Prenatal and Infancy Nurse Home Visiting and 18-Year Outcomes of a Randomized Trial

Kitzman, H., Olds, D. L., Knudtson, M. D., Cole, R., Anson, E., et al. · 2019

grade Brctdeveloper-ledunreplicatednumbers spot-checked

Sample

742 randomized; 629 youth assessed at age 18

Population

Low-income primarily African-American mothers and children, Memphis.

Design

Long-running RCT of the Nurse-Family Partnership, the most widely disseminated home-visiting program, with pre-specified primary outcomes at age 18.

Key findings

The flagship home-visiting program is NULL at age 18 on every pre-specified full-sample outcome, including nonverbal intelligence. Positive results exist only in a maternal-resources subgroup. Home visiting is not a demonstrated lever on children's cognitive outcomes.

Counterfactual

NOT nothing — controls received free transportation for prenatal care plus child development screening and referral.

Genetic confound

RCT.

Replication notes

The pattern — null on pre-specified full-sample outcomes, positive in a subgroup — is exactly what multiplicity correction is designed to catch.

Cost

Intensive nurse home visiting from pregnancy through age 2 — a high-cost program.

DOI / URL

10.1542/peds.2018-3876

Cite

BibTeX RIS

Effects

Outcome	Metric	Value	Measure	Timing	Vs	Horizon	Class
Nonverbal intelligence, full sample	pre-specified primary outcome	NULL	standardized	adult	active-alternative	adulthood	g
Receptive language and math achievement, full sample	pre-specified primary outcomes	NULL	standardized	adult	active-alternative	adulthood	domain-skill
Behavioural health (internalising, substance use, STI)	pre-specified primary outcomes	NULL	mixed	adult	active-alternative	adulthood	behaviour
Math achievement, low-psychological-resources SUBGROUP	SD	+0.38 (0.14-0.61), p=.002 — subgroup only	standardized	adult	active-alternative	adulthood	domain-skill

Cited by

The early home environment — what parents can and cannot causally movemixedconf: highgc: low