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Chapter 21 - Nurse Family Partnership (Elmira)
Introduction to the Original Evaluation (Excerpt)
The Nurse Family Partnership (NFP) operated in Elmira, New York, a semi-rural area, from 1978 to 1982. It was designed to "help low-income, first-time parents start their lives with their children on a sound course and prevent the health and parenting problems that can contribute to the early development of antisocial behavior." The program had three main objectives: (1) to improve women's health-related behaviors during pregnancy; (2) to aid parents in the attainment of parenting skills; and (3) to enhance the maternal life-course development of participating women by encouraging family planning, educational development, and self- sufficiency. This intervention was unique in that it used nurses on home visits to direct mothers toward specific behaviors. David Olds, now professor of pediatrics at the University of Colorado Health Sciences Center and creator of the nurse-visitor design, and his colleagues (the "NFP team") evaluated the NFP using random assignment that took place between 1978 and 1980. They reported large reductions in welfare use among participating mothers and delinquency rates among participating children, particularly for the subsample of low socioeconomic status (SES) families. Olds also conducted a benefit-cost analysis when the children reached age four, which was updated by Lynn A. Karoly and her colleagues at RAND. This analysis suggests that, after fifteen years, the program saved $4 for every dollar spent. The savings were driven by reductions or delays in second births to the mothers and concomitant reductions in the receipt of welfare and food stamps among mothers. As the generalizability of the findings is an open question, the NFP team has recognized the need for replication of their findings. They have embarked on a strategy to examine the program's effects in different settings and support independent evaluations by other researchers. One remaining concern about the evaluation is that it was conducted by the same group that designed the intervention and has yet to be independently evaluated.
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