Prevention Science

, Volume 3, Issue 3, pp 153–172 | Cite as

Prenatal and Infancy Home Visiting by Nurses: From Randomized Trials to Community Replication

  • David L. Olds


This paper summarizes a 25-year program of research that has attempted to improve the early health and development of low-income mothers and children and their future life trajectories with prenatal and infancy home visiting by nurses. The program has been tested in two separate large-scale randomized controlled trials with different populations living in different contexts. The program has been successful in improving parental care of the child as reflected in fewer injuries and ingestions that may be associated with child abuse and neglect; and maternal life-course, reflected in fewer subsequent pregnancies, greater work force participation, and reduced use of public assistance and food stamps. In the first trial, the program also produced long-term effects on the number of arrests, convictions, emergent substance use, and promiscuous sexual activity of 15-year-old children whose nurse-visited mothers were low-income and unmarried when they registered in the study during pregnancy. Since 1996, the program has been offered for public investment outside of research contexts. Careful attention has been given to ensuring that the program is replicated with fidelity to the model tested in the scientifically controlled studies by working with community leaders to ensure that organization and community contexts are favorable for the program; by providing the nurses with excellent training and technical assistance and detailed visit-by-visit guidelines; and by providing organizations with a web-based clinical information system that creates a basis for monitoring program performance and continuous quality improvement.

