Impact of the Nurse-Family Partnership on Neighborhood Context, Government Expenditures, and Children's School Functioning

The Denver trial of NFP home visitation to low-income mothers bearing their first child produced significant positive effects. Each participating mother-child dyad gained an average of 0.15 quality-adjusted life years (QALYs). Its benefits net of the value of the QALYs saved and of associated health-related earnings gains exceeded its costs by an estimated $8,036 per mother assisted. This report describes the methods used to quantify and value the NFP benefits. The second study augmented the data collection procedures of the Denver trial of the NFP by obtaining third-grade teachers' ratings of children's behaviors and teacher reports of children's grade-point averages in reading and math in third grade. The study found no statistically significant program effects on teacher reports of children's behavior, parent reports of children's behavior, or children's grade-point averages; however, there was a reduction, as a trend, in the extent to which nurse-visited 9-year-old children, compared to controls, were rated as having internalizing (emotional) disorders (3.6 percent vs. 8.2 percent). The third study determined whether the NFP program of prenatal and infancy home-visiting by nurses might buffer mothers and their first-born children from the adverse effects of concentrated neighborhood disadvantage. The analyses of neighborhood disadvantage as a mediator and moderator of program effects found in the trials of the NFP are explained in the context of widely differing levels of neighborhood disadvantage. Study references, tables, and figures