Study Details | Pathways to Work

101093-Study of Prenatal an

Study quality: High

High

Reason for the rating: This study received a high study quality rating because it is a randomized controlled trial with low attrition, suggesting the findings can be attributed to the program.

Program: Prenatal and Infancy Home Visiting by Nurses

Characteristics of study participants:

Parents

Services provided:

Case management, Job readiness, Personalized Assistance, Physical health services

Setting: Tested in multiple settings

Methods and Standards Protocol version used for review: Version 2.0

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Study design

Design:

Randomized controlled trial

Study group formation:

Eligible participants in Denver, Colorado completed baseline interviews. Their identifying information was sent to a data operations office where the information was entered into a computer program that randomized participants to the Prenatal and Infancy Home Visiting by Nurses program, to an alternative version of the home visiting program delivered by paraprofessionals, or to a usual services comparison group. This study focuses on participants assigned either to the program as delivered by nurses as the program group or to the usual services comparison group. A total of 490 participants were in this comparison, with 235 participants assigned to the program group and 255 participants assigned to the comparison group.

Time period of study:

The study ran from March 1994 through June 1997. Study enrollment occurred from March 1994 to June 1995. Data collection occurred from March 1994 through June 1997, with outcomes measured for a 48-month follow-up period after study enrollment.

Primary outcome domains examined:

Increase long-term employment, Decrease long-term benefit receipt

Other outcome domains examined:

Maternal education, maternal health, child well-being, child health

Study funded by:

The study was funded by the Colorado Trust, Grant Number 99030; the U.S. Department of Health and Human Services, Administration for Children and Families, Grant Number 90PD0232); and a National Institute of Mental Health Senior Research Scientist Award, Grant Number 1-K05-MH01382-01.

Results

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Outcome domain	Measure	Timing	Study quality by finding	Comparison group mean	Program group mean	Impact	Units	Sample size
Increase long-term employment	Number of months employed	Months 25 to 48	High	13.38	14.42	1.04	months	424
Decrease long-term benefit receipt	Number of months received AFDC	Months 25 to 48	High	2.10	1.88	-0.22	months	424
Decrease long-term benefit receipt	Number of months received food stamps	Months 25 to 48	High	3.98	4.32	0.34	months	424
Decrease long-term benefit receipt	Number of months received Medicaid	Months 25 to 48	High	6.98	7.34	0.36	months	424

Short-term outcomes are those measured 18 months or fewer after participants are first offered services. Long-term outcomes are those measured between 18 months and 5 years after participants are first offered services. Very long-term outcomes are those measured 5 years or more after participants are first offered services.

Means are not displayed when not reported or not aligned with the impact estimates. For example, if the impact estimate is regression-adjusted but only unadjusted means are reported in the study, the unadjusted means are not displayed as they are not aligned with the adjusted impact estimate.

Impact estimates are not shown when the estimate units cannot be converted to natural units.

Findings quality key:

High
Moderate

Study quality terms?

The findings quality describe our confidence that a given study’s finding is because of the program. We do not display findings that rate low.

Findings key:

A moderate-to-large favorable finding that is unlikely to be due to chance
A moderate-to-large favorable finding that might to be due to chance
A small favorable finding that is unlikely to be due to chance
A small favorable finding that might be due to chance
A favorable finding that is unlikely to be due to chance, but we cannot determine the standardized effect size
A favorable finding that might be due to chance, but we cannot determine the standardized effect size
A moderate-to-large unfavorable finding that is unlikely to be due to chance
A moderate-to-large unfavorable finding that might to be due to chance
A small unfavorable finding that is unlikely to be due to chance
A small unfavorable finding that might be due to chance
An unfavorable finding that is unlikely to be due to chance, but we cannot determine the standardized effect size
An unfavorable finding that might be due to chance, but we cannot determine the standardized effect size
A finding that is unlikely to be due to chance, but we cannot determine the standardized effect size or direction
A finding of no effect that might be due to chance

Favorable findings are impacts in a direction that is socially desirable. Statistical significance indicates the likelihood that a study finding is due to the program, rather than due to chance. Findings are described as moderate-to-large if the program produced a sufficiently large change in the outcome. An impact receives this designation if the standardized effect size is equal to or greater than 0.25 or equal to or less than -0.25.

Sample characteristics

The sample consisted of women with low income who were pregnant, had no previous live births, and either had no private insurance or qualified for Medicaid. Thirty-six percent of participants were White, not Hispanic; 15 percent were Black or African American, and 46 percent were another race.

Age

Mean age

20 years

Sex

Female

100%

Race and ethnicity

Black or African American	15%
White, not Hispanic	36%
Another race	46%
Unknown, not reported, or other	3%

The race and ethnicity categories may sum to more than 100 percent if the authors reported race and ethnicity separately; in these cases, we report the category White, rather than White, not Hispanic.

Family status

Parents

100%

Program implementation

Implementing organization:

Nurse-Family Partnership

Program history:

Prenatal and Infancy Home Visiting by Nurses was an existing home visiting program that has been implemented by Nurse-Family Partnership for over 30 years.

Program services:

The program group was offered home visiting by nurses prenatally up through the child's second birthday in addition to developmental screening and referral services. Services focused on improving maternal and fetal health, strengthening parental caregiving, and promoting work and continuing education and personal development and planning.

Mandatory services:

None

Comparison services:

The comparison group was offered developmental screening and referral services.

Service receipt duration:

The program was offered over a 30-month period from prenatal visits through the child's second birthday.

Program funding:

The study did not specify the source of program funding.

Study publications

Miller, Ted R., and Delia Hendrie (2015). Nurse Family Partnership: Comparing costs per family in randomized trials versus scale-up, Journal of Primary Prevention 36: 419-425. Available at: https://doi.org/10.1007/s10935-015-0406-3

Miller, Ted R., David Olds, Michael Knudtson, Dennis Luckey, Jessica Bondy, and Amanda Stevenson (2005). Return on investment: Nurse and paraprofessional home visitation, Denver. Final Grant Report 2005-MU-MU-0001. U.S. Department of Justice.

Olds, David L. (2002). Prenatal and infancy home visiting by nurses: From randomized trials to community replication, Prevention Science 3(3): 153-172. Available at: https://doi.org/10.1023/A:1019990432161

Olds, David L., JoAnn Robinson, Lisa Pettitt, Dennis W. Luckey, John Holmberg, Rosanna K. Ng, Kathy Isacks, Karen Sheff, and Charles R. Henderson, Jr. (2004). Effects of home visits by paraprofessionals and by nurses: Age 4 follow-up results of a randomized trial, Pediatrics 114: 1560-1568. Avaiable at: https://doi.org/10.1542/peds.2004-0961

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Pathways to Work refers to programs by the names used in study reports or manuscripts. Some program names may use language that is not consistent with our style guide, preferences, or the terminology we use to describe populations.

Study of Prenatal and Infancy Home Visiting by Nurses