Black or African American
93%
Source
Peer reviewed?
Yes
Kitzman, H., Olds, D. L., Knudtson, M. D., Cole, R., Anson, E., Smith, J. A., Fishbein, D., DiClemente, R., Wingood, G., Caliendo, A. M., Hopfer, C., Miller, T., & Conti, G. (2019). Prenatal and/or infancy nurse home visiting and 18-year outcomes of a randomized trial. Pediatrics, 144(6). https://doi.org/10.1542/peds.2018-3876
Model(s) Reviewed
Study Registration
Funding Sources
This research was supported by Award Number R01DA021624 from the National Institutes of Health.
Study Design
| Design | Attrition | Baseline equivalence | Confounding factors | Valid, reliable measures? |
|---|---|---|---|---|
| Randomized controlled trial | Low | Not assessed for randomized controlled trials with low attrition |
No |
Yes |
Notes
Findings on mother’s partnership status and costs for public benefits were ineligible for review because they are not in one of HomVEE's eligible outcome domains. Findings for mother’s Social Security Administration earnings when children were 12 months to 16 years of age were not eligible for review because findings at each follow-up time were not available for review, as required by HomVEE standards. Findings for maternal substance abuse received an indeterminate rating because HomVEE could not confirm the reliability of the measure. Information on sample sizes, reliability and validity of measures, and means and standard deviations for the impact estimates is based on correspondence with the authors.
Study Participants
Participants were recruited from an obstetric and pediatric care clinic in Memphis, Tennessee. To be eligible, participants had to be pregnant (< 29 weeks’ gestation), have no previous live births, and have at least two sociodemographic risk factors (unmarried, no high school diploma, or unemployed). They were randomly assigned to either the Nurse-Family Partnership intervention (228 participants) or the comparison condition (514 participants). Six hundred and eighteen mothers were included in the analyses in this manuscript (192 in the intervention group and 426 in the comparison group). Participants were in the study from the time of enrollment at pregnancy until the child was 24 months old. Selected outcomes collected from administrative records were obtained every year from baseline until the 18-year follow-up. All other outcomes were measured at the 18-year follow-up. In the study, 92 percent of the participants were African American; at enrollment, 98 percent were unmarried, 64 percent were younger than 18 years of age, and 85 percent were from households with incomes below the federal poverty guidelines.
Setting
The study took place in Memphis, Tennessee.
Home Visiting Services
As described in this manuscript, the Nurse-Family Partnership intervention consisted of prenatal and infancy home visits until the focal child was 24 months old. Participants also received free transportation for scheduled prenatal care. Children received developmental screening and referral at ages 6, 12, and 24 months. All participants received four weekly home visits at the beginning of the intervention to establish a relationship with the nurse. The initial visits focused on mothers’ aspirations, concerns about their prenatal health, the developing fetus, birth, and the challenges of caring for a newborn. To address individual needs revealed in the visits, nurses used their clinical judgment to adjust the dosage and content of the visit, and used telephone communications when in-person visits were not possible. Nurses completed an average of seven home visits during pregnancy and 26 visits during the first two years postpartum. All visits took place in the families’ homes.
Comparison Conditions
Participants assigned to the comparison condition were not eligible to receive home visits through Nurse-Family Partnership. They received free transportation for scheduled prenatal care. The children in the study received developmental screening and referral at ages 6, 12, and 24 months.
Were any subgroups examined?
Yes
Subgroups examined
• Mother has psychological vulnerability (yes or no) • Child gender (boy or girl)
Study Participants
Participants were recruited from an obstetric and pediatric care clinic in Memphis, Tennessee. To be eligible, participants had to be pregnant (< 29 weeks’ gestation), have no previous live births, and have at least two sociodemographic risk factors (unmarried, no high school diploma, or unemployed). They were randomly assigned to either the Nurse-Family Partnership intervention (228 participants) or the comparison condition (514 participants). Six hundred and eighteen mothers were included in the analyses in this manuscript (192 in the intervention group and 426 in the comparison group). Participants were in the study from the time of enrollment at pregnancy until the child was 24 months old. Selected outcomes collected from administrative records were obtained every year from baseline until the 18-year follow-up. All other outcomes were measured at the 18-year follow-up. In the study, 92 percent of the participants were African American; at enrollment, 98 percent were unmarried, 64 percent were younger than 18 years of age, and 85 percent were from households with incomes below the federal poverty guidelines.
