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Projected Outcomes of Nurse-Family Partnership Home Visitation During 1996–2013, USA

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Abstract

Nurse-Family Partnership (NFP) targets intensive prenatal and postnatal home visitation by registered nurses to low-income first-time mothers. Through 2013, 177,517 pregnant women enrolled in NFP programs. This article projects how NFP will affect their lives and the lives of their babies. NFP has been evaluated in six randomized trials and several more limited analyses of operational programs. We systematically reviewed evaluation findings on 21 outcomes and calculated effects on three more. We added outcome data from the NFP national data system and personal communications that filled outcome data gaps on some trials. We assumed effectiveness in replication declined by 21.8 %, proportionally with the decline in mean visits per family from trials to operational programs. By 2031, NFP program enrollments in 1996–2013 will prevent an estimated 500 infant deaths, 10,000 preterm births, 13,000 dangerous closely spaced second births, 4700 abortions, 42,000 child maltreatment incidents, 36,000 intimate partner violence incidents, 90,000 violent crimes by youth, 594,000 property and public order crimes (e.g., vandalism, loitering) by youth, 36,000 youth arrests, and 41,000 person-years of youth substance abuse. They will reduce smoking during pregnancy, pregnancy complications, childhood injuries, and use of subsidized child care; improve language development; increase breast-feeding; and raise compliance with immunization schedules. They will eliminate the need for 4.8 million person-months of child Medicaid spending and reduce estimated spending on Medicaid, TANF, and food stamps by $3.0 billion (present values in 2010 dollars). By comparison, NFP cost roughly $1.6 billion. Thus, NFP appears to be a sound investment. It saves money while enriching the lives of participating low-income mothers and their offspring and benefiting society more broadly by reducing crime and safety net demand.

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References

  • Allen, S., Blum, D. P., Gabbe, S. G., Von Zychin, C., Brooks, P., Brown, M., O’Grady, J., & Long, T. (2010). Better beginnings: 2009 annual report. Columbus: Better Birth Outcomes.

    Google Scholar 

  • Bushery, J. (1981). Recall bias for different reference periods in the National Crime Survey. 1981 Proceedings of the Section on Survey Research Methods, American Statistical Association, 238–243.

  • Carabin, H., Cowan, L. D., Beebe, L. A., Skaggs, V. J., Thompson, D., & Agbangla, C. (2005). Does participation in a nurse visitation programme reduce the frequency of adverse perinatal outcomes in first-time mothers? Paediatric Perinatal Epidemiology, 19, 194–205.

    Article  PubMed  Google Scholar 

  • Corso, P. C., Finkelstein, E., Miller, T. R., Fiebelkorn, I. A., & Zaloshnja, E. (2006). Incidence and lifetime costs of injuries in the United States. Injury Prevention, 12, 212–218.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Cox, M. (2006). An analysis of deaths among infants and children born into the Children First program, 1997–2004. Oklahoma City: Children First.

    Google Scholar 

  • Donovan, E. F., Ammerman, R. T., Besl, J., Atherton, H., Khoury, J. C., Altaye, M., Putnam, F. W., & Van Ginkel, J. B. (2007). Intensive home visiting is associated with decreased risk of infant death. Pediatrics, 119, 1145–1151.

    Article  PubMed  Google Scholar 

  • Eckenrode, J., Ganzel, B., Henderson, C., Smith, E., Olds, D., Powers, J., Cole, R., Kitzman, H., & Sidora, K. (2000). Preventing child abuse and neglect with a program of nurse home visitation: The limiting effects of domestic violence. Journal American Medical Association, 284, 1385–1391.

    Article  CAS  Google Scholar 

  • Eckenrode, J., Campa, M., Luckey, D. W., Henderson, C. R., Jr., Cole, R., Kitzman, H., Anson, E., Sidora-Arcoleo, K., Powers, J., & Olds, D. (2010). Long-term effects of prenatal and infancy nurse home visitation on the life course of youths: 19-year follow-up of a randomized trial. Archives of Pediatric & Adolescent Medicine, 164, 9–15.

