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Olds, D. L., Kitzman, H., Cole, R., Robinson, J., Sidora, K., Luckey, D. W., et al. (2004). Effects of nurse home-visiting on maternal life course and child development: Age 6 follow-up results of a randomized trial. Pediatrics, 114(6), 1550–1559

Manuscript screening details
Screening decision Screening conclusion HomVEE procedures and standards version
Passes screens Eligible for review Version 1
Study design details
Rating Design Attrition Baseline equivalence Compromised randomization Confounding factors Valid, reliable measure(s)
High Randomized controlled trial Low Difference in SES, but controlled in analysis. None None Not assessed in manuscripts reviewed before 2021
Notes:

In 2020, HomVEE updated this review in two ways. First, HomVEE removed remove seven mother's partnership status/family structure findings from the Family Economic Self-Sufficiency domain because ACF determined that mother's partnership status is ineligible for review by HomVEE.  In addition, in the Child Development and School Readiness domain, the review was updated to clarify that the direction for "child attended Head Start, preschool, day care, or early intervention, age 24-54 months" is ambiguous, rather than favorable.  Second, HomVEE removed two partner SES variables from the Family Economic Self-Sufficiency domain because partner SES is not eligible for review unless the same SES variable is measured for the mother, and the partner is coresident with the mother.

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Except for the Achenbach Child Behavioral Problems Checklist, for which HomVEE calculated the effect size, the effect sizes in this table for Olds, Kitzman, Cole, Robinson, Sidora, Luckey, et al. (2004) are those reported in the study, and could not be confirmed by HomVEE calculations. The sample size was received through communication with the author.

Study characteristics
Study participants The sample included pregnant, first-time mothers who were less than 29 weeks pregnant. Women were recruited through an obstetrical clinic if they had no previous live births, no chronic illnesses linked to fetal growth retardation or preterm delivery, and at least two of the following sociodemographic characteristics: unmarried, less than 12 years of education, and unemployed. Between June 1990 and August 1991, 1,290 women were invited to participate and 1,139 consented and were randomly assigned. At enrollment, 92 percent of the women enrolled were African American, 98 percent were unmarried, and 64 percent were age 18 or younger. This study measured the sample when the children were 6 years old. The study sample included 641 women, 197 in the program group and 444 in the comparison group.
Setting Memphis, Tennessee
Intervention services The study included two treatment groups. The first treatment group received home visits from a nurse during pregnancy and two postpartum visits (one in the hospital prior to discharge and one in the home). The treatment group also received the screening and transportation services described below for the comparison groups. The second treatment group received the same services as the first treatment group, but the home visiting continued until the child was 2 years old. On average, the nurses completed 7 home visits during pregnancy and 26 home visits postpartum. Nurses used a detailed protocol for each visit, which focused on health-related behaviors, parenting, education, and employment. The two treatment groups were combined for the prenatal analysis. Only the second treatment group was followed for postnatal outcomes.
Comparison conditions The study included two comparison groups. The first comparison group received taxicab transportation for prenatal care appointments. The second comparison group received the transportation plus developmental screening and referral to services when the children were 6, 12, and 24 months old. The two comparison groups were combined for the prenatal analysis. Only the second group was followed for postnatal outcomes.
Subgroups examined This field lists subgroups examined in the manuscript (even if they were not replicated in other samples and not reported on the summary page for this model’s report).

• Mother has psychological vulnerability (yes or no)

Funding sources The Administration for Children and Families, Department of Health and Human Services (grant 90PD0215/01); the Hearst Foundation; the Robert Wood Johnson Foundation (grant 027901); and a Senior Research Scientist Award (1-K05-MH01382-01) to D.L.O.
Author affiliation David L. Olds, a study author, is a developer of this model.
Peer reviewed Peer reviewed status is not listed for manuscripts reviewed before 2021.

