NFP Research


Based on proven results

Through extensive research conducted over more than three decades, NFP has a proven level of effectiveness. Three randomized, controlled trials demonstrate that Nurse-Family Partnership delivers against its goals of better pregnancy outcomes, improved child health and development, and increased economic self-sufficiency. These outcomes contribute to preventing child abuse, reducing juvenile crime, and increasing school readiness.

Download Excel spreadsheet to view all research documentation

Notice: This document is up to date until Feb 24, 2017, more recent articles are listed below. 

United States Randomized Controlled Trials

Consistent and Significant Results Across at Least 2 of the 3 US Trials:


Prenatal Health

  • Reduced prenatal cigarette use

  • Fewer hypertensive disorders of pregnancy

Child Wellbeing

  • Reduced child injuries

  • Improved child language and cognitive development among children born to mothers with low psychological resources

  • Reduced child behavioural problems

  • Reduced substance use

  • Reduced depression/anxiety

Maternal Wellbeing

  • Fewer closely spaced subsequent pregnancies

  • Improved parenting

  • Increased employment

  • Reduced dependence on social assistance

  • Reduced substance use

  • Reduced behavioural impairment due to substance use

1. Elmira Trial

Improving the Delivery of Prenatal Care and Outcomes of Pregnancy: A Randomized Trial of Nurse Home Visitation.

Olds DL, Henderson CR Jr, Tatelbaum R, Chamberlin R. Pediatrics. 1986;77(1):16-28.

Preventing Child Abuse and Neglect: A Randomized Trial of Nurse Home Visitation

Olds DL, Henderson CR Jr, Chamberlin R, Tatelbaum R. Pediatrics. 1986;78:65-78

Does Prenatal and Infancy Nurse Home Visitation Have Enduring Effects on Qualities of Parental Caregiving and Child Health at 25 to 50 Months of Life?

Olds DL, Henderson CR Jr, Kitzman H. Pediatrics. 1994;93(1):89-98.

Long-term Effects of Home Visitation on Maternal Life Course and Child Abuse and Neglect. Fifteen-year Follow-up of a Randomized Trial.

Olds DL, Eckenrode J, Henderson CR Jr, Kitzman H, Powers J, Cole R, Sidora K, Morris P, Pettitt LM, Luckey D. JAMA. 1997;278(8):637-43.

Long-term Effects of Nurse Home Visitation on Children's Criminal and Antisocial Behavior: 15-year Follow-up of a Randomized Controlled Trial.

Olds D, Henderson CR Jr, Cole R, Eckenrode J, Kitzman H, Luckey D, Pettitt L, Sidora K, Morris P, Powers J. JAMA. 1998;280(14):1238-44.

Preventing Child Abuse and Neglect with a Program of Nurse Home Visitation: the Limiting Effects of Domestic Violence.

Eckenrode J, Ganzel B, Henderson CR Jr, Smith E, Olds DL, Powers J, Cole R, Kitzman H, Sidora K. JAMA. 2000;284(11):1385-91.

Long-term Effects of Prenatal and Infancy Nurse Home Visitation on the Life Course of Youths: 19-year Follow-up of a Randomized Trial.

Eckenrode J, Campa M, Luckey DW, Henderson CR Jr, Cole R, Kitzman H, Anson E, Sidora-Arcoleo K, Powers J, Olds DL. Arch Pediatr Adolesc Med. 2010;164(1):9-15. 

2. Memphis Trial

Effect of Prenatal and Infancy Home Visitation by Nurses on Pregnancy Outcomes, Childhood Injuries, and Repeated Childbearing. A Randomized Controlled Trial.

Kitzman H, Olds DL, Henderson CR Jr, Hanks C, Cole R, Tatelbaum R, McConnochie KM, Sidora K, Luckey DW, Shaver D, Engelhardt K, James D, Barnard K. JAMA. 1997;278(8):644-52.

Enduring Effects of Nurse Home Visitation on Maternal Life Course: a 3-year Follow-up of a Randomized Trial.

Kitzman H, Olds DL, Sidora K, Henderson CR Jr, Hanks C, Cole R, Luckey DW, Bondy J, Cole K, Glazner J. JAMA. 2000;283(15):1983-9.

Effects of Nurse Home-visiting on Maternal Life Course and Child Development: age 6 Follow-up Results of a Randomized Trial.

