| One of the most successful interventions for improving both maternal and child outcomes is the Nurse Home Visitation Program, designed by Dr. David Olds. This program was studied in a series of randomized, control-group studies in three different locations: one semirural county (Elmira, NY), and two urban areas (Memphis, TN and Denver, CO). The first randomized trial was begun in 1977 in Elmira, New York. Four hundred women who were pregnant with their first child were recruited for the study (89 percent were white). Eighty-five percent of the women had one or more of the following risk factors at study entry: low-income, single parent, or younger than age 19. The women were randomly assigned to one of four treatment groups. Families in Treatment 1 were given free developmental screenings of the child at age 12 and 24 months. Families in Treatment 2 received these screenings, plus free transportation for prenatal and well-baby care through the child’s second birthday. Families in Treatment 3 were provided the screening and transportation services, and in addition were provided with a nurse home visitor during the pregnancy. Treatment 4 families received all services provided to families in Treatment 3, but the nurses continued to visit the home through the child’s second birthday. During the home visits, the nurses covered topics ranging from personal health habits (e.g., reducing cigarette and drug use, adequate diet), to parenting behaviors (e.g., emphasizing sensitivity and responsivity), to home safety. Results of the study indicated significant differences in the level of child maltreatment and child cognitive developmental outcomes based on receiving a nurse home visitation intervention. Reviews of randomized trials of other home visitation programs indicate that, to produce comparable effects, the interventions must include all the elements that are part of this particular model, including the use of nurses rather than paraprofessionals (Korfmacher et al., 1999; Olds & Kitzman, 1993). |