    Article  Google Scholar 

  • Glazner, J., Bondy, J., Luckey, D., & Olds, D. (2004). Final report to the Administration for Children and Families: Effect of the nurse family partnership on government expenditures for vulnerable first-time mothers and their children in Elmira, New York, Memphis, Tennessee, and Denver, Colorado Washington, DC: Administration for Children and Families, Office of Planning, Research and Evaluation.

  • Henry J Kaiser Family Foundation. (2014). Medicaid payments per enrollee, FY 2010. Retrieved July, 2014, from http://kff.org/medicaid/state-indicator/medicaid-payments-per-enrollee/.

  • Ikramullah, E., Barry, M., Manlove, J., & Moore, K. A. (2011). Facts at a glance: A fact sheet reporting national, state, and city trends in teen child-bearing. Washington, DC: Child Trends.

    Google Scholar 

  • Ingoldsby, E. M., Baca, P., McClatchey, M. W., Luckey, D. W., Ramsey, M. O., Loch, J. M., Lewis, J., Blackaby, T. S., Petrini, M. B., Smith, B. J., McHale, M., Perhacs, M., & Olds, D. L. (2013). Quasi-experimental pilot study of intervention to increase participant retention and completed home visits in the nurse-family partnership. Prevention Science, 14, 525–534.

    Article  PubMed Central  PubMed  Google Scholar 

  • Johnson, B., Thorn, B., McGill, B., Suchman, A., Mendelson, M., Patlan, K. L., Freeman, B., Gotlieb, R., & Connor, P. (2013). WIC participant and program characteristics 2012 final report. Washington DC: Food and Nutrition Service, US Department of Agriculture.

    Google Scholar 

  • Karoly, L. A., & Bigelow, J. H. (2005). The economics of investing in universal preschool education in California. Santa Monica: RAND Corporation.

    Google Scholar 

  • Kitzman, H., Olds, D. L., Henderson, C. R., Jr., Hanks, C., Cole, R., Tatelbaum, R., McConnochie, K. M., Sidora, K., Luckey, D. W., Shaver, D., Engelhardt, K., James, D., & Barnard, K. (1997). Effect of prenatal and infancy home visitation by nurses on pregnancy outcomes, childhood injuries, and repeated childbearing: A randomized controlled trial. Journal of the American Medical Association, 278, 644–652.

    Article  CAS  PubMed  Google Scholar 

  • Kitzman, H., Olds, D. L., Sidora, K., Henderson, C. R. J., Hanks, C., Cole, R., Luckey, D. W., Bondy, J., Cole, K., & Glazner, J. (2000). Enduring effects of nurse home visitation on maternal life course: A 3-year follow-up of a randomized trial. Journal of the American Medical Association, 283, 1983–1999.

    Article  CAS  PubMed  Google Scholar 

  • Kitzman, H. J., Olds, D. L., Cole, R. E., Hanks, C. A., Anson, E. A., Arcoleo, K. J., Luckey, D. W., Knudtson, M. D., Henderson, C. R., Jr., & Holmberg, J. R. (2010). Enduring effects of prenatal and infancy home visiting by nurses on children: Follow-up of a randomized trial among children at age 12 years. Archives of Pediatric and Adolescent Medicine, 164, 412–418.

    Article  Google Scholar 

  • Lee, S., Aos, S., Drake, E., Pennucci, A., Miller, M., & Anderson, L. (2012). Return on investment: Evidence-based options to improve statewide outcomes. Olympia: Washington State Institute for Public Policy.

    Google Scholar 

  • Martin, J. A., Hamilton, B. E., Ventura, S. J., Osterman, M. J. K., Kirmeyer, S., Mathews, T. J., & Wilson, E. C. (2011). Births: Final data for 2009. National Vital Statistics System, 60:1. Hyattsville, MD: National Center for Health Statistics.

  • Matone, M., O’Reilly, A., Luan, X., Localio, R., & Rubin, D. (2012a). Home visitation program effectiveness and the influence of community behavioral norms: A propensity score matched analysis of prenatal smoking cessation. BMC Public Health, 12, 1016.

