Manuscript Details

Olds, D. L., Kitzman, H., Anson, E., Smith, J. A., Knudtson, M. D., Miller, T., Cole, R., Hopfer, C., & Conti, G. (2019). Prenatal and infancy nurse home visiting effects on mothers: 18-year follow-up of a randomized trial. Pediatrics, 144(6), 12. https://doi.org/10.1542/peds.2018-3889

Peer Reviewed

High rating
Study reviewed under: Handbook of Procedures and Standards, Version 2
Study design characteristics contributing to rating
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 from the review of this manuscript

Findings for math achievement measured at ages 6, 12, and 18 received a low rating because they did not meet the HomVEE reliability standards. Findings for nonverbal intelligence measured at ages 6 and 18, sustained attention measured at ages 12 and 18, working memory measured at age 18, risky decision making measured at age 18, and time to substance use disorder measured at age 18 received an indeterminate rating because HomVEE could not confirm the reliability of the measures. Information on sample sizes, reliability and validity of measures, and proportions for the impact estimates is based on correspondence with the authors.

Family Economic Self-Sufficiency
Outcome Measure Timing of Follow-Up Rating Direction of Effect Effect Size (Absolute Value) Stastical Significance Sample Size Sample Description
AFDC and TANF - Number of months using the service/benefit 1 year High
0.09 Not statistically significant, p = 0.28 667 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
AFDC and TANF - Number of months using the service/benefit 2 years High
0.16 Not statistically significant, p = 0.06 667 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
AFDC and TANF - Number of months using the service/benefit 3 years High
0.08 Not statistically significant, p = 0.35 667 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
AFDC and TANF - Number of months using the service/benefit 4 years High
0.27 Statistically significant, p = 0.00 667 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
AFDC and TANF - Number of months using the service/benefit 5 years High
0.03 Not statistically significant, p = 0.71 622 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
AFDC and TANF - Number of months using the service/benefit 6 years High
0.09 Not statistically significant, p = 0.31 641 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
AFDC and TANF - Number of months using the service/benefit 7 years High
0.05 Not statistically significant, p = 0.60 636 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
AFDC and TANF - Number of months using the service/benefit 8 years High
0.02 Not statistically significant, p = 0.84 636 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
AFDC and TANF - Number of months using the service/benefit 9 years High
0.02 Not statistically significant, p = 0.86 636 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
AFDC and TANF - Number of months using the service/benefit 10 years High
0.07 Not statistically significant, p = 0.38 636 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
AFDC and TANF - Number of months using the service/benefit 11 years High
0.05 Not statistically significant, p = 0.55 636 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
AFDC and TANF - Number of months using the service/benefit 12 years High
0.05 Not statistically significant, p = 0.54 636 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
AFDC and TANF - Number of months using the service/benefit 13 years High
0.05 Not statistically significant, p = 0.59 636 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
AFDC and TANF - Number of months using the service/benefit 14 years High
0.01 Not statistically significant, p = 0.95 636 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
AFDC and TANF - Number of months using the service/benefit 15 years High
0.16 Not statistically significant, p = 0.07 636 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
AFDC and TANF - Number of months using the service/benefit 16 years High
0.07 Not statistically significant, p = 0.40 629 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
AFDC and TANF - Number of months using the service/benefit 17 years High
0.05 Not statistically significant, p = 0.53 606 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
AFDC and TANF - Number of months using the service/benefit 18 years High
0.01 Not statistically significant, p = 0.87 601 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Medicaid - Number of months using the service/benefit 1 year High
0.12 Not statistically significant, p = 0.15 643 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Medicaid - Number of months using the service/benefit 2 years High
0.11 Not statistically significant, p = 0.21 643 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Medicaid - Number of months using the service/benefit 3 years High
0.05 Not statistically significant, p = 0.53 643 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Medicaid - Number of months using the service/benefit 4 years High
0.18 Statistically significant, p = 0.04 643 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Medicaid - Number of months using the service/benefit 5 years High
0.22 Statistically significant, p = 0.01 619 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Medicaid - Number of months using the service/benefit 6 years High
0.12 Not statistically significant, p = 0.14 641 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Medicaid - Number of months using the service/benefit 7 years High
0.06 Not statistically significant, p = 0.50 634 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Medicaid - Number of months using the service/benefit 8 years High
0.05 Not statistically significant, p = 0.56 634 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Medicaid - Number of months using the service/benefit 9 years High
0.02 Not statistically significant, p = 0.80 634 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Medicaid - Number of months using the service/benefit 10 years High