Setting
The study took place in Memphis, Tennessee.
Home Visiting Services
As described in this manuscript, the Nurse-Family Partnership intervention consisted of prenatal and infancy home visits until the focal child was 24 months old. Participants also received free transportation for scheduled prenatal care. Children received developmental screening and referral at ages 6, 12, and 24 months. All participants received four weekly home visits at the beginning of the intervention to establish a relationship with the nurse. The initial visits focused on mothers’ aspirations, concerns about their prenatal health, the developing fetus, birth, and the challenges of caring for a newborn. To address individual needs revealed in the visits, nurses used their clinical judgment to adjust the dosage and content of the visit, and used telephone communications when in-person visits were not possible. Nurses completed an average of seven home visits during pregnancy and 26 visits during the first two years postpartum. All visits took place in the families’ homes.
Comparison Conditions
Participants assigned to the comparison condition were not eligible to receive home visits through Nurse-Family Partnership. They received free transportation for scheduled prenatal care. The children in the study received developmental screening and referral at ages 6, 12, and 24 months.
Were any subgroups examined?
Yes
Subgroups examined
• Mother has psychological vulnerability (yes or no) • Child gender (boy or girl)
Findings that rate moderate or high in this manuscript
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Peabody Picture Vocabulary Test III (PPVT-III), Receptive language |
6 years |
High | 0.09 | Not statistically significant, p = 0.31 |
612 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014, full sample |
||
Peabody Picture Vocabulary Test III (PPVT-III), Receptive language |
18 years |
High | 0.05 | Not statistically significant, p= 0.55 |
621 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014, full sample |
||
Peabody Picture Vocabulary Test III (PPVT-III), Receptive language |
6 years |
High | 0.13 | Not statistically significant, p = 0.28 |
323 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014; Subgroup: Mother has psychological vulnerability |
||
Peabody Picture Vocabulary Test III (PPVT-III), Receptive language |
18 years |
High | 0.24 | Statistically significant, p= 0.05 |
331 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014; Subgroup: Mother has psychological vulnerability |
||
Facial Emotion Recognition Task, Emotion recognition |
18 years |
High | 0.14 | Not statistically significant, p= 0.08 |
617 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014, full sample |
||
Facial Emotion Recognition Task, Emotion recognition |
18 years |
High | 0.22 | Statistically significant, p= 0.04 |
329 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014; Subgroup: Mother has psychological vulnerability |
||
Graduated from high school |
18 years |
High | 0.12 | Not statistically significant, p= 0.35 |
619 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014, full sample |
||
Graduated from high school |
18 years |
High | 0.04 | Not statistically significant, p= 0.83 |
333 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014; Subgroup: Mother has psychological vulnerability |
||
Graduated with honors |
18 years |
High | 0.46 | Statistically significant, p= 0.03 |
619 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014, full sample |
||
Graduated with honors |
18 years |
High | 0.73 | Statistically significant, p= 0.02 |
333 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014; Subgroup: Mother has psychological vulnerability |
||
Current drug use in the past month or positive lab test result |
18 years |
High | 0.06 | Not statistically significant, p= 0.55 |
613 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014, full sample |
||
Time to first pregnancy |
18 years |
High | 0.86 | Not statistically significant, p= 0.57 |
305 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014; Subgroup: Child gender (boys) |
||
Time to first pregnancy |
18 years |
High | 0.85 | Not statistically significant, p= 0.46 |
324 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014; Subgroup: Child gender (girls) |
||
Time to first live birth |
18 years |
High | 1.20 | Not statistically significant, p= 0.62 |
305 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014; Subgroup: Child gender (boys) |
||
Time to first live birth |
18 years |
High | 0.80 | Not statistically significant, p= 0.44 |
324 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014; Subgroup: Child gender (girls) |
||
Any positive STI laboratory test result |
18 years |
High | 0.03 | Not statistically significant, p= 0.89 |
286 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014; Subgroup: Child gender (boys) |
||
Any positive STI laboratory test result |
18 years |
High | 0.09 | Not statistically significant, p= 0.60 |
