancy + infancy and development screening comparison (Memphis) | ||
| Conduct grades (grades 4–6) | 12-year follow-up | High | 1.87 | Not statistically significant, p ≥ 0.05 | 635 children | Nurse visited during pregnancy + infancy and development screening comparison (Memphis) | ||
| Ever placed in special education (grades 1–6) | 12-year follow-up | High | 0.28 | Not statistically significant, p ≥ 0.05 | 635 children | Nurse visited during pregnancy + infancy and development screening comparison (Memphis) | ||
| Ever retained | 12-year follow-up | High | 0.14 | Not statistically significant, p ≥ 0.05 | 635 children | Nurse visited during pregnancy + infancy and development screening comparison (Memphis) | ||
| PIAT scores (reading and math) at 12 years | 12-year follow-up | High | 2.25 | Not statistically significant, p ≥ 0.05 | 568 children | Nurse visited during pregnancy + infancy and development screening comparison (Memphis) | ||
| GPA (reading and math) (grades 1–6) | 12-year follow-up | High | 2.07 | Not statistically significant, p ≥ 0.05 | 635 children | Nurse visited during pregnancy + infancy and development screening comparison (Memphis) | ||
| GPA (reading and math) (grades 4–6) | 12-year follow-up | High | 1.70 | Not statistically significant, p ≥ 0.05 | 635 children | Nurse visited during pregnancy + infancy and development screening comparison (Memphis) | ||
| Group achievement test scores (reading and math) (grades 1–6), percentile | 12-year follow-up | High | 2.12 | Not statistically significant, p ≥ 0.05 | 578 children | Nurse visited during pregnancy + infancy and development screening comparison (Memphis) | ||
| Group achievement test scores (reading and math) (grades 4–6), percentile | 12-year follow-up | High | 0.89 | Not statistically significant, p ≥ 0.05 | 635 children | Nurse visited during pregnancy + infancy and development screening comparison (Memphis) | ||
| Leiter-R Sustained Attention test scaled score | 12-year follow-up | High | -0.42 | Not statistically significant, p ≥ 0.05 | 578 children | Nurse visited during pregnancy + infancy and development screening comparison (Memphis) | ||
| Internalizing disorders | 12 years | High | -0.28 | Statistically significant, p < .05 | 578 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | ||
| Externalizing disorders | 12 years | High | 0.08 | Not statistically significant, p ≥ 0.05 | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | |||
| Total problems | 12 years | High | 0.14 | Not statistically significant, p ≥ 0.05 | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | |||
| Used cigarettes, alcohol, or marijuana in the past 30 days | 12 years | High | -0.69 | Statistically significant, p < .05 | 578 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | ||
| Number of substances used in the past 30 days | 12 years | High | Statistically significant, p < .05 | 578 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | |||
| Incidence of days of substance use in the past 30 days | 12 years | High | Statistically significant, p < .05 | 578 children | Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) | |||
| Internalizing disorders | 12 years | High | -0.13 | Not statistically significant, p ≥ 0.05 | 326 mothers | Nurse home visitors and comparison (Memphis); Subgroup: Mother has psychological vulnerability | ||
| Externalizing disorders | 12 years | High | 0.07 | Not statistically significant, p ≥ 0.05 | 326 mothers | Nurse home visitors and comparison (Memphis); Subgroup: Mother has psychological vulnerability | ||
| Total problems | 12 years | High | 0.09 | Not statistically significant, p ≥ 0.05 | 326 mothers | Nurse home visitors and comparison (Memphis); Subgroup: Mother has psychological vulnerability | ||
| Conduct grades (grades 4-6) | 12-year follow-up | High | 0.93 | Not statistically significant, p ≥ 0.05 | 326 mothers | Nurse home visitors and comparison (Memphis); Subgroup: Mother has psychological vulnerability | ||
| Ever placed in special education (grades 1-6) | 12-year follow-up | High | -0.02 | Not statistically significant, p ≥ 0.05 | 326 mothers | Nurse home visitors and comparison (Memphis); Subgroup: Mother has psychological vulnerability | ||
| Ever retained | 12-year follow-up | High | -0.16 | Not statistically significant, p ≥ 0.05 | 326 mothers | Nurse home visitors and comparison (Memphis); Subgroup: Mother has psychological vulnerability | ||
| PIAT scores (reading and math) at 12 years | 12-year follow-up | High | 3.91 | Statistically significant, p < .05 | 326 mothers | Nurse home visitors and comparison (Memphis); Subgroup: Mother has psychological vulnerability | ||
| GPA (reading and math) (grades 1-6) | 12-year follow-up | High | 3.32 | Statistically significant, p < .05 | 326 mothers | Nurse home visitors and comparison (Memphis); Subgroup: Mother has psychological vulnerability | ||
| GPA (reading and math) (grades 4-6) | 12-year follow-up | High | 2.83 | Statistically significant, p < .05 | 326 mothers | Nurse home visitors and comparison (Memphis); Subgroup: Mother has psychological vulnerability | ||
| Group achievement test scores (reading and math) (grades 1-6), percentile1 | 12-year follow-up | High | 3.39 | Statistically significant, p < .05 | 326 mothers | Nurse home visitors and comparison (Memphis); Subgroup: Mother has psychological vulnerability | ||
| Group achievement test scores (reading and math) (grades 4-6), percentile1 | 12-year follow-up | High | 1.87 | Not statistically significant, p ≥ 0.05 | 326 mothers | Nurse home visitors and comparison (Memphis); Subgroup: Mother has psychological vulnerability | ||
| Leiter-R Sustained Attention test scaled score | 12-year follow-up | High | -0.39 | Not statistically significant, p ≥ 0.05 | 326 mothers | Nurse home visitors and comparison (Memphis); Subgroup: Mother has psychological vulnerability | ||
| Conduct grades (grades 1-6) | 12-year follow-up | High | 1.61 | Not statistically significant, p ≥ 0.05 | 326 mothers | Nurse home visitors and comparison (Memphis); Subgroup: Mother has psychological vulnerability |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Ever arrested | 12 years | High | 0.00 | Not statistically significant | 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