Visits by nurses help young families adjust, thrive

April 17, 2000

Home visits by nurses to young women who are pregnant improve the lives not only of the children but also the mothers and their partners as well, a study published in the April 19 issue of the Journal of the American Medical Association has found. The positive effects last for years.

The program, developed by researchers at the University of Rochester and the Colorado Health Sciences Center, is one of only a handful of programs that have been shown to promote self sufficiency among young, struggling families. Compared to families who did not receive prenatal and infancy home visits by nurses, families who were visited spent fewer months on welfare and food stamps. Mothers in these families also had fewer subsequent pregnancies and longer intervals between the birth of their first and second child. And their family structure was more stable, with women's partners more involved in the raising of the child and more likely to be employed.

The latest study of 1,139 young mothers was done in Memphis, Tenn., in the early 1990s. The majority of participants were African-American, and most were 18 or younger. Most were unmarried, had not graduated from high school, and were unemployed. One group received standard care; nurses visited women in the other group in their homes during pregnancy and for two years after the birth of their first child. Researchers then tracked the participants for three years after the program ended.

"The investment that society can make at this critical stage in a woman's life pays off over the long run in many ways having to do not only with care of the children but also with the woman's potential for economic self-sufficiency and the stability in her relationships," says Harriet Kitzman, R.N., Ph.D., the Loretta Ford Professor of Nursing at the University of Rochester School of Nursing.

The nurse visitation program was developed more than 20 years ago by developmental psychologist David Olds, Ph.D., formerly on the University of Rochester faculty and now at the University of Colorado Health Sciences Center, and other University of Rochester faculty members. Working as a pediatric nurse practitioner in the late 1960s, Kitzman actively engaged in home nursing visits and noticed the difference in the lives of the families she visited. She hooked up with Olds, who was conducting a study of home visits in Elmira, a small city in a rural area in southern New York State, to conduct a study that has been underway for nearly 20 years. Those results from a very different socio-cultural group, announced previously, mirror the latest findings. In addition, the team has tracked children from the Elmira study for 15 years and has found that children in families who were visited by nurses are less likely to use drugs, have fewer run-ins with the law, have fewer injuries, and are less likely to engage in irresponsible sexual behavior.

"There's a universal desire on the parts of mothers to protect their children and create optimal opportunities for them," Kitzman says. "Regardless of whether you're talking about rural white women or urban black women, mothers want the best for their children. This program helps women develop the resources to achieve that, so it's not surprising that the findings replicate from one site to another."

As a result of the studies, 130 communities around the country now use the nurse visitation program developed by Olds and Kitzman. A center that trains health officials to use the program is based at the University of Colorado and is funded by the Robert Wood Johnson Foundation.

The visits are geared toward young first-time mothers without many resources. The women may have dropped out of school, may not have the support of a spouse or partner, and often haven't developed a means to provide for their child. "While the women have observed mothering before, this is their first experience as parents, and they are open to learning more about what infants need for optimal development," Kitzman says.

The starting point for most of the nurse visits was the health of the baby. The nurses and mothers talked about how to read the subtle cues that babies give off, how to look for signs of illness, what to expect at certain ages, and the risks of habits like smoking and drinking.

"The nurses provide information about the health aspects of pregnancy, and that provides an entry point to a number of other issues. The topic of health provides an easy entry for the nurse and mother to work on other stresses the woman and her family are experiencing."

Building on the bond of trust centered on the baby's welfare, conversations typically branched out into other areas. Continuing their education, housing needs, employment opportunities, the availability of other resources, and the involvement of the women's partners and other family members in caring for the child were among the topics of most visits.

"Many visits really came to center on helping the women envision the future and to set goals for themselves," says Kitzman. "The nurse became the person to help the mother see the opportunities, and to develop the resources and skills to take advantage of them."
-end-
Kitzman and Olds were joined on the study by several other authors from Rochester, Colorado, Cornell University, and the Baylor School of Nursing. Other authors from Rochester include Robert Cole, Ph.D., associate professor of nursing and of psychiatry, and research associate Kimberly Sidora, M.P.H. The study was funded by the Department of Health and Human Services, the Carnegie Corporation of New York, and the Robert Wood Johnson Foundation.

University of Rochester

Related Health Articles from Brightsurf:

The mental health impact of pandemics for front line health care staff
New research shows the impact that pandemics have on the mental health of front-line health care staff.

Modifiable health risks linked to more than $730 billion in US health care costs
Modifiable health risks, such as obesity, high blood pressure, and smoking, were linked to over $730 billion in health care spending in the US in 2016, according to a study published in The Lancet Public Health.

New measure of social determinants of health may improve cardiovascular health assessment
The authors of this study developed a single risk score derived from multiple social determinants of health that predicts county-level cardiovascular disease mortality.

BU study: High deductible health plans are widening racial health gaps
The growing Black Lives Matter movement has brought more attention to the myriad structures that reinforce racial inequities, in everything from policing to hiring to maternal mortality.

Electronic health information exchange improves public health disease reporting
Disease tracking is an important area of focus for health departments in the midst of the COVID-19 pandemic.

E-health resource improves men's health behaviours with or without fitness facilities
Men who regularly used a free web resource made significantly more health changes than men who did not, finds a new study from the University of British Columbia and Intensions Consulting.

Mental health outcomes among health care workers during COVID-19 pandemic in Italy
Symptoms of posttraumatic stress disorder, depression, anxiety and insomnia among health care workers in Italy during the COVID-19 pandemic are reported in this observational study.

Mental health of health care workers in china in hospitals with patients with COVID-19
This survey study of almost 1,300 health care workers in China at 34 hospitals equipped with fever clinics or wards for patients with COVID-19 reports on their mental health outcomes, including symptoms of depression, anxiety, insomnia and distress.

Health records pin broad set of health risks on genetic premutation
Researchers from the University of Wisconsin-Madison and Marshfield Clinic have found that there may be a much broader health risk to carriers of the FMR1 premutation, with potentially dozens of clinical conditions that can be ascribed directly to carrying it.

Attitudes about health affect how older adults engage with negative health news
To get older adults to pay attention to important health information, preface it with the good news about their health.

Read More: Health News and Health Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.