Black or African American
92%
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
Model(s): Nurse-Family Partnership (NFP)®
Study Registration: ClinicalTrials.gov
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 |
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 |
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
Note: Navigate to the model page for more information about the home visiting model. See the source manuscript for more information about how the model was implemented in this study.
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)
Funding Sources
This research was supported by Award Number R01DA021624 from the National Institutes of Health.
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.