Home nursing visits provide wide-ranging benefits for mothers, young children

Nurse Georgia Graves smiles at Avery Sanchez, 6-months-old, during a visit to the infant's home in Oceanside, Calif.

Credit: Lillian Mongeau/EdSource

Children born to low-income, first-time mothers who received home nursing visits showed increased mental health, stronger social and emotional development and academic gains, according to researchers who analyzed the impact of the Nurse-Family Partnership program, one of the largest home visiting programs in the country.

Researchers also found the program reduces anxiety and improves the parenting skills of mothers. It also has a positive impact on home environments and behavior skills in children, researchers found. Researchers said the benefits of the program “warrant continued and increased investment.”

The Nurse-Family Partnership program utilizes trained, registered nurses who work closely with families during pregnancy and up to age 2. The nurses teach them to maintain proper health, develop parenting skills and establish work and family goals.

The research team that conducted the analysis was led by James Heckman, a Nobel Laureate in economics and professor and director of the Center for Economics of Human Development at the University of Chicago. The study, titled “Nurse-Family Partnership: Parental education and early health result in better child outcomes,” was released Monday.

“This study of Nurse-Family Partnership (NFP) shows that parenting early in life very much matters, and that voluntary programs that work closely with parents to strengthen parenting skills and provide early health can make a difference,” the study states. Researchers analyzed information on the health and well-being of mothers and children from pregnancy up to age 12. The study includes a sample size of 1,138 participants. The study analyzed outcomes for children who participated in the program, compared to children who were not part of the program but received some services at the same ages.

A family’s participation in the Nurse-Family Partnership program ends when a child turns 2 but the study found long-term benefits. For instance, the study found that young boys who participated in the program scored higher than peers that did not participate in the program on reading and math assessments, as 12-year-olds, the age when they were last assessed. Researchers said this academic achievement could be attributed, in large part, to the program’s impact — seen as early as age 6 — on cognitive skills, such as a child’s ability to understand, reason, learn and remember.

While the study found the program improved cognitive skills for both boys and girls at age 6, it did not find any significant effect on reading and math achievement for 12-year-old girls who participated in the program. Researchers did not directly address reasons for this in the study.

During home visits, nurses help to promote healthy eating, prenatal care and eliminating the use of tobacco, alcohol and illegal drugs, the study states. After delivery, nurses help to foster strong parenting skills and show new moms how to interact with their children. For example, parents are encouraged to read to their children. Mothers are also given advice on goal setting in areas such as work, school and family planning.

The study divided its analysis into five categories: child health, family environments, child cognition (thinking, learning, understanding), social and emotional development (behaviors and attitudes) and achievement scores on math and reading. For example, The Peabody Picture Vocabulary Test, which measures what experts in the field call English receptive language skills. That refers to words young children can identify and understand when they hear them.

Other key findings in the study include :

• Improved birth weight for infant boys. Boys were healthier at the time of delivery. If left untreated, low birth weight is associated with developmental problems that can persist as a child grows.
• Healthier home environments, parenting attitudes and maternal mental health “significantly improved” among participating mothers for boys and girls by age 2. Mothers of young girls specifically experienced less anxiety, more self-control, higher self-esteem and greater emotional stability, the study states. Under the same categories for boys, results show “mixed.”
• Girls showed more improvement in social and emotional skills, the ability to manage and understand emotions. They specifically improved in areas such as warmth and sensitivity.
• By age 6, both boys and girls who participated in the program showed better cognitive skills, such as thinking, reading, memory and learning.
• Long-term benefits of the program were more evident for boys than girls. For example, by age 12 boys outperformed peers who were not a part of the program in reading and math achievement. Study states “much weaker long-term effects” for girls.
• Positive effects overall were associated with the program’s impact on mothers’ health and early investment in young children.