    Article  PubMed Central  PubMed  Google Scholar 

  • Matone, M., O’Reilly, A., Luan, X., Localio, A., & Rubin, D. (2012b). Emergency department visits and hospitalizations for injuries among infants and children following statewide implementation of a home visitation model. Maternal and Child Health Journal, 16, 1754–1761.

    Article  PubMed  Google Scholar 

  • Mejdoubi, J., van den Heijkant, S. C., van Leerdam, F. J., Heymans, M. W., Hirasing, R. A., & Crijnen, A. A. (2013). Effect of nurse home visits vs. usual care on reducing intimate partner violence in young high-risk pregnant women: A randomized controlled trial. PLoS ONE, 8, e78185.

    CAS  PubMed  Google Scholar 

  • Mejdoubi, J., van den Heijkant, S. C., van Leerdam, F. J., Crone, M., Crijnen, A., & Hirasing, R. A. (2014). Effects of nurse home visitation on cigarette smoking, pregnancy outcomes and breastfeeding: A randomized controlled trial. Midwifery, 30, 688–695.

    Article  PubMed  Google Scholar 

  • Mejdoubi, J., van den Heijkant, S. C., van Leerdam, F. J., Heymans, M. W., Crijnen, A. A., & Hirasing, R. A. (2015). The effect of VoorZorg, the Dutch nurse family partnership, on child maltreatment and development: A randomized controlled trial. PLoS ONE, 10, e0120182.

    Article  PubMed Central  PubMed  Google Scholar 

  • Miller, T., & Hendrie, D. (2015). Incidence and costs of violence and other personal crimes, United States, 2010. Calverton: Pacific Institute for Research & Evaluation.

    Google Scholar 

  • Miller, T. R., & Levy, D. T. (2000). Cost-outcome analysis in injury prevention and control: Eighty-four recent estimates for the United States. Medical Care, 38, 562–582.

    Article  CAS  PubMed  Google Scholar 

  • Nagle, G. (2002). Maternal participation, depression, and partner violence in a state-run child abuse prevention program: Louisiana nurse home visitation, 1999–2002. Unpublished Doctoral dissertation, Tulane University, New Orleans.

  • National Center for Health Statistics. (n.d.). Health data interactive. Retrieved May 11, 2011, from the World Wide Web: http://www.cdc.gov/nchs/hdi.htm.

  • National Committee for Quality Assurance. (2011). Continuous improvement and the expansion of quality measurement: The state of health care quality 2011. National Committee for Quality Assurance. Retrieved February 28, 2012, from the World Wide Web: http://www.ncqa.org/LinkClick.aspx?fileticket=FpMqqpADPo8%3D

  • Nguyen, J. D., Carson, M. L., Parris, K. M., & Place, P. (2003). A comparison pilot study of public health field nursing home visitation program interventions for pregnant Hispanic adolescents. Public Health Nursing, 20, 412–418.

    Article  PubMed  Google Scholar 

  • Northam, S., & Knapp, T. R. (2006). The reliability and validity of birth certificates. Journal of Obstetrics, Gynecology, and Neonatal Nursing, 35, 3–12.

    Article  Google Scholar 

  • Nurse-Family Partnership National Service Office. (2011). Guidance for implementation and quality of the Nurse-Family Partnership Program. Retrieved from http://www.nursefamilypartnership.org/assets/PDF/Policy/HV-Funding-Guidance/NFP_Guidance_Implementation_Quality.aspx, accessed July 2014.

  • Nurse-Family Partnership National Service Office. (2014). Quarterly report for national NFP: Data through 31 Dec 2013. Denver: Nurse-Family Partnership National Service Office.

    Google Scholar 

  • NYC Department of Health and Mental Hygiene. (August/September 2013). Featured outcomes for NYC NFP moms 2003-2013. NYC Nurse-Family Partnership E-News, p. 5.

  • Office of Child Care. (2010). FY 2010 final CCDF allocations (Including realloted funds). Administration for Children and Families, DHHS.

  • Olds, D. L., Henderson, C. R., Birmingham, M. T., Chamberlin, R., & Tatelbaum, R. (1983). Final report: Prenatal/early infancy project. Springfield: National Technical Information Service.

