Abstract
We conducted a cluster-based randomized controlled trial of an intervention designed to improve participant retention in community replication sites of the Nurse-Family Partnership (NFP). We registered 26 sites and randomized them into three groups: retention intervention (RI, N = 9), delayed RI (DRI, N = 6), or control (C, NFP as usual, N = 11). The RI consisted of training nurses to give more explicit control over the frequency of visits and content of the program to the parent participants. Two of the sites assigned to the RI, two assigned to the DRI, and two out of four nurses in one other site assigned to the DRI chose not to participate in the intervention. Primary analyses (intention to treat) contrasted changes in participant retention and completed visits (the primary outcomes) in the two intervention groups (RI and DRI) compared to control sites, focusing on differences in performance among baseline cohorts compared to cohorts enrolled during the first year during which the retention intervention was implemented. Compared to baseline, retention declined in the control sites over time but stayed the same in the RI and DRI sites (p value for interaction = 0.099). Compared to baseline, the number of completed home visits declined over time in the control sites but did not in the RI and DRI sites, producing a significant treatment difference in change in mean completed home visits over time (2.71 visits, SE = 1.164, p = 0.020). The intervention offset a decline over time in retention and completed home visits found in the control group during the time covered by this trial. Quantitative and qualitative evaluation of the intervention indicated that improvements are needed to promote its uptake.
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Abbreviations
- NFP:
-
Nurse-Family Partnership
- RI:
-
Retention intervention
- DRI:
-
Delayed retention intervention
- MI:
-
Motivational interviewing
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Acknowledgments
This study was funded by a grant from the W.T. Grant Foundation (6797) to David Olds and an institutional NRSA postdoctoral research training program, 5T32 MH015442, Developmental Psychopathology, Psychobiology, and Behavior (DPRG) for Erin Ingoldsby. We thank the nurses who participated in this study.
Conflict of Interest
None of the authors has a personal financial interest in the Nurse-Family Partnership. The Prevention Research Center for Family and Child Health, directed by DLO at the University of Colorado School of Medicine, has a contract with the Nurse-Family Partnership© to conduct research to improve the NFP program and its implementation. DLO, PB, EI, DL, and MDK were employed by this center at the time the study was conducted. Olds is the founder of the Nurse Family Partnership.
Author Contributions
Study concept and design: Olds, Baca, and Ingoldsby. Acquisition of data: McClatchy, Loch, Ramsey. Analysis and interpretation of data: Olds, McClatchey, Luckey, Knudtson. Drafting the manuscript: Olds, Luckey, Knudtson. Critical revision of manuscript for important intellectual content: Olds, Baca, Ingoldsby, Luckey, Knudtson, Loch, and Ramsey. Statistical analysis: McClatchey, Luckey, Knudtson. Obtained funding: Olds. Study supervision: Olds, Baca, Loch, and Ramsey.
Additional Contributions
We thank Wendy Gehring (UC Denver) for data management and Cheryl Loston-Williams (UC Denver) for help with manuscript preparation. All of these contributors received compensation from research grants for their work.
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Olds, D.L., Baca, P., McClatchey, M. et al. Cluster Randomized Controlled Trial of Intervention to Increase Participant Retention and Completed Home Visits in the Nurse-Family Partnership. Prev Sci 16, 778–788 (2015). https://doi.org/10.1007/s11121-015-0563-x
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DOI: https://doi.org/10.1007/s11121-015-0563-x