Olds DL, Kitzman H, Cole R, Robinson J, Sidora K, Luckey DW, Henderson CR Jr, Hanks C, Bondy J, Holmberg J. Pediatrics. 2004;114(6):1550-9.

Effects of Nurse Home Visiting on Maternal and Child Functioning: Age-9 Follow-up of a Randomized Trial.

Olds DL, Kitzman H, Hanks C, Cole R, Anson E, Sidora-Arcoleo K, Luckey DW, Henderson CR Jr, Holmberg J, Tutt RA, Stevenson AJ, Bondy J. Pediatrics. 2007;120(4):e832-45.

Enduring Effects of Prenatal and Infancy Home Visiting by Nurses on Children: Age-12 Follow-Up of a Randomized Trial.

Kitzman HJ, Olds DL, Cole RE, Hanks CA, Anson EA, Arcoleo KJ, Luckey DW, Knudtson MD, Henderson CR Jr, Holmberg JR. Arch Pediatr Adolesc Med. 2010;164(5):412-418.  

Enduring Effects of Prenatal and Infancy Home Visiting by Nurses on Maternal Life Course and Government Spending.

Olds DL, Kitzman HJ, Cole RE, Hanks CA, Arcoleo KJ, Anson EA, Luckey DW, Knudtson MD, Henderson CR Jr, Bondy J, Stevenson AJ.   Arch Pediatr Adolesc Med. 2010;164(5):419-424.

Effect of Home Visiting by Nurses on Maternal and Child Mortality: Results of a 2-Decade Follow-Up of a Randomized, Clinical Trial.

Olds DL, Kitzman H, Knudtson MD, Anson E, Smith JA, Cole R. JAMA Pediatr. 2014;168(9):800-6.

3. Denver Trial

Home Visiting by Paraprofessionals and by Nurses: A Randomized Controlled Trial.

Olds DL, Robinson J, O'Brien R, Luckey DW, Pettitt LM, Henderson CR Jr, Ng RK, Sheff KL, Korfmacher J, Hiatt S, Talmi A. Pediatrics. 2002;110(3):486-496. 

Effects of Home Visits by Paraprofessionals and by Nurses: Age 4 Follow-up Results of a Randomized Trial.

Olds DL, Robinson J, Pettitt L, Luckey DW, Holmberg J, Ng RK, Isacks K, Sheff K, Henderson CR Jr. Pediatrics. 2004;114(6):1560-8.  

Effects of Home Visits by Paraprofessionals and by Nurses on Children: Age-six and Nine Follow-up of a Randomized Trial.

Olds DL, Holmberg JR, Donelan-McCall N, Luckey DW, Knudtson MD, Robinson J. JAMA Pediatr. 2014;168(2):114-21.

NFP International Research

Dr. Olds and his staff at the Prevention Research Center have developed a model for adapting and testing the Nurse-Family Partnership program in international contexts that is grounded in the same rigorous research standards that serve as a foundation for the U.S. program. In general, an international implementation effort has four phases:

Phase One: Adaption. Examine the adaptations needed to deliver the NFP program in local contexts while ensuring fidelity to the NFP model.

Phase Two: Feasibility and Acceptability through Pilot Testing and Evaluation. Conduct a pilot test of the adapted NFP program to inform what additional adaptations may be needed to ensure the feasibility and acceptability of the adapted NFP program.

Phase Three: Randomized Controlled Trial (RCT). Consider expansion of the testing and evaluation work by conducting a Randomized Controlled Trial (RCT).

Phase Four: Continued Refinement and Expansion. Once the evaluation of the RCT has been completed and the outcomes found to be of public health significance, the implementing agency may decide to further refine and expand the adapted NFP Program in their society.

Australia

The Australian Nurse-Family Partnership Program for aboriginal mothers and babies: Describing client complexity and implications for program delivery.

Zarnowiecki D, Nguyen H, Hampton C, Boffa J, Segal L. Midwifery. 2018 Jun 23. 

Child protection outcomes of the Australian Nurse Family Partnership Program for Aboriginal infants and their mothers in Central Australia

Segal L, Nguyen H, Gent D, Hampton C, Boffa J. PLoS ONE. 2018;13(12): e0208764 

Canada

Healthy Connections Project Process Evaluation: A Mixed Methods Protocol to Describe the Implementation and Delivery of the Nurse-Family Partnership in Canada.