    Google Scholar 

  • Olds, D. L., Henderson, C. R., Tatelbaum, R., & Chamberlin, R. (1986). Improving the delivery of prenatal care and outcomes of pregnancy: A randomized trial of nurse home visitation. Pediatrics, 77, 16–28.

    CAS  PubMed  Google Scholar 

  • Olds, D. L., Henderson, C. R., Tatelbaum, R., & Chamberlin, R. (1988). Improving the life-course development of socially disadvantaged mothers: A randomized trial of nurse home visitation. American Journal of Public Health, 78, 1436–1445.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Olds, D. L., Henderson, C. R., Jr., & Kitzman, H. (1994). Does prenatal and infancy nurse home visitation have enduring effects on qualities of parental caregiving and child health at 25 to 50 months of life? Pediatrics, 93, 89–98.

    CAS  PubMed  Google Scholar 

  • Olds, D. L., Henderson, C. R., Jr., Kitzman, H., & Cole, R. (1995). Effects of prenatal and infancy nurse home visitation on surveillance of child maltreatment. Pediatrics, 95, 365–372.

    CAS  PubMed  Google Scholar 

  • Olds, D. L., Eckenrode, J., Henderson, C. R., Kitzman, H., Powers, J., Cole, R., Sidora, K., Morris, P., Pettitt, L. M., & Luckey, D. (1997). Long-term effects of home visitation on maternal life course and child abuse and neglect. Journal of the American Medical Association, 278, 637–643.

    Article  CAS  PubMed  Google Scholar 

  • Olds, D. L., Henderson, C. R., Jr., Cole, R., Eckenrode, J., Kitzman, H., Luckey, D., Pettitt, L., Sidora, K., Morris, P., & Powers, J. (1998). Long-term effects of nurse home visitation on children’s criminal and antisocial behavior: 15-year follow-up of a randomized controlled trial. Journal of the American Medical Association, 280, 1238–1244.

    Article  CAS  PubMed  Google Scholar 

  • Olds, D. L., Robinson, J., O’Brien, R., Luckey, D. W., Pettitt, L. M., Henderson, C. R., Ng, R. N., Korfmacher, J., Hiatt, S., & Talmi, A. (2002). Home visiting by paraprofessionals and nurses: A randomized, controlled trial. Pediatrics, 110, 486–496.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  • Olds, D. L., Robinson, J., Pettitt, L. M., Luckey, D. W., Holmberg, J., Ng, R. K., Isacks, K., Sheff, K., & Henderson, C. R. (2004b). Effects of home visits by paraprofessionals and by nurses: Age 4 follow-up results of a randomized trial. Pediatrics, 114, 1560–1568.

    Article  PubMed  Google Scholar 

  • Olds, D. L., Kitzman, H., Hanks, C., Cole, R., Anson, E., Sidora-Arcoleo, K., Luckey, D. W., Henderson, C. R., Jr., Holmberg, J., Tutt, R. A., Stevenson, A. J., & Bondy, J. (2007). Effects of nurse home visiting on maternal and child functioning: Age-9 follow-up of a randomized trial. Pediatrics, 120, e832–e845.

    Article  PubMed Central  PubMed  Google Scholar 

  • Olds, D. L., Kitzman, H. J., Cole, R. E., Hanks, C. A., Arcoleo, K. J., Anson, E. A., Luckey, D. W., Knudtson, M. D., Henderson, C. R., Jr., Bondy, J., & Stevenson, A. J. (2010). Enduring effects of prenatal and infancy home visiting by nurses on maternal life course and government spending: Follow-up of a randomized trial among children at age 12 years. Archives of Pediatric and Adolescent Medicine, 164, 412–418.

    Article  Google Scholar 

  • Olds, D. L., Donelan-McCall, N., O’Brien, R., MacMillan, H., Jack, S., Jenkins, T., Dunlap, W. P. I., O’Fallon, M., Yost, E., Thorland, B., Pinto, F., Gasbarro, M., Baca, P., Melnick, A., & Beeber, L. (2013). Improving the nurse-family partnership in community practice. Pediatrics, 132, S110–S117.

