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Section D
The Nurse-Family Partnership
Nurse-Family Partnership
Source: http://www.nursefamilypartnership.org/
3
Trials of Program
4
Three Goals
1.  Improve pregnancy outcomes
2.  Improve child health and development
3.  Improve parents’ economic self-sufficiency
5
The Nurse Home Visit Program (D. Olds)

Targeted low-income, unwed pregnant women

Randomized controlled study with four arms

Screenings for children at 12 and 24 months

Screenings plus free child care through 24 months

Same as 2-plus home visits prenatally

Same as 3-plus home visits through 24 months
6
Nurse Activities

Form a relationship with parents by reinforcing their strengths

Help women improve their health behaviors

Promote effective and responsible care of children

Help parents plan future pregnancies, complete their educations,
and find work
7
Enduring Effects on Low-Income, Unmarried Mothers

Enduring effects on low-income, unmarried mothers’ behavior:
Elmira 15-year follow-up
-  79% fewer verified reports of child abuse and neglect
-  32% fewer subsequent births
-  30 fewer months of welfare use
-  44% fewer behavioral problems due to alcohol and drug abuse
-  69% fewer arrests
-  Less utilization of emergency department
Source: Olds, D., Eckenrode, J., Henderson, Jr., C., et al. (1997). Long-term effects of home visitation on maternal
life course and child abuse and neglect: 15-year follow-up of a randomized trial. JAMA, 278, 637–643.
8
Nurse Home Visitation and Child Maltreatment

How does nurse home visitation prevent child maltreatment?
Fewer children
and closely
spaced births
Less child
maltreatment
over 15 years
Home
visiting
Less welfare
use
9
Enduring Effects on High-Risk Adolescents

Enduring effects on high-risk adolescents’ behavior: Elmira 15-year
follow-up
-  54% fewer arrests
-  69% fewer convictions
-  58% fewer sexual partners
-  28% fewer cigarettes smoked
-  51% fewer days consuming alcohol
Source: Olds D., Henderson, C.R., Jr., Cole, R., et al. (1998). Long-term effects of nurse home visitation on
children’s criminal and antisocial behavior: 15-year follow-up of a randomized trial. JAMA, 280, 1238–1244.
10
Elmira 19-Year Child Follow-up

310 adolescents were interviewed (88% of available participants)

Data was collected on education, employment, substance use,
sexual behaviors, childbearing history, and criminal offending

52% were female; 78% were Caucasian

The average age of the respondents was 19.64 (SD = .57)
11
Cumulative Cost Savings: Elmira Home Visits

Cumulative cost savings: Elmira home visits (high-risk families)
Source: Karoly, L. A., Everingham, S. S., Hoube, J., et al. (1997). Benefits and costs of earlychildhood interventions: A documented briefing. Santa Monica, California: RAND.
12
Sources of Savings: Elmira Home Visits

Sources of savings: Elmira home visits (high-risk families)
13