Jack S, Sheehan D, Gonzalez A, MacMillan H, Catherine N, Waddell C. British Columbia BMC Nursing. 2015;14(47):1

Improving Children's Health and Development in British Columbia through Nurse Home Visiting: A Randomized Controlled Trial Protocol. 

Catherine NL, Gonzalez A, Boyle M, Sheehan D, Jack SM, Hougham KA, McCandless L, MacMillan HL, Waddell C; British Columbia Healthy Connections Project Scientific Team. BMC Health Serv Res. 2016 Aug 4;16(a):349. doi: 10.1186/s12913-016-1594-0

BC Healthy Connections Project Report. 

This report is the first publication from the Canadian NFP RCT currently being conducted in British Columbia and details the findings of the baseline data collected when the young pregnant women participants entered the study.

BC Healthy Connections Project Report Update

May, 31 2019. 


Weathering the rural reality: Delivery of the Nurse-Family Partnership home visitation program in rural British Columbia, Canada.

Campbell, KA, MacKinnon, K, Dobbins, M, Van Borek, N, & Jack, SM., for the British Columbia Healthy Connections Project Process Evaluation Research Team. BMC Nursing. 2019;18(1):17.

The British Columbia Healthy Connections Project: findings on socioeconomic disadvantage in early pregnancy

Catherine, NLA, Lever, R, Sheehan, D, Zheng, Y, Boyle, MH, McCandless, L, Gafni, A, Gonzalez, A, Jack, SM, Tonmyr, L, Varcoe, C, MacMillan, HL, Waddell, C. BMC Public Health. 2019, 19:1161.

Nurse-Family Partnership and Geography: An Intersectional Perspective

Campbell, K. A., MacKinnon, K., Dobbins, M., & Jack, S. M. for the British Columbia Healthy Connections Project. (2020). Global Qualitative Nursing Research. 2020, 7:1-12.

Nurse-Family Partnership and Geography: An Intersectional Perspective

Campbell, K. A., MacKinnon, K., Dobbins, M., & Jack, S. M. for the British Columbia Healthy Connections Project. (2020). Global Qualitative Nursing Research. 2020, 7:1-12.

Retaining Participants in Community-Based Health Research: A Case Example on Standardized Planning and Reporting 

Catherine NLA, Lever R, Marcellus L, Tallon C, Sheehan D, MacMillan H, Gonzalez A, Jack SM, Waddell C. Trials. 2020, 21:393.

"The Hardest Job You Will Ever Love": Nurse Recruitment, Retention, and Turnover in the Nurse-Family Partnership Program in British Columbia, Canada.  

Campbell KA, Van Borek N, Marcellus L, Landy CK, Jack SM.  PLoS ONE. 2020, 15:9.

England

Effectiveness of Nurse-led Intensive Home-visitation Programme for First-time Teenage Mothers (Building Blocks): A Pragmatic Randomised Controlled Trial.

Robling M, Bekkers MJ, Bell K, Butler CC, Cannings-John R, Channon S, Martin BC, Gregory JW, Hood K, Kemp A, Kenkre J, Montgomery AA, Moody G, Owen-Jones E, Pickett K, Richardson G, Roberts ZE, Ronaldson S, Sanders J, Stamuli E, Torgerson D. The Lancet. 2015;387(10014):146-155.

Building Evidence to Improve Maternal and Child Health

Olds D. The Lancet. 2015;387(10014):105:107.

Cost‐effectiveness of the Family Nurse Partnership (FNP) programme in England: Evidence from the building blocks trial

Corbacho B, Bell K, Stamuli E, Richardson G, Ronaldson S, Hood K, Sanders J, Robling M, Torgerson D; Building Blocks trial group. J Eval Clin Pract. 2017; 1-8. 

Assessing the medium-term impact of a home-visiting programme on child maltreatment in England: protocol for a routine data linkage study.

Lugg-Widger FV, Cannings-John R, Channon S, Fitzsimmons D, Hood K, Jones KH, Kemp A, Kenkre J, Longo M, McEwan K, Moody G, Owen-Jones E, Sanders J, Segrott J, Robling M; 2017 Jul 13;7(7):e015728.


What is usual care for teenagers expecting their first child in England? A process evaluation using key informant mapping and participant survey as part of the Building Blocks randomised controlled trial of specialist home visiting

Robling M, Cannings-John R, Channon S, Hood K, Moody G, Poole R, Sanders J; BMJ Open. 2018 May 5;8(5):e020152.