    Article  PubMed Central  PubMed  Google Scholar 

  • Olds, D. L., Holmberg, J., Donelan-McCall, N., Luckey, D., Knudtson, M., & Robinson, J. (2014a). Effects of home visits by paraprofessionals and by nurses on children: Follow-up of a randomized trial at ages 6 and 9 years. JAMA Pediatrics, 168, 114–121.

    Article  PubMed Central  PubMed  Google Scholar 

  • Olds, D. L., Kitzman, H., Knudtson, M., Anson, E., Smith, J., & Cole, R. (2014b). Effect of home visiting by nurses on maternal and child mortality: Results of a 2-decade follow-up of a randomized clinical trial. JAMA Pediatrics, 168, 800–806.

    Article  PubMed Central  PubMed  Google Scholar 

  • Rubin, D. M., O’Reilly, A. L. R., Luan, X., Dai, D., Localio, A. R., & Christian, C. W. (2009). Evaluating the Nurse-Family Partnership programs in the Commonwealth of Pennsylvania. Executive summary. Philadelphia: The Children’s Hospital of Philadelphia Research Institute.

    Google Scholar 

  • Rubin, D. M., O’Reilly, A. L. R., Luan, X., Dai, D., Localio, A. R., & Christian, C. W. (2011). Variation in pregnancy outcomes following statewide implementation of a prenatal home visitation program. Archives of Pediatric & Adolescent Medicine, 165, 198–204.

    Article  Google Scholar 

  • Sandner, M. (2013a). Effects of early childhood intervention on child development and early skill formation: Evidence from a randomized controlled trial. Discussion paper 518 Retrieved from http://www.econstor.eu/bitstream/10419/92949/1/768255511.pdf, accessed July 2014.

  • Sandner, M. (2013b). Effects of early childhood intervention on maternal employment, fertility and well-being. Evidence from a randomized experiment. Discussion paper 516. Retrieved from http://ideas.repec.org/p/han/dpaper/dp-516.html, accessed July 2014.

  • Sedlak, A. J., Mettenburg, J., Basena, M., Petta, I., McPherson, K., Greene, A., & Li, S. (2010). Fourth national incidence study of child abuse and neglect (NIS–4): Report to Congress. Washington, DC: Administration for Children and Families.

    Google Scholar 

  • Senter, L., Pai, N., & Miller, T. (2010). Benefits and costs of nurse-family partnership in New York City over 15 years, city government perspective. New York City: Department of Health and Mental Hygiene.

    Google Scholar 

  • Snyder, H. N. (2011). Arrests in the US 1980–2009. NCJ 234319. Washington, DC: Bureau of Justice Statistics.

  • Sonnier, S. W. (2007). Nurse-Family Partnership - Demonstrating results, Prepared for Baptist Community Ministries. New Orleans: Tulane University of Infant and Early Childhood Mental Health.

    Google Scholar 

  • University of Illinois at Chicago. (2010). Maternal and child health services block grant FFY’11 needs assessment. Springfield, IL: Illinois Department of Human Services, Division of Specialized Care for Children.

  • Zielinski, D. S., Eckenrode, J., & Olds, D. L. (2009). Nurse home visitation and the prevention of child maltreatment: Impact on the timing of official reports. Development and Psychopathology, 21, 441–453.

    Article  PubMed  Google Scholar 

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Acknowledgments

This work was partially funded by National Institute of Drug Abuse grant 1-R01 DA021624. Thanks to David Olds, Mike Knudtson, Dennis Luckey, Denise Nguyen, Jamila Mejdoubi, and the NFP NSO for supplying unpublished data and answering questions. Numerous reviewers provided extremely helpful comments, notably Tamar Bauer, Karen Kalaijian, Sandy Dunlap, other staff of the NFP NSO, David Olds, and anonymous reviewers enlisted by the Pew Center on the States and this journal. The views expressed are those of the author and do not necessarily reflect those of the funders or reviewers.

Conflict of Interest

In terms of possible conflicts, the author receives consulting fees for economic analysis support from the NFP NSO.

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Correspondence to Ted R. Miller.

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Miller, T.R. Projected Outcomes of Nurse-Family Partnership Home Visitation During 1996–2013, USA. Prev Sci 16, 765–777 (2015). https://doi.org/10.1007/s11121-015-0572-9

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