Pediatrics – a leading, peer鈥恟eviewed journal of the American Academy of Pediatrics – published an 18鈥恲ear follow鈥恥p of participants in a randomized, clinical trial of Nurse鈥怓amily Partnership ® (NFP). This study found that Nurse鈥怓amily Partnership significantly improved the cognitive functioning and academic performance of 18鈥恲ear-old youth born to high鈥恟isk mothers with limited psychological resources to cope with poverty. An additional Pediatrics study, over the same 18鈥恲ear period, found that Nurse Family Partnership saved government $17,310 per family in public benefit costs, resulting in a net savings of $4,732 in government costs (in 2009 dollars).
These studies are the largest and longest follow鈥恥ps of Nurse鈥怓amily Partnership – a national early intervention program serving first time mothers and their children living in poverty – to measure youth cognitive development and academic performance and cost savings per family to government.
“It’s rare for studies of early invention programs to examine early鈥恑ntervention effects over an 18鈥恲ear period,” said David Olds, PhD, professor of pediatrics at University of Colorado and one of the lead investigators of the studies. “This early intervention, Nurse Family Partnership, produced long term improvements in the cognitive functioning of 18鈥恲ear鈥恛ld youth born to mothers who had limited personal resources to cope with the adversities of living in deep poverty. This new evidence shows promise that Nurse鈥怓amily Partnership’s effects may carry over into adulthood.”
“We know that mothers participating in Nurse鈥怓amily Partnership truly changed the life course for themselves and their children,” said Frank Daidone, president and CEO of Nurse鈥怓amily Partnership.“These nurse home visits during pregnancy and the mother’s first two years of parenting had a profound effect in laying the foundation for moms to reduce the impact of poverty and build stronger families. There’s no better public investment – than investing in building stronger families. Not only does the government save money, but youth and families prosper and communities thrive.”
Improved Outcomes for Youth:
The youth study found that youth – whose mothers had participated in nurse home visits during pregnancy and until their second birthday – had improved cognitive outcomes compared to youth in the control group. These benefits were observed for children born to high鈥恟isk mothers with limited psychological resources to cope with poverty, that is, those with lower intellectual functioning, mental health and sense of mastery (meaning confidence in their ability to manage challenges in their lives).
The outcomes for youth at age 18 included: improved math achievement scores, receptive language abilities, working memory, and ability to accurately read others’ emotions. In addition, the nurse visited youth were three times as likely to graduate from high school with honors compared to the control group. Also, at age 18, the proportion of nurse鈥恦isited youth receiving supplemental security income (SSI) for disability was 64.2% lower than that of the control group.
Moreover, nurse鈥恦isited female children born to all mothers participating in Nurse鈥怓amily Partnership, as a trend, had fewer convictions at age 18 than female children in the control group (an effect also observed for 19鈥恲ear鈥恛ld females in a previous randomized, clinical trial of the program in Elmira, N.Y). There were no other beneficial effects of the program on youth’s behavioral health.
Improved Outcomes for Family’s Economic Self鈥怱ufficiency:
The additional 18鈥恲ear study of high鈥恟isk mothers – who had participated in nurse home visits during pregnancy until their first child’s second birthday – showed that when their first child was 18 years old, they had saved the government $17,310 (2009 dollars) in public benefits compared to women in the control group. These savings came from reduced costs for Medicaid, the Supplemental Nutrition Assistance Program (SNAP), and welfare cash assistance. Considering the $12,578 cost per family of program participation, this represents a net savings of $4,732 (2009 dollars) in government costs. The reduction in public benefit costs was explained in part by nurse鈥恦isited mothers better planning subsequent鈥恜regnancies.
This study demonstrates how Nurse鈥怓amily Partnership when serving high鈥恟isk mothers improved the mother’s life course – improving her economic self鈥恠ufficiency – and strengthened families. Nurse鈥恦isited mothers, when compared to the control group, were more likely to get married over the 18鈥恲ear follow鈥恥p period and had higher rates of co鈥恏abitation. These mothers also had greater sense of mastery, that is, confidence in their ability to manage challenges in their lives. At the 18鈥恲ear assessment, nurse visited mothers had spouses who were employed 14 months more than those in the control group. There were no other program effects on maternal self鈥恟eported behavioral health.
Study Design
Beginning in 1990, this study enrolled primarily African鈥怉merican women with high鈥恟isk characteristics: 85% were living in households below the federal poverty level and in highly disadvantaged neighborhoods in Memphis, TN.
Both studies had high retention rates, which contribute to the validity of the findings. The mother study completed assessments on 85% of those mothers that were still alive at their first child’s eighteenth birthday; while the youth study completed assessments on 90% of the children still alive at age 18. These high rates of retention are rare in longitudinal studies.
These follow鈥恥p studies are the most recent reports from a series of randomized, clinical trials of Nurse鈥怓amily Partnership over the past four decades. Families in these trials are being followed over their life course to estimate NFP’s long鈥恡erm effects – far beyond when the program ends at the first child’s second birthday. These studies have found that Nurse鈥怓amily Partnership is successful in reducing welfare use, improving maternal life course, improving children’s cognitive development and academic achievement, reducing juvenile crime, and improving birth outcomes.
Le Bonheur Children's Hospital has one team of eight nurses who has served more than 700 mother/child combinations since the program began at Le Bonheur in 2010.
About Nurse鈥怓amily Partnership
Nurse鈥怓amily Partnership ® changes the future for the most vulnerable babies born into poverty by giving a first鈥恡ime mom trusted support from her own personal nurse throughout the first 1,000 days, from pregnancy until her child’s second birthday. The program is backed by over 40 years of scientifically鈥恜roven outcomes for both mom and baby, and currently serves over 38,000 moms in 41 states, the U.S. Virgin Islands and many Tribal communities. Nurse鈥怓amily Partnership is headquartered in Denver, Colorado. Follow NFP on Twitter @NFP_nursefamily, Facebook at facebook.com/nursefamilypartnership and Instagram at www.instagram.com/nursefamilypartnership/.