Implementation of the Family Nurse Partnership programme in England: experiences of key health professionals explored through trial parallel process evaluation

Sanders J, Channon S, Gobat N, Bennert K, Addison K, Robling M. BMC Nursing 2019;18:13


Repeat pregnancies in teenage mothers: An exploratory study

Bucknall A, Bick, D. Journal of Advanced Nursing. 2019;00:1-11.


The Netherlands

Please note that the Netherlands in no longer implementing NFP/VoorZorg.

The Effect of VoorZorg, the Dutch Nurse-Family Partnership, on Child Maltreatment and Development: A Randomized Controlled Trial.

Mejdoubi J, van den Heijkant SC, van Leerdam FJ, Heymans MW, Crijnen A, Hirasing RA. PLoS One. 2015;10(4): e0120182

Effect of Nurse Home Visits vs. Usual Care on Reducing Intimate Partner Violence in Young High-risk Pregnant Women: a Randomized Controlled Trial.

Mejdoubi J, van den Heijkant SC, van Leerdam FJ, Heymans MW, Hirasing RA, Crijnen AA. PLoS One. 2013 Oct 21;8(10):e78185.

Effects of Nurse Home Visitation on Cigarette Smoking, Pregnancy Outcomes and Breastfeeding: a Randomized Controlled Trial. Midwifery.

Mejdoubi J, van den Heijkant SC, van Leerdam FJ, Crone M, Crijnen A, HiraSing RA. 2014 Jun;30(6):688-95.

Addressing Risk Factors for Child Abuse among High Risk Pregnant Women: Design of a Randomised Controlled Trial of the Nurse Family Partnership in Dutch Preventive Health Care.

Mejdoubi J, van den Heijkant S, Struijf E, van Leerdam F, HiraSing R, Crijnen A. BMC Public Health. 2011;21;11:823.

The Identification of Pregnant Women at Risk for Child Abuse: Methodology.

Mejdoubi J, Heijkant SC, Struijf S, Van Leerdam F, Crijnen A, HiraSing A. Gynecol Obstet Res Open J. 2015; 1(1):18-25.

Norway

Real-Time Evaluation of “FAMILIE FOR FØRSTE GANG”/ THE NORWEGIAN NURSE-FAMILY PARTNERSHIP PILOT

Pedersen E, Nilsen W. Work Research Institute (AFI), OsloMet. Report 10: 2018.

Familie for første gang”/Norwegian Nurse-Family Partnership (NFP) Pilot. - Final Report on a Four-Year Real-Time Evaluation

Pedersen, E., Ballo, J.G., Nilsen, W. Work Research Institute (AFI) - AFI report 2020:03

Nothern Ireland

Public Health Agency Response to the Re-Valuation of Family Nurse Partnership in Northern Ireland

Webb D, PHA, 2018.

Scotland

Nurse Family Partnership Programme in Scotland: An Update

Trotter G, Community Practitioner, Aug 2012;85(8).

Evaluability assessment of the Family Nurse Partnership in Scotland

Wimbush E., Geddes, R., Woodman, K., Craig, P. and Jepson, R. NHS Health Scotland. 2015.

Evaluating the Family Nurse Partnership Programme in Scotland: a Natural Experiment Approach.

Cannings-John, R., Lugg-Widger, F., Robling, M., Paranjothy, S., White, J., Pell, J., and Sanders, J. International Journal of Population Data Science. 2018;3(3):403.

REvaluation of the Family Nurse Partnership Programme in Scotland.

This publication has been produced in collaboration with the REvaluation team, Scottish Government and Family Nurse supervisors, nurses and clients across Scotland. June 2019.

USA Implementation Research

The Nurse–Family Partnership in Colorado: Supporting High-Quality Programming With Implementation Science

Neal M, Fixsen A. Journal of Nursing Scholarship. 2019;0:0,1–8. 

Independent Research and Reports

Not only has NFP been rigorously evaluated in several countries, it is recognized by other researchers and organizations as a top-tier evidentiary intervention. The Nurse-Family Partnership is one of two specific home-visiting programmes that have been shown to prevent child maltreatment and associated outcomes such as injuries:

Interventions to Prevent Child Maltreatment and Associated Impairment.

MacMillan HL, Wathen CN, Barlow J, Fergusson DM, Leventhal JM, Taussig HN. Lancet. 2009;373(9659):250-66.