0.10 Not statistically significant, p = 0.26 634 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Medicaid - Number of months using the service/benefit 11 years High
0.14 Not statistically significant, p = 0.10 634 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Medicaid - Number of months using the service/benefit 12 years High
0.01 Not statistically significant, p = 0.88 634 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Medicaid - Number of months using the service/benefit 13 years High
0.04 Not statistically significant, p = 0.64 634 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Medicaid - Number of months using the service/benefit 14 years High
0.03 Not statistically significant, p = 0.72 634 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Medicaid - Number of months using the service/benefit 15 years High
0.07 Not statistically significant, p = 0.43 628 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Medicaid - Number of months using the service/benefit 16 years High
0.06 Not statistically significant, p = 0.52 608 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Medicaid - Number of months using the service/benefit 17 years High
0.02 Not statistically significant, p = 0.83 603 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Medicaid - Number of months using the service/benefit 18 years High
0.08 Not statistically significant, p = 0.34 603 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Months mother worked per year 2 years High
0.06 Not statistically significant, p = 0.46 641 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Months mother worked per year 4.5 years High
0.11 Not statistically significant, p = 0.19 646 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Months mother worked per year 6 years High
0.01 Not statistically significant, p = 0.89 649 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Months mother worked per year 9 years High
0.14 Not statistically significant, p = 0.11 640 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Months mother worked per year 12 years High
0.14 Not statistically significant, p = 0.11 642 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Months mother worked per year 18 years High
0.07 Not statistically significant, p = 0.43 618 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Months mother's current spouse employed 18 years High
0.22 Statistically significant, p= 0.01 604 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Supplemental NutritionAssistance Program (SNAP) - Number of months using the service/benefit 1 year High
0.01 Not statistically significant, p = 0.88 643 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Supplemental NutritionAssistance Program (SNAP) - Number of months using the service/benefit 2 years High
0.12 Not statistically significant, p = 0.16 643 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Supplemental NutritionAssistance Program (SNAP) - Number of months using the service/benefit 3 years High
0.03 Not statistically significant, p = 0.69 643 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Supplemental NutritionAssistance Program (SNAP) - Number of months using the service/benefit 4 years High
0.17 Statistically significant, p < 0.05 643 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Supplemental NutritionAssistance Program (SNAP) - Number of months using the service/benefit 5 years High
0.19 Statistically significant, p = 0.03 619 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Supplemental NutritionAssistance Program (SNAP) - Number of months using the service/benefit 6 years High
0.16 Not statistically significant, p = 0.07 641 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Supplemental NutritionAssistance Program (SNAP) - Number of months using the service/benefit 7 years High
0.13 Not statistically significant, p = 0.13 636 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Supplemental NutritionAssistance Program (SNAP) - Number of months using the service/benefit 8 years High
0.12 Not statistically significant, p = 0.15 636 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Supplemental NutritionAssistance Program (SNAP) - Number of months using the service/benefit 9 years High
0.10 Not statistically significant, p = 0.25 636 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Supplemental NutritionAssistance Program (SNAP) - Number of months using the service/benefit 10 years High
0.21 Statistically significant, p = 0.01 636 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Supplemental NutritionAssistance Program (SNAP) - Number of months using the service/benefit 11 years High
0.19 Statistically significant, p = 0.03 636 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Supplemental NutritionAssistance Program (SNAP) - Number of months using the service/benefit 12 years High
0.06 Not statistically significant, p = 0.48 636 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Supplemental NutritionAssistance Program (SNAP) - Number of months using the service/benefit 13 years High
0.07 Not statistically significant, p = 0.43 636 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Supplemental NutritionAssistance Program (SNAP) - Number of months using the service/benefit 14 years High
0.04 Not statistically significant, p = 0.61 636 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Supplemental NutritionAssistance Program (SNAP) - Number of months using the service/benefit 15 years High
0.05 Not statistically significant, p = 0.55 636 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Supplemental NutritionAssistance Program (SNAP) - Number of months using the service/benefit 16 years High
0.01 Not statistically significant, p = 0.94 629 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Supplemental NutritionAssistance Program (SNAP) - Number of months using the service/benefit 17 years High
0.03 Not statistically significant, p = 0.71 606 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Supplemental NutritionAssistance Program (SNAP) - Number of months using the service/benefit 18 years High
0.04 Not statistically significant, p = 0.67 601 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Effect rating key
