Reference Catalog

Status of Birth Outcomes in Clients of the Nurse-Family Partnership

William Thorland and Dustin W. Currie

• Nurse-Family Partnership (NFP)

Background: The Nurse-Family Partnership (NFP) is a national, evidence-based home visiting program currently serving over 30,000 first-time, low-income mothers. Prior to public implementation, three foundational randomized controlled trials demonstrated program effectiveness in achieving beneficial birth, child development, and maternal life-course outcomes. This study describes birth outcomes of contemporary NFP clients compared to a reference cohort, providing the first evidence of program effect on a nation-wide basis during scale-up. Methods: A cohort of NFP clients beginning the program between 7/1/2007-6/30/2010 was compared to a reference cohort of first-time mothers from publicly available birth data (US Natality Data). Employing propensity score matching, NFP clients (n = 27,195) were each matched to three controls based on maternal age, race-ethnicity, smoking status, education, and marital status. Measures of low birth weight and preterm birth were compared between clients and controls using McNemar’s Tests. Results: Similar to the foundational trials, no significant difference in low birth weight was observed (NFP 9.4%, matched controls 9.6%, p = 0.20). However, in contrast to the foundational trials, the incidence of preterm births in NFP clients was significantly lower than in matched controls (8.7% vs. 12.3%, respectively; p < 0.0001). Discussion: A recent review of NFP birth outcomes employing data pooling techniques (overcoming the statistical power limitations of the original foundational trials) has shown a trend toward a favorable program effect in the incidence of preterm births. The present study provides evidence of such an effect in a well-powered evaluation of recent clients during nation-wide scale-up, with these results meriting further confirmation. (author abstract)

Finished

• Participant, Family, and Program Outcomes