The Nurse-Family Partnership appears to be a sound investment because it reduces intimate partner violence, child maltreatment, and youth crime and substance abuse; increases independence; and saves both money and lives.
Projected Outcomes of Nurse-Family Partnership Home Visitation During 1996-2013, USA.

Miller T. Prev Sci. 2015;16(6):765-77.

The Coalition for Evidence-Based Policy (a non-profit, non-partisan organization) has determined that the NFP meets the Congressional Top Tier Evidence standard, defined as: Interventions shown in well-designed and implemented randomized controlled trials, preferably conducted in typical community settings, to produce sizable, sustained benefits to participants and/or society.

The NFP program model meets the criteria established by the US Department of Health and Human Services for an “evidence-based early childhood home visiting service delivery model.”

The RAND Organization has determined that the economic benefits of early childhood interventions [such as NFP] are likely to be greatest for programs that effectively serve targeted, disadvantaged children compared with universal programs or programs that serve more-advantaged children

Early Childhood Interventions - Proven Results, Future Promise

Karoly LA, Kilburn MR, Jill S. Cannon JS.

The Nurse-Family Partnership is a “certified model program” included in the Blueprints for Healthy Youth Development registry of evidence-based positive youth development programs designed to promote the health and well-being of children and teens

The World Health Organization (2013) European report on preventing child maltreatment report identifies the positive outcomes plus cost-savings of Nurse-Family Partnership.

The Washington State Institute for Public Policy published a report in 2008 “Evidence-Based Programs to Prevent Children from Entering and Remaining in The Child Welfare System: Benefits and Costs for Washington” that included NFP in a “portfolio” of evidence-based and economically sound options.

They have subsequently published an update in 2012 that identifies NFP as the program with the highest return on investment in the area child welfare.

The Public Health Agency of Canada lists Nurse-Family Partnership in their Best Practices Portal. A Best Practice is defined as an intervention, program, service, or strategy that has, through multiple implementations, demonstrated: High Impact - positive changes related to the desired goal(s); High Adaptability - successful adaptation and transferability to different settings; and High Quality of Evidence - excellent quality of research/evaluation methodology, confirming the intervention's high impact and adaptability evidence.

The independent analysis of the Memphis trial by Nobel Laureate, Jim Heckman of the University of Chicago, “An Analysis of the Memphis Nurse-Family Partnership Program”, puts NFP through its most rigorous analysis to date and finds that the program improved maternal mental health and parenting skills, which resulted in better outcomes for their children.


An Analysis of the Memphis Nurse-Family Partnership Program

Heckman JJ, Holland ML, Makino K, Pinto R, Rosales-Rueda M. NBER Working Paper No. 23610. Issued in July 2017.

The Life-cycle Benefits of an Influential Early Childhood Program

García JL, Heckman JJ, Leaf ED, Prados MJ. NBER Working Paper No. 22993. Issued in May 26, 2017.

The Influence of Social-developmental Context and Nurse Visitation Intervention on Self-agency Change in Unmarried Adolescent Mothers.

DeSocio JE, Holland ML, Kitzman HJ, Cole RE. Res Nurs Health. 2013 Apr;36(2):158-70.

Exploring Multilevel Factors for Family Engagement in Home Visiting Across Two National Models.

Latimore AD, Burrell L, Crowne S, Ojo K, Cluxton-Keller F, Gustin S, Kruse L, Hellman D, Scott L, Riordan A, Duggan A. Prev Sci. 2017 Jul;18(5):577-589.

The Mental Health Needs of Low-Income Pregnant Teens: A Nursing–Social Work Partnership in Care.

Payne NA, Anastas JW. Research on Social Work Practice. 2015; 25(5): 595-606

Addressing Social Determinants of Health and
Health Disparities: A Vital Direction for Health and Health Care

Adler NE, Cutler DM, Fielding JE, Galea S, Glymour MM, Koh HK, Satcher D. NAM Perspectives. Discussion Paper, National Academy of Medicine, Washington, DC. 2016.

MIECHV Evaluations

A number of US states have been involved in the Maternal, Infant and Early Childhood Home Visiting (MIECHV) initiative, which has been evaluating various aspects of a number of home visiting programs (including NFP) being provided. The online journal – Maternal and Child Health recently published (June 2018) a special edition with a number of articles which examine a number of areas relating to home visiting including:


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