Nurse Family Partnership: Comparing Costs per Family in Randomized Trials Versus Scale-Up




Ted R. Miller and Delia Hendrie

Brief Type

Journal Publication


  • Nurse-Family Partnership (NFP)


The literature that addresses cost differences between randomized trials and full-scale replications is quite sparse. This paper examines how costs differed among three randomized trials and six statewide scale-ups of nurse family partnership (NFP) intensive home visitation to low income first-time mothers. A literature review provided data on pertinent trials. At our request, six well-established programs reported their total expenditures. We adjusted the costs to national prices based on mean hourly wages for registered nurses and then inflated them to 2010 dollars. A centralized data system provided utilization. Replications had fewer home visits per family than trials (25 vs. 31, p = .05), lower costs per client ($8860 vs. $12,398, p = .01), and lower costs per visit ($354 vs. $400, p = .30). Sample size limited the significance of these differences. In this type of labor intensive program, costs probably were lower in scale-up than in randomized trials. Key cost drivers were attrition and the stable caseload size possible in an ongoing program. Our estimates reveal a wide variation in cost per visit across six state programs, which suggests that those planning replications should not expect a simple rule to guide cost estimations for scale-ups. Nevertheless, NFP replications probably achieved some economies of scale. (author abstract)

Data Collection Methods

  • Program administrative record reviews



For More Information

Miller, T. R., & Hendrie, D. (2015). Nurse Family Partnership: Comparing costs per family in randomized trials versus scale-up. The Journal of Primary Prevention, 36, 419–425. doi: 10.1007/s10935-015-0406-3
Author Contact Information:
Ted R. Miller


  • Cost