Manuscript Detail | Home Visiting Evidence of Effectiveness

Source

Holmberg, John; Luckey, Dennis; Olds, David. (2011) Teacher data for the Denver Year-9 follow-up. Unpublished report submitted to the U.S. Department of Justice.

High rating

Study reviewed under: Handbook of Procedures and Standards, Version 1

Model(s) Reviewed

Nurse-Family Partnership (NFP)®

NFP with Paraprofessional Home Visitors

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.

Author Affiliation

David L. Olds, a study author, is a developer of this model.

Funding Sources

Not specified.

Study Design

Design	Attrition	Baseline equivalence	Confounding factors	Valid, reliable measures?
Randomized controlled trial	Low	Established on race/ethnicity and SES	None	Not assessed in manuscripts reviewed under Handbook of Procedures and Standards, Version 1

Notes

This study received a mixed rating. Some outcomes rate high, others moderate, and still others low. For the low psychological resources subgroup, we were unable to determine attrition and if the baseline information provided corresponds to the analytic sample, so the outcomes for the low psychological resources subgroup rate low. For paraprofessional versus control comparison in the whole sample, the study rates high because there is low attrition and demonstration of baseline equivalence on race/ethnicity and socioeconomic status (SES). For the nurse versus control comparison in the whole sample, most of the outcomes had high attrition, but baseline equivalence was established on race/ethnicity and SES, so these outcomes rate moderate. Within the nurse versus control comparison in the whole sample, there are two outcomes for which attrition is low, and these outcomes rate high.

Study Participants

Women were recruited through 21 antepartum clinics that served low-income pregnant women. Recruitment focused on women who had no previous live births and either qualified for Medicaid or had no private health insurance. From March 1994 to June 1995, 1,178 women were invited to participate and 735 consented and were randomly assigned to one of three conditions: a control group, nurse home visiting, and paraprofessional home visiting. Randomization was conducted within strata based on maternal race (Hispanic, white, black, American Indian, or Asian); maternal gestational age (fewer than 32 weeks, 32 weeks or more); and geographic region. This study augments the data collection procedures of the Denver trial of the NFP . The authors conducted follow-up evaluations with interviews and direct tests of the children on 575 families.

Setting

Denver, Colorado metropolitan area

Home Visiting Services

The study included two program groups: one serviced by paraprofessionals and one serviced by nurses. Women assigned to either group received developmental screening and referral services for their children and home visits during pregnancy and infancy (until the child was 2 years old). Both groups had the same goals: (1) to improve women’s health-related behaviors, (2) to support parents in providing competent care, and (3) to encourage planning future pregnancies and promote education and employment. Paraprofessionals conducted 6.3 home visits, on average, during pregnancy and 16 visits during infancy. Nurses conducted 6.5 home visits, on average, during pregnancy and 21 visits during infancy.

Model(s) Reviewed

Nurse-Family Partnership (NFP)®

NFP with Paraprofessional Home Visitors

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

Women in the comparison group received developmental screening and referral services for their children at 6, 12, 15, 21, and 24 months.

Subgroups examined

• Mother has psychological vulnerability (yes or no)