home visiting pregnancy infancy child abuse injuries maternal health 


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  1. Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191–215.Google Scholar
  2. Barnard, K. E. (1990). Keys to caregiving. Seattle, WA: University of Washington Press.Google Scholar
  3. Bowlby, J. (1969). Attachment and loss: Vol 1. Attachment. New York: Basic Books.Google Scholar
  4. Brafford, L. J., & Beck, K. H. (1991). Development and validation of a condom self-efficacy scale for college students. Journal of American College of Health, 39, 219–225.Google Scholar
  5. Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge, MA: Harvard University Press.Google Scholar
  6. Bronfenbrenner, U. (1995). Developmental ecology through space and time: A future perspective. In P. Moen, G. H. Elder, Jr., & K. Luscher (Eds.), Examining lives in context (pp. 619–647). Washington, DC: American Psychological Association.Google Scholar
  7. Buchsbaum, H. K., Toth, S. L., Clyman, R. B., Chichetti, D., & Emde, R. N. (1992). The use of a narrative story stem technique with maltreated children: Implications for theory and practice. Development and Psychopathology, 4, 603–625.Google Scholar
  8. Clark, A. S., Soto, S., Bergholz, T., & Schneider, M. (1996). Maternal gestational stress alters adaptive and social behavior in adolescent rhesus monkey offspring. Infant Behaviour and Development., 19, 453–463.Google Scholar
  9. Dodge, K. A., Bates, J. E., & Pettit, G. S. (1990, December 21). Mechanisms in the cycle of violence. Science, 250, 1678–1683.Google Scholar
  10. Dolezol, S., & Butterfield, P. M. (1994). Partners in parenting education. Denver, CO: How to Read Your Baby.Google Scholar
  11. Eckenrode, J., Ganzel, B., Henderson, C. R., Smith, E., Olds, D., Powers, J., Cole, R., Kitzman, H., & Sidora, K. (2000). Preventing child abuse and neglect with a program of nurse home visitation: The limiting effects of domestic violence. Journal of the American Medical Association, 284, 1385–1391.Google Scholar
  12. Egeland, B., Jacobvitz, D., & Sroufe, L. A. (1988). Breaking the cycle of abuse. Child Development, 59, 1080–1088.Google Scholar
  13. Elster, A., & McAnarney, E. (1980). Medical and psychosocial risks of pregnancy and childbearing during adolescence. Pediatric Annals, 9, 13.Google Scholar
  14. Emde, R. N., & Buchsbaum, H. K. (1990). “Didn't you hear my”: Autonomy with connectedness in moral self-emergence. In D. Chicchetti & M. Beeghly (Eds.), The self in transition (pp. 35–60). Chicago: University of Chicago Press.Google Scholar
  15. Families andWork Institute, The University of Chicago (1996). Rethinking the brain-new insights into early development (Executive summary).Google Scholar
  16. Fried, P. A., Watkinson, B. W., & Dillon, R. F. (1987). Neonatal neurological status in a low-risk population after prenatal exposure to cigarettes, marijuana, and alcohol. Developmental and Behavioral Pediatrics, 8, 318–326.Google Scholar
  17. Furstenberg, F. F., Brooks-Gunn, J., & Morgan, S. P. (1987). Adolescent mothers in later life. Cambridge: Cambridge University Press.Google Scholar
  18. Gallup Organization (2000, November 27). Nurses remain at top of honesty and ethics poll.Google Scholar
  19. Gomby, D. S., Culross, P. L., & Behrman, R. E. (1999). Home-visiting; recent program evaluations-Analysis and recommendations. The Future of Children: Home Visiting: Recent Program Evaluations, 9, 4–26.Google Scholar
  20. Heinrich, L. (1993). Contraceptive self-efficacy in college women. Journal of Adolescent Health, 14, 269–276.Google Scholar
  21. Institute of Medicine (1990). Nutrition during pregnancy. Washington, DC: National Academy Press.Google Scholar
  22. Karoly, L. A., Greenwood, P. W., Everingham, S. S., Hoube, J., Kilburn, M. R., Rydell, C. P., Sanders, M., & Chiesa, J. (1998). Investing in our children: What we know and don't know about the costs and benefits of early childhood interventions. Santa Monica, CA: The RAND Corporation.Google Scholar
  23. Kellam, S. G., & Werthamer-Larsson, L. (1986). Developmental epidemiology: A basis for prevention. In M. Kessler & S. E. Goldston (Eds.), A decade of progress in primary prevention (pp. 154–180). Hanover, NH: University Press of New England.Google Scholar
  24. Kitzman, H., Olds, D. L., Henderson, C. R., Jr., Hanks, C., Cole, R., Tatelbaum, R., McConnochie, K. M., Sidora, K., Luckey, D. W., Shaver, D., Engelhardt, K., James, D., & Barnard, K. (1997). Effect of prenatal and infancy home visitation by nurses on pregnancy outcomes, childhood injuries, and repeated childbearing: A randomized controlled trial. Journal of the American Medical Association, 278, 644–652.Google Scholar
