Prenatal and infancy home visiting by nurses: From randomized trials to community replication
Abstract
This paper summarizes a 25-year program of research that has attempted to improve the early health and development of low-income mothers and children and their future life trajectories with prenatal and infancy home visiting by nurses. The program has been tested in two separate large-scale randomized controlled trials with different populations living in different contexts. The program has been successful in improving parental care of the child as reflected in fewer injuries and ingestions that may be associated with child abuse and neglect; and maternal life-course, reflected in fewer subsequent pregnancies, greater work force participation, and reduced use of public assistance and food stamps. In the first trial, the program also produced long-term effects on the number of arrests, convictions, emergent substance use, and promiscuous sexual activity of 15-year-old children whose nurse-visited mothers were low-income and unmarried when they registered in the study during pregnancy. Since 1996, the program has been offered for public investment outside of research contexts. Careful attention has been given to ensuring that the program is replicated with fidelity to the model tested in the scientifically controlled studies by working with community leaders to ensure that organization and community contexts are favorable for the program; by providing the nurses with excellent training and technical assistance and detailed visit-by-visit guidelines; and by providing organizations with a web-based clinical information system that creates a basis for monitoring program performance and continuous quality improvement.
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The literature on low-SES parenting and infant/child stress indicates that early intervention improved child developmental outcomes in part by lowering treated groups' exposure to care that is stressful under adversity.
“In general, the literature on parenting and infant and child stress in the context of low SES suggests that one way in which early intervention has enhanced child developmental outcomes is through reducing the exposure of infants and children in treated groups to a type of care that is stressful in the context of adversity.”
From Stress and the development of self-regulation in context (2010) · cites this paper as Olds, 2002
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“Most, though not all, intervention studies have either targeted parenting behaviors directly (Barnard, 1997; Olds, 2002) or, as in the case of center-based care, provided a type of care that is characterized by high levels of caregiver sensitivity and careful structuring of experience (Gross, Spiker, & Haynes, 1997).”
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Self-citation
- Authors
- Olds, D. L.
- Affiliations
- University of Colorado Denver (US)
- Corresponding author
- Olds, David L.
- Venue
- Prevention Science
- Published
- 2002-09
- Volume
- 3
- Issue
- 3
- Pages
- 153-172
- ISSN
- 1389-4986 (ISSN-L)
- 1573-6695
- OpenAlex
- W1511827756
- Cited by
- 490
- References
- 66
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 13 · 2023: 10 · 2022: 8 · 2021: 15 · 2020: 10 · 2019: 20 · 2018: 15 · 2017: 24 · 2016: 20 · 2015: 28 · 2014: 21 · 2013: 33 · 2012: 40
- FWCI
- 33.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Prevention Science (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01mh049381-04)
- Administration for Children and Families
- U.S. Public Health Service (MCJ-363378-01-0, MCR-360403-07-0)
- National Institute of Mental Health (1-R01-MH49381-01A1, K05MH001382, 1-K05-MH01382-01)
- National Institute of Nursing Research (NR01-01691-05)
- National Center for Research Resources (S7RR-05403-25)
- Topics
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
- Keywords
- home visiting, home-visit nursing, low-income mothers, child abuse and neglect prevention, adolescent pregnancy, adolescent substance use, adolescent sexual activity, program replication, implementation fidelity, community-based implementation, Supplemental Nutrition Assistance Program, labor force participation, continuous quality improvement
- MeSH terms
- Child, Child Health Services, Child Welfare, Community Health Nursing, Female, Home Care Services, House Calls, Humans, Infant, Infant, Newborn, Maternal Health Services, Pregnancy, Clinical Nursing Research, Randomized Controlled Trials as Topic
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