Favorable finding / Statistically significant
Unfavorable finding / Statistically significant
Ambiguous finding / Statistically significant
No effect / Not statistically significant
Maternal Health
Outcome Measure Timing of Follow-Up Rating Direction of Effect Effect Size (Absolute Value) Stastical Significance Sample Size Sample Description
Beck Anxiety Screening Inventory, clinical or borderline threshold 18 years High
0.04 Not statistically significant, p= 0.82 617 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Beck Depression Screening Inventory, Maternal depression, clinical or borderline threshold 18 years High
0.07 Not statistically significant, p= 0.72 617 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Drug Use Screening Inventory (DUSI), current substance use 18 years High
0.08 Not statistically significant, p= 0.49 617 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Mothers' subsequent births 1 year High
0.30 Statistically significant, p = 0.00 694 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Mothers' subsequent births 2 years High
0.25 Statistically significant, p = 0.00 686 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Mothers' subsequent births 3 years High
0.25 Statistically significant, p = 0.00 681 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Mothers' subsequent births 4 years High
0.24 Statistically significant, p = 0.00 681 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Mothers' subsequent births 5 years High
0.22 Statistically significant, p = 0.01 670 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Mothers' subsequent births 6 years High
0.17 Statistically significant, p < 0.05 668 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Mothers' subsequent births 7 years High
0.15 Not statistically significant, p = 0.08 660 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Mothers' subsequent births 8 years High
0.12 Not statistically significant, p = 0.17 658 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Mothers' subsequent births 9 years High
0.08 Not statistically significant, p = 0.32 658 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Mothers' subsequent births 10 years High
0.05 Not statistically significant, p = 0.58 645 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Mothers' subsequent births 11 years High
0.05 Not statistically significant, p = 0.54 643 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Mothers' subsequent births 12 years High
0.04 Not statistically significant, p = 0.62 643 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Mothers' subsequent births 13 years High
0.04 Not statistically significant, p = 0.64 629 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Mothers' subsequent births 14 years High
0.04 Not statistically significant, p = 0.65 618 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Mothers' subsequent births 15 years High
0.04 Not statistically significant, p = 0.66 618 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Mothers' subsequent births 16 years High
0.04 Not statistically significant, p = 0.67 618 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Mothers' subsequent births 17 years High
0.05 Not statistically significant, p = 0.57 618 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Mothers' subsequent births 18 years High
0.05 Not statistically significant, p = 0.54 574 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Pearlin Mastery Scale 36th week of pregnancy High
0.14 Not statistically significant, p = 0.09 657 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Pearlin Mastery Scale 6 months High
0.07 Not statistically significant, p = 0.44 666 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Pearlin Mastery Scale 2 years High
0.19 Statistically significant, p = 0.03 670 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Pearlin Mastery Scale 6 years High
0.04 Not statistically significant, p = 0.65 635 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Pearlin Mastery Scale 9 years High
0.05 Not statistically significant, p = 0.53 625 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Pearlin Mastery Scale 12 years High
0.09 Not statistically significant, p = 0.32 582 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
Pearlin Mastery Scale 18 years High
1.98 Not statistically significant, p= 0.19 616 mothers NFP vs. Resource referral RCT, Memphis TN, 1990-2015, full sample
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
92%
Unknown
8%

Maternal Education

Data not available

Other Characteristics

Data not available

This study included participants from the following locations:

  • Tennessee
Study Participants

Participants were recruited from an obstetric and pediatric care clinic in Memphis, Tennessee. To be eligible, the 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 randomized to either the Nurse-Family Partnership intervention (228 participants) or the comparison condition (514 participants). Children born to the participants who were randomized were included in the analyses in this manuscript (194 youth born to mothers in the intervention group and 435 youth born to mothers in the comparison group). Participants were in the study from the time of enrollment during pregnancy until the focal child was 24 months old. Outcomes were measured when youth were ages 6, 12, and 18. 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 guideline.

Setting

The study took place in Memphis, Tennessee.

Intervention condition
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.

Subgroups examined

• Mother has high psychological resources (yes or no)

Author Affiliation

The study authors are affiliated with the University of Rochester, University of Colorado Anschutz Medical Campus, Pennsylvania State University, New York University, Columbia University, Brown University, Curtin University, and University College London. David Olds, one of the authors of the manuscript, is a developer of the Nurse-Family Partnership home visiting model.

Funding Sources

This research was supported by Award Number R01DA021624 from the National Institutes of Health.