  25. Kitzman, H., Olds, D., Sidora, K., Henderson, C., Hanks, C., Cole, R., Luckey, D., Bondy, J., Cole, K., & Glazner, J. (2002). Enduring effects of nurse home visitation on maternal life course: A 3-year follow-up of a randomized trial. The Journal of the American Medical Association, 283(15), 1983–1989.Google Scholar
  26. Klein, L., & Goldenberg, R. L. (1990). Prenatal care and its effect on preterm birth and low birthweight. In I. R. Merkatz & J. E. Thompson (Eds.), New perspectives on prenatal care (pp. 501–529). New York: Elsevier.Google Scholar
  27. Kramer, M. S. (1987). Intrauterine growth and gestational duration determinants. Pediatrics, 80, 502–511.Google Scholar
  28. Levinson, R. A. (1986). Contraceptive self-efficacy: A perspective on teenage girls' contraceptive behavior. Journal of Sex Research, 22, 347–369.Google Scholar
  29. Main, M., Kaplan, N., & Cassidy, J. (1985). Security in infancy, childhood, and adulthood:Amove to the level of representation. In I. Bretherton & E. Waters (Eds.), Growing points of attachment theory and research. Monographs of the Society for Research in Child Development, 50 (1-2, Serial No. 209, pp. 66-104).Google Scholar
  30. Mayes, L. C. (1994). Neurobiology of prenatal cocaine exposure: Effect on developing monoamine systems. Infant Mental Health Journal, 15, 121–133.Google Scholar
  31. McLanahan, S., & Carlson, M. (2002, Winter/Spring). Welfare reform, fertility, and father involvement. Future of Children, 12, 147–166.Google Scholar
  32. Milberger, S., Biederman, J., Faraone, S., Chen, L., & Jones, J. (1996). Is maternal smoking during pregnancy a risk factor for attention deficit hyperactivity disorder in children? American Journal of Psychiatry, 153, 1138–1142.Google Scholar
  33. Moffitt, T. E. (1993). Adolescence-limited and life-course-persistent antisocial behavior: A developmental taxonomy. Psychological Review, 100, 674–701.Google Scholar
  34. Musick, J. S. (1993). Young, poor and pregnant. New Haven, CT: Yale University Press.Google Scholar
  35. Newberger, C. M., & White, K. M. (1990). Cognitive foundations for parental care. In D. Cicchetti & V. Carlson (Eds.), Child maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 302–316). Cambridge, England: Cambridge University Press.Google Scholar
  36. Olds, D. L. (1997). Tobacco exposure and impaired development: A review of the evidence. Mental Retardation and Developmental Disabilities Research Reviews, 3, 1–13.Google Scholar
  37. Olds, D. L., Eckenrode, J., Henderson, C. R., Jr., Kitzman, H., Powers, J., Cole, R., Sidora, K., Morris, P., Pettitt, L. M., & Luckey, D. (1997a). Long-term effects of home visitation on maternal life course and child abuse and neglect: 15-year follow-up of a randomized trial. Journal of the American Medical Association, 278, 637–643.Google Scholar
  38. Olds, D. L., Henderson, C. R., Chamberlin, R., & Tatelbaum, R. (1986a). Preventing child abuse and neglect: A randomized trial of nurse home visitation. Pediatrics, 78, 65–78.Google Scholar
  39. Olds, D., Henderson, C. R., Jr., Cole, R., Eckenrode, J., Kitzman, H., Luckey, D., et al. (1998a). Long-term effects of nurse home visitation on children's criminal and antisocial behavior: 15-year follow-up of a randomized trial. Journal of the American Medical Association, 280, 1238–1244.Google Scholar
  40. Olds, D. L., Henderson, C. R., & Kitzman, H. (1994a). 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? Pediatrics, 98, 89–98.Google Scholar
  41. Olds, D. L., Henderson, C. R., Kitzman, H., & Cole, R. (1995). Effects of prenatal and infancy nurse home visitation on surveillance of child maltreatment. Pediatrics, 95, 365–372.Google Scholar
  42. Olds, D. L., Henderson, C. R., Jr., Kitzman, H., Eckenrode, J., Cole, R., Tatelbaum, R., et al. (1998b). Prenatal and infancy home visitation by nurses: A program of research. In C. Rovee-Collier, L. P. Lipsitt, & H. Hayne (Eds.), Advances in infancy research (Vol. 12). Stamford, CT: Ablex Publishing.Google Scholar
  43. Olds, D. L., Henderson, C., Tatelbaum, R., and Chamberlin, R. (1988). Improving the life-course development of socially disadvantaged parents: A randomized trial of nurse home visitation. American Journal of Public Health, 78, 1436–1445.Google Scholar
  44. Olds, D. L., Henderson, C. R., & Tatelbaum, R. (1994b). Intellectual impairment in children of women who smoke cigarettes during pregnancy. Pediatrics, 93, 221–227.Google Scholar
  45. Olds, D. L., Henderson, C. R., & Tatelbaum, R. (1994c). Prevention of intellectual impairment in children of women who smoke cigarettes during pregnancy. Pediatrics, 93, 228–233.Google Scholar
  46. Olds, D. L., Henderson, C. R., Tatelbaum, R., & Chamberlin, R. (1986b). Improving the delivery of prenatal care and outcomes of pregnancy: A randomized trial of nurse home visitation. Pediatrics, 77, 16–28.Google Scholar
