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Visits by Nurses Improve Life of New Mothers, Children for Years

Success Leads to a $13 Million Grant for Nationwide Rollout

Thursday, December 09, 2004

Backed by 20 years of work, Rochester researchers have developed a program for home visits by nurses to low-income women who are pregnant with their first child that dramatically improves the lives of both the mothers and their children.

A nationwide rollout of the program is now in full swing at 170 sites, backed by urging from the Justice Department and $13 million in grants from the Robert Wood Johnson Foundation. And hundreds of millions of public dollars, to cover operating costs, have been invested by communities where the program is being established. The support confirms the program as an effective, practical way to help people with fewer resources at a crucial time in their lives.

The most recent findings by University of Rochester School of Nursing researchers and their colleagues, published this week in the journal Pediatrics, show a host of program benefits for the mothers and their children.

The women assisted by nurses had fewer subsequent pregnancies, longer intervals between births of their firstand second children, longer relationships with current partners, and fewer months ofusing welfare and food stamps. For mothers of lower socio-economic status, all of these factors are important in the health of their children and their family’s quality of life.

In addition, nurse-visited children demonstratedhigher intellectual functioning, better vocabulary scores and fewer behavior problems. Nurse-visited children born to mothers with some psychological problems had higher arithmetic achievementtest scores, less trouble with comprehension and also exhibited less aggression. Overall, the children are better prepared to enter school because of better cognitive and language development and fewer behavior problems.

Just as significant, the latest research is based on a follow-up, four years after the nurses finished their visits with the families. So initial benefits, as previously observed by the research team, have proven to last over several years. Previous research enrolled primarily rural white women; this latest study involved an urban African-American population. Yet both studies showed the same kind of benefits.

Under the program, nurses help pregnant women improve their health by eating nutritiously and reducing their use of cigarettes, alcohol, and illegal drugs. The nurses also identify any emerging obstetrical problems and make sure they’re treated before they become more serious.

Once the child is born, the nurses help guide the parents to provide more responsible and competent care for their children. And they encourage families to become economically self-sufficient by helping parents develop a vision for their future, plan future pregnancies, continue their education and find jobs.

“These visits are intense and comprehensive,” says Harriet Kitzman, PhD, RN, co-investigator on the study and professor of nursing and pediatrics at the University of Rochester. “Over two decades, we’ve refined the program to make sure we’re addressing the vital needs of these women and their families. Our research is showing lasting effects on their lives.”

            Based on the success of its work, the research team has just received funding to do a 27-year follow-up study with the original group of participants to see if the benefits continue.

The accelerated nationwide rollout has created sites in 23 states now, including in Elmira and Cayuga County in New York State. The program is now serving 13,000 families per year.

Besides Professor Kitzman, other School of Nursing researchers on the team are Robert Cole, PhD, and Kimberly Sidora-Arcoleo, MPH. David L. Olds, PhD, now of the University of Colorado, was on faculty at the School of Nursing when the research began.

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