Findings that rate moderate or high

Child development and school readiness
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High CBCL (externalizing problems)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources – Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 335 children % (adjusted) = 22.00 Adjusted mean % = 24.00 OR = 0.87 HomVEE calculated = -0.09 Not statistically significant,
p = 0.63
High CBCL (internalizing problems)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources – Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 335 children % (adjusted) = 20.00 Adjusted mean % = 17.00 OR = 1.30 HomVEE calculated = 0.16 Not statistically significant,
p = 0.40
High CBCL (total problems, percentage)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources – Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 335 children Adjusted mean % = 3.70 Adjusted mean % = 6.60 Difference = -2.90 Study reported = -0.37 Not statistically significant,
p = 0.31
High HTC Rating Scale(academic engagement)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources – Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 335 children Adjusted mean = 4.74 Adjusted mean = 4.23 Mean difference = 0.51 Study reported = 0.02 Not statistically significant,
p = 0.86
High HTC Rating Scale(classroom social skills)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources – Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 335 children Adjusted mean = 24.54 Adjusted mean = 22.92 Mean difference = 1.62 Study reported = 0.14 Not statistically significant,
p = 0.27
High KABC arithmetic achievement
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources – Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 335 children Adjusted mean = 88.61 Adjusted mean = 85.42 Mean difference = 3.19 Study reported = 0.25 Statistically significant,
p = 0.04
High KABC mental processing composite (arithmetic and reading)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources – Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 335 children Adjusted mean = 90.49 Adjusted mean = 87.64 Mean difference = 2.85 Study reported = 0.25 Statistically significant,
p = 0.03
High KABC reading achievement
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources – Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 335 children Adjusted mean = 92.07 Adjusted mean = 90.87 Mean difference = 1.20 Study reported = 0.09 Not statistically significant,
p = 0.44
High MSSB (dysregulated aggression index)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources – Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 335 children Adjusted mean = 98.58 Adjusted mean = 101.10 Mean difference = -2.52 Study reported = -0.25 Statistically significant,
p = 0.04
High MSSB (percentage incoherent stories)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources – Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 335 children Adjusted mean = 20.90 Adjusted mean = 29.84 Mean difference = -8.94 Study reported = -0.34 Statistically significant,
p < 0.01
High MSSB (warmth/ empathy index)
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources – Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 335 children Adjusted mean = 100.30 Adjusted mean = 98.98 Mean difference = 1.32 Study reported = 0.13 Not statistically significant,
p = 0.27
High PPVT-III receptive vocabulary
FavorableUnfavorable or ambiguousNo Effect
Mothers with low psychological resources – Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 335 children Adjusted mean = 81.75 Adjusted mean = 79.08 Mean difference = 2.67 Study reported = 0.21 Not statistically significant,
p = 0.07
High CBCL (externalizing problems)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 615 children % (adjusted) = 17.40 Adjusted mean % = 20.20 OR = 0.83 HomVEE calculated = -0.11 Not statistically significant, p = 0.43
High CBCL (internalizing problems)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 615 children % (adjusted) = 12.60 Adjusted mean % = 14.70 OR = 0.84 HomVEE calculated = -0.11 Not statistically significant, p = 0.50
High CBCL (total problems)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 615 children % (adjusted) = 2.00 Adjusted mean % = 5.00 OR = 0.32 HomVEE calculated = -0.37 Statistically significant,
p = 0.04

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Statistical significance reported on authors’ calculations of the odds ratio.

High HTC Rating Scale (classroom social skills)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 615 children Adjusted mean = 24.93 Adjusted mean = 24.53 Mean difference = 0.40 Study reported = 0.03 Not statistically significant,
p = 0.71
High HTC Rating Scale(academic engagement)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 615 children Adjusted mean = 6.16 Adjusted mean = 6.86 Mean difference = -0.70 Study reported = -0.03 Not statistically significant,
p = 0.72
High KABC arithmetic achievement
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 615 children Adjusted mean = 89.75 Adjusted mean = 88.61 Mean difference = 1.14 Study reported = 0.09 Not statistically significant, p = 0.30
High KABC mental processing composite (arithmetic and reading)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 615 children Adjusted mean = 92.34 Adjusted mean = 90.24 Mean difference = 2.10 Study reported = 0.18 Statistically significant,
p = 0.03
High KABC reading achievement
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 615 children Adjusted mean = 93.79 Adjusted mean = 93.56 Mean difference = 0.23 Study reported = 0.02 Not statistically significant, p = 0.84
High MSSB (dysregulated aggression index)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 615 children Adjusted mean = 99.24 Adjusted mean = 100.26 Mean difference = -1.02 Study reported = -0.10 Not statistically significant,
p = 0.26
High MSSB (percentage incoherent stories)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 615 children Adjusted mean = 21.15 Adjusted mean = 25.22 Mean difference = -4.07 Study reported = -0.16 Not statistically significant,
p = 0.07
High MSSB (warmth/empathy index)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 615 children Adjusted mean = 100.86 Adjusted mean = 99.51 Mean difference = 1.35 Study reported = 0.14 Not statistically significant,
p = 0.13
High PPVT-III receptive vocabulary
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 615 children Adjusted mean = 84.32 Adjusted mean = 82.13 Mean difference = 2.19 Study reported = 0.17 Statistically significant,
p = 0.04
High Child attended Head Start, preschool, day care, or early intervention, age 24–54 months
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 641 mothers % (adjusted) = 82.00 Adjusted mean % = 75.00 OR = 1.53 HomVEE calculated = 0.26 Statistically significant,
p = 0.05

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Statistical significance reported on authors’ calculations of the odds ratio.

Child health
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High Subsequent NICU/special care admission (rate per subsequent birth)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 641 mothers % (adjusted) = 18.00 Adjusted mean % = 23.00 OR = -0.72 HomVEE calculated = -0.20 Not statistically significant,
p = 0.14

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Statistical significance reported on authors’ calculations of the odds ratio.