  47. Olds, D. L., Hill, P. L., O'Brien, R., Racine, D., & Moritz, P. (in press). Taking preventive intervention to scale: The nurse-family partnership. Cognitive and Behavioral Practice.Google Scholar
  48. Olds, D., Hill, P., Robinson, J., Song, N., & Little, C. (2000). Update on home visiting for pregnant women and parents of young children. Current Problems in Pediatrics, 30(4), 105–148.Google Scholar
  49. Olds, D. L., & Kitzman, H. (1993). Review of research on home visiting. Future of Children, 3, 51–92.Google Scholar
  50. Olds, D. L., Kitzman, H., Cole, R., & Robinson, J. (1997b). Theoretical foundations of a program of home visitation for pregnant women and parents of young children. Journal of Community Psychology, 25, 9–25.Google Scholar
  51. Olds, D. L., & Korfmacher, J. (1997). Maternal psychological characteristics as influences on home visitation contact. Journal of Community Psychology, 26, 23–36.Google Scholar
  52. Olds, D. L., Pettitt, L. M., Robinson, J., Henderson, C., Jr., Eckenrode, J., Kitzman, H., & Powers (1998c). Reducing risks for antisocial behavior with a program of prenatal and early childhood home visitation. Journal of Community Psychology, 26, 65–83.Google Scholar
  53. Olds, D. L., Robinson, J., O'Brien, R., Luckey, D. W., Pettitt, L. M., Henderson, C. R., Ng, R. N., Korfmacher, J., Hiatt, S., & Talmi, A. (2002). Home visiting by nurses and by paraprofessionals: A randomized controlled trial. Pediatrics, 110(3), 486–496.Google Scholar
  54. Overpeck, M. D., Brenner, M. D., Trumble, A. C., Trifiletti, L. B., & Berendes, H. W. (1998). Risk factors for infant homicide in the United States. New England Journal of Medicine, 339(17), 1121–1216.Google Scholar
  55. Peterson, L., & Gable, S. (1998). Holistic injury prevention. In J. R. Lutzker (Ed.), Handbook of child abuse research and treatment (pp. 291–318). New York: Plenum.Google Scholar
  56. Plomin, R. (1986). Development, genetics, and psychology. Hillsdale, NJ: Erlbaum.Google Scholar
  57. Quinton, D., & Rutter, M. (1984). Parents with children in care: II. Intergenerational continuities. Journal of Child Psychology and Psychiatry, 25, 231–250.Google Scholar
  58. Raine, A., Brennan, P., & Mednick, S. A. (1994). Birth complications combined with early maternal rejection at age 1 year predispose to violent crime at age 18 years. Archives of General Psychiatry, 51, 984–988.Google Scholar
  59. Rotter, J. B. (1966). Generalized expectancies for internal versus external control of reinforcements. Psychological Monographs: General and Applied, 80(1), 1–28.Google Scholar
  60. Rutter, M. (1989). Intergenerational continuities and discontinuities in serious parenting difficulties. In D. Cicchetti & V. Carlson (Eds.), Child maltreatment-Theory and research on the causes and consequences of child abuse and neglect (pp. 315–348). Cambridge, MA: Cambridge University Press.Google Scholar
  61. Sameroff, A. J. (1983). Parental views of child development. In R. A. Hoekelman (Ed.), Minimizing high-risk parenting (pp. 31–45). Media, PA: Harwal Publishing.Google Scholar
  62. Saxon, D. W. (1978). The behavior of infants whose mothers smoke in pregnancy. Early Human Development, 2, 363–369.Google Scholar
  63. Sroufe, A., & Carlson, E. A. (1995). Contribution of attachment theory to developmental psychopathology. In D. Cicchetti & D. Cohen (Eds.), Developmental psychopathology:Vol. 1. Theory and methods (pp. 581–617). New York: Wiley.Google Scholar
  64. Streissguth, A. P., Sampson, P. D., Barr, H. M., Bookstein, F. L., & Olson, H. C. (1994). The effects of prenatal exposure to alcohol and tobacco: Contributions from the Seattle longitudinal prospective study and implications for public policy. In H. L. Needleman & D. Bellinger (Eds.), Prenatal exposure to toxicants-Developmental consequences (pp. 148–183). Baltimore, MD: Johns Hopkins University Press.Google Scholar
  65. Teicher, M. H. (2000, Fall). Wounds that time won't heal: The neurobiology of child abuse. Cerebrum, 2(4), 50–67.Google Scholar
  66. Tygart, C. E. (1991). Juvenile delinquency and number of children in a family: Some empirical and theoretical updates. Youth and Society, 22, 525–536.Google Scholar
  67. Wakschlag, L. S., Pickett, K. E., Cook, E., Benowitz, N. L., & Leventhal, B. L. (2002). Maternal smoking during pregnancy and severe antisocial behavior in offspring: A review. American Journal of Public Health, 92, 966–974.Google Scholar

Copyright information

© Society for Prevention Research 2002

Authors and Affiliations

  • David L. Olds
    • 1
  1. 1.Prevention Research CenterUniversity of ColoradoDenver

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