Findings that rate moderate or high in this manuscript

Child development and school readiness

Outcome measure	Timing of follow-up	Rating	Effect size (absolute value)	Stastical significance	Sample size	Sample description
Reading Grades: Parent Report	Age 9 follow-up	High	0.05	p-value = 0.62	375 mothers	Denver Nurse Family Partnership (NFP) - Nurse vs. Control
Math Grades: Parent Report	Age 9 follow-up	High	0.11	p-value = 0.32	374 mothers	Denver Nurse Family Partnership (NFP) - Nurse vs. Control
Current grade placement	Age 9 follow-up	Moderate	0.06	p-value = 0.57	304 mothers	Denver Nurse Family Partnership (NFP) - Nurse vs. Control
Reading Grades: School Report	Age 9 follow-up	Moderate	0.03	p-value = 0.8	294 mothers	Denver Nurse Family Partnership (NFP) - Nurse vs. Control
Math Grades: Parent Report	Age 9 follow-up	Moderate	0.11	p-value = 0.32	374 mothers	Denver Nurse Family Partnership (NFP) - Nurse vs. Control
Math Grades: School Report	Age 9 follow-up	Moderate	0.12	p-value = 0.24	295 mothers	Denver Nurse Family Partnership (NFP) - Nurse vs. Control
Learning support services: hrs/week	Age 9 follow-up	Moderate	0.02	p-value = 0.83	294 mothers	Denver Nurse Family Partnership (NFP) - Nurse vs. Control
Times sent to Principal's office	Age 9 follow-up	Moderate	0.02	p-value = 0.85	308 mothers	Denver Nurse Family Partnership (NFP) - Nurse vs. Control
CBCL Internalizing - Dual Rater Clinical	Age 9 follow-up	Moderate	0.53	p-value = 0.1	302 mothers	Denver Nurse Family Partnership (NFP) - Nurse vs. Control
CBCL Externalizing - Dual Rater Clinical	Age 9 follow-up	Moderate	0.29	p-value = 0.26	303 mothers	Denver Nurse Family Partnership (NFP) - Nurse vs. Control
CBCL Total - Dual Rater Clinical	Age 9 follow-up	Moderate	0.18	p-value = 0.47	302 mothers	Denver Nurse Family Partnership (NFP) - Nurse vs. Control
ASPD Total Score - borderline/clinical	Age 9 follow-up	Moderate	0.26	p-value = 0.59	310 mothers	Denver Nurse Family Partnership (NFP) - Nurse vs. Control
Special Education school report	Age 9 follow-up	Moderate	0.17	p-value = 0.42	294 mothers	Denver Nurse Family Partnership (NFP) - Nurse vs. Control
Current grade placement	Age 9 follow-up	High	0.16	p-value = 0.13	321 mothers	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control
Reading Grades: Parent Report	Age 9 follow-up	High	0.07	p-value = 0.47	391 mothers	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control
Reading Grades: School Report	Age 9 follow-up	High	0.16	p-value = 0.14	307 mothers	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control
Math Grades: Parent Report	Age 9 follow-up	High	0.15	p-value = 0.16	391 mothers	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control
Math Grades: School Report	Age 9 follow-up	High	0.15	p-value = 0.15	305 mothers	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control
Learning support services: hrs/week	Age 9 follow-up	High	0.09	p-value = 0.4	309 mothers	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control
Times sent to Principal"s office	Age 9 follow-up	High	0.15	p-value = 0.18	326 mothers	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control
CBCL Internalizing - Dual Rater Clinical	Age 9 follow-up	High	0.03	p-value = 0.9	317 mothers	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control
CBCL Externalizing - Dual Rater Clinical	Age 9 follow-up	High	0.20	p-value = 0.33	320 mothers	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control
CBCL Total - Dual Rater Clinical	Age 9 follow-up	High	0.01	p-value = 0.94	317 mothers	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control
ASPD Total Score - borderline/clinical	Age 9 follow-up	High	0.37	p-value = 0.37	328 mothers	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control
Special Education school report	Age 9 follow-up	High	0.01	p-value = 0.98	308 mothers	Denver Nurse Family Partnership (NFP) - Paraprofessional vs. Control

Effect rating key

Favorable finding / Statistically significant

Unfavorable finding / Statistically significant

Ambiguous finding / Statistically significant

No effect / Not statistically significant

This study included participants with the following characteristics at enrollment:

Race/Ethnicity

The race and ethnicity categories may sum to more than 100 percent if Hispanic ethnicity was reported separately or respondents could select two or more race or ethnicity categories.

Black or African American

16%

Hispanic or Latino

45%

White

36%

Unknown

Maternal Education

Data not available

Other Characteristics

Data not available

This study included participants from the following locations:

Colorado

Manuscript Details

Source

Study Design

Findings that rate moderate or high in this manuscript

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