High Subsequent low birth weight newborn (rate per subsequent birth)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 641 mothers % (adjusted) = 11.00 Adjusted mean % = 16.00 OR = -0.69 HomVEE calculated = -0.22 Not statistically significant,
p = 0.16

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Statistical significance reported on authors’ calculations of the odds ratio.

Family economic self-sufficiency
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High SES of current job (mother)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 641 mothers Adjusted mean = 14.01 Adjusted mean = 13.06 Mean difference = 0.95 Study reported = 0.05 Not statistically significant, p = 0.56
High Months mother employed (54–72 months postpartum)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 641 mothers Adjusted mean = 9.96 Adjusted mean = 9.99 Mean difference = -0.03 Study reported = 0.00 Not statistically significant, p = 0.97
High Months of AFDC (54–72 months postpartum)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 641 mothers Adjusted mean = 7.21 Adjusted mean = 8.96 Mean difference = -1.75 Study reported = -0.22 Statistically significant, p = 0.01
High Months of food stamps (54–72 months postpartum)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 641 mothers Adjusted mean = 9.67 Adjusted mean = 11.50 Mean difference = -1.83 Study reported = -0.24 Statistically significant, p < 0.01
High Months of Medicaid, (54–72 months postpartum)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 641 mothers Adjusted mean = 11.98 Adjusted mean = 13.08 Mean difference = -1.10 Study reported = -0.15 Not statistically significant, p = 0.08
High Mother graduated from high school/earned GED (percentage)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 641 mothers % (adjusted) = 69.00 Adjusted mean % = 66.00 OR = 1.12 Study reported = 0.07 Not statistically significant,
p = 0.54

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Statistical significance reported on authors’ calculations of the odds ratio.

Maternal health
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High MHI
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 641 mothers Adjusted mean = 100.18 Adjusted mean = 99.92 Mean difference = 0.26 Study reported = 0.03 Not statistically significant,
p = 0.76
High Behavioral problems attributable to substance abuse
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 641 mothers % (adjusted) = 4.00 Adjusted mean % = 4.00 OR = 0.94 HomVEE calculated = -0.03 Not statistically significant,
p = 0.88

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Statistical significance reported on authors’ calculations of the odds ratio.

High Currently uses marijuana
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 641 mothers % (adjusted) = 5.00 Adjusted mean % = 3.00 OR = 1.37 HomVEE calculated = 0.19 Not statistically significant,
p = 0.47

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Statistical significance reported on authors’ calculations of the odds ratio.

High Moderate/heavy drinker (= 3 drinks = 3 times per month)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 641 mothers % (adjusted) = 5.00 Adjusted mean % = 3.00 OR = 2.03 HomVEE calculated = 0.44 Not statistically significant,
p = 0.11

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Statistical significance reported on authors’ calculations of the odds ratio.

High Months between births of first and second children
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 641 mothers Adjusted mean = 34.38 Adjusted mean = 30.23 Mean difference = 4.15 Study reported = 0.26 Statistically significant,
p = 0.01
High Number of subsequent children (birth to 72 months postpartum)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 641 mothers Adjusted mean = 1.08 Adjusted mean = 1.28 Mean difference = -0.20 Study reported = -0.22 Statistically significant,
p = 0.01
High Number of subsequent pregnancies (birth to 72 months postpartum)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 641 mothers Adjusted mean = 1.16 Adjusted mean = 1.38 Mean difference = -0.22 Study reported = -0.22 Statistically significant,
p = 0.01
High Pearlin Mastery Scale
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 641 mothers Adjusted mean = 100.46 Adjusted mean = 99.79 Mean difference = 0.67 Study reported = 0.07 Not statistically significant,
p = 0.43
High Subsequent abortion (rate per subsequent pregnancy)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 641 mothers % (adjusted) = 4.00 Adjusted mean % = 5.00 OR = 0.70 HomVEE calculated = -0.23 Not statistically significant,
p = 0.42

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Statistical significance reported on authors’ calculations of the odds ratio.

High Subsequent miscarriage (rate per subsequent pregnancy)
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 641 mothers % (adjusted) = 3.00 Adjusted mean % = 5.00 OR = 0.75 HomVEE calculated = -0.27 Not statistically significant,
p = 0.50

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Statistical significance reported on authors’ calculations of the odds ratio.

Reductions in juvenile delinquency, family violence, and crime
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High Any domestic violence, birth to age 6
FavorableUnfavorable or ambiguousNo Effect
Nurse visited during pregnancy + infancy and developmental screening comparison (Memphis) 6-year follow-up 641 mothers % (adjusted) = 39.00 Adjusted mean % = 40.00 OR = 0.97 Study reported = -0.02 Not statistically significant,
p = 0.87

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Statistical significance reported on authors’ calculations of the odds ratio.