Nurse home visits have a lasting impact for disadvantaged mothers and daughters, health data show

Nurse home visits to disadvantaged mothers can significantly reduce their rates of hypertension and their daughters' likelihood of obesity, finds a new reanalysis of health data by a team led by a UCL researcher.

The study, "Early Home-Visits and Health Outcomes in Low-Income Mothers and Offspring: 18-Year Follow-Up of a Randomized Trial" appearing in the journal JAMA Network Open, reanalyzed data taken as part of a Nurse-Family Partnership trial started more than 30 years ago—The Memphis New Mothers Study (1990–1994).

The researchers found that prenatal and infancy nurse home visits decreased the likelihood of daughters being obese by 55% and being severely obese by 81% in adolescence. Similarly, mothers of girls showed a decrease of 39% and 88% for rates of Stage 1 and Stage 2 hypertension, respectively.

Lead author Professor Gabriella Conti (UCL Economics) said, "Nurse visits are a powerful tool that can make a huge difference in people's lives. This data shows the positive influence that public programs like this can have on the long-term health of not just the children born into adverse circumstances, but also for the mothers themselves."

Poverty and related adverse childhood experiences negatively impact a child's long-term health by increasing the risk of chronic health conditions, including heart disease, type 2 diabetes and kidney failure which can lead to premature death. The study was in part set up to look for ways that early intervention could help alleviate or prevent these lasting conditions.

Co-author Dr. Joyce Smith, Assistant Professor at the University of Rochester School of Nursing, United States, said, "These ongoing benefits show the tremendous potential of a strong relationship between nurses and mothers. Investing in that relationship early on leads to a lifetime of positive outcomes."

The study of nurse home visits began in New York in the 1970s and sought to gauge the impact of nurse home visits for mothers facing serious social adversities in order to improve pregnancy outcomes, child health and development and maternal health and life course.

The community health program, which provides nurse home visits for first-time mothers, spread across the United States and was adopted internationally.

Previous research using Nurse-Family Partnership data, has demonstrated positive effects of the program on first-time parents, including fostering healthier pregnancies and deliveries, improving child health and development, and increasing the economic self-sufficiency of families.

The Memphis New Mothers Study was launched in 1990 and followed 742 disadvantaged mothers in the city of Memphis, Tennessee in the southern United States. Clinicians then revisited the families at ages 12 and 18 to assess their health and collect a wide range of health data. Data from the study are still being collected in a current 30-year follow-up.

All expectant mothers in the study were given free transportation for prenatal care and child developmental screenings in the first two years of the child's life, while a subset received prenatal and infant/toddler nurse home-visits as well.

Co-author Professor David Olds of the University of Colorado Denver—Anschutz Medical Campus, said, "The women in this study were facing profound adversities. The trial showed that the relatively small investment for these nurse visits can lead to big changes because the benefits are the most pronounced where the needs are the greatest."

Other similar trials were set up in England, Canada, the Netherlands and Germany as well. The program also operates at scale in a number of locations across England and Scotland.

Professor Conti says, "Given the differences in public policy environments today as compared to the time of the Memphis trial, it is crucial to understand whether and to which extent the positive results that we've seen in Memphis can be duplicated for disadvantaged mothers around the world today. It's a subject my team is continuing to investigate and we hope to develop policy recommendations for best practices to implement a similar program in the contemporaneous landscape."