319 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014; Subgroup: Child gender (girls) |
||
HIV risk |
18 years |
High | 0.08 | Not statistically significant, p= 0.38 |
604 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014, full sample |
||
Achenbach System of Empirically Based Assessment (ASEBA), Internalizing Behavior Problems (borderline or clinical threshold) |
6 years |
High | 0.08 | Not statistically significant, p = 0.62 |
618 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014, full sample |
||
Achenbach System of Empirically Based Assessment (ASEBA), Internalizing Behavior Problems (borderline or clinical threshold) |
12 years |
High | 0.21 | Not statistically significant, p = 0.09 |
577 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014, full sample |
||
Achenbach System of Empirically Based Assessment (ASEBA), Internalizing Behavior Problems (borderline or clinical threshold) |
18 years |
High | 0.05 | Not statistically significant, p= 0.73 |
625 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014, full sample |
||
Achenbach System of Empirically Based Assessment (ASEBA) Externalizing Behavior Problems, borderline or clinical threshold |
6 years |
High | 0.09 | Not statistically significant, p = 0.51 |
620 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014, full sample |
||
Achenbach System of Empirically Based Assessment (ASEBA), Externalizing Behavior Problems (borderline or clinical threshold) |
12 years |
High | 0.09 | Not statistically significant, p = 0.50 |
574 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014, full sample |
||
Achenbach System of Empirically Based Assessment (ASEBA), Externalizing Behavior Problems (borderline or clinical threshold) |
18 years |
High | 0.07 | Not statistically significant, p= 0.72 |
611 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014, full sample |
||
Achenbach System of Empirically Based Assessment (ASEBA), Total Behavior Problems (borderline or clinical threshold) |
6 years |
High | 0.48 | Not statistically significant, p = 0.11 |
616 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014, full sample |
||
Achenbach System of Empirically Based Assessment (ASEBA), Total Behavior Problems (borderline or clinical threshold) |
12 years |
High | 0.13 | Not statistically significant, p = 0.31 |
575 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014, full sample |
||
Achenbach System of Empirically Based Assessment (ASEBA), Total Behavior Problems (borderline or clinical threshold) |
18 years |
High | 0.28 | Not statistically significant, p= 0.22 |
611 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014, full sample |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Supplemental Security Income, disability enrollment |
18 years |
High | 0.33 | Not statistically significant, p= 0.19 |
619 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014, full sample |
||
Supplemental Security Income, disability enrollment |
18 years |
High | 0.67 | Statistically significant, p= 0.01 |
330 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014; Subgroup: Mother has psychological vulnerability |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Number of arrests |
18 years |
High | 1.02 | Not statistically significant, p= 0.93 |
629 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014, full sample |
||
Number of arrests |
18 years |
High | 0.84 | Not statistically significant, p= 0.65 |
324 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014; Subgroup: Mother has psychological vulnerability |
||
Number of convictions |
18 years |
High | 0.86 | Not statistically significant, p= 0.59 |
629 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014, full sample |
||
Number of convictions |
18 years |
High | 0.47 | Not statistically significant, p= 0.08 |
324 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014; Subgroup: Mother has psychological vulnerability |
||
Number of interpersonal violence arrests |
18 years |
High | 1.39 | Not statistically significant, p= 0.32 |
629 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014, full sample |
||
Number of interpersonal violence arrests |
18 years |
High | 1.48 | Not statistically significant, p= 0.42 |
324 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014; Subgroup: Child gender (girls) |
||
Number of interpersonal violence convictions |
18 years |
High | 1.33 | Not statistically significant, p= 0.43 |
629 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014, full sample |
||
Number of interpersonal violence convictions |
18 years |
High | 0.81 | Not statistically significant, p= 0.69 |
324 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014; Subgroup: Child gender (girls) |
||
Ever in a gang |
18 years |
High | 0.18 | Not statistically significant, p= 0.27 |
625 children | NFP vs. Resource referral RCT, Memphis TN, 1990-2014, full sample |
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