Nurse-Family Partnership Impact Evaluation in South Carolina

NCT ID: NCT03360539

Last Updated: 2025-12-12

Study Results

Results available

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Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

5670 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-04-01

Study Completion Date

2046-04-01

Brief Summary

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This study evaluates the effects of the Nurse Family Partnership (NFP), an established home-visiting program, using a scientifically rigorous individual-level randomized controlled trial. The study will be based in South Carolina, where a Medicaid waiver in combination with a pay-for-success contract will allow expansion of the program to women on Medicaid. The study plans to enroll 4000 low-income, first time mothers and their children into the intervention group, and another 2000 into the control group. The study will evaluate the program's impacts on outcomes using administrative records. This study aims to yield new evidence on the effect of NFP in a modern context, applied to a new population, across a broad range of outcomes, and financed by a novel public-private partnership based on accountability for outcomes.

Detailed Description

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This study is an individual-level randomized controlled trial, with randomization post-consent. The study will enroll pregnant women who are income-eligible for Medicaid, less than 28 weeks pregnant, and have not had a previous live birth. All eligible applicants who provide written consent will be randomly assigned either to a treatment group that is offered access to NFP or to a control group that is not. Two-thirds of those recruited will be randomized to the treatment group and one-third to the control group. Control group members will have access to the standard of care and whatever other programs and services are available in the community.

The investigators will assess the effect of NFP on a range of short- and long-run maternal and child outcomes using administrative data that will be available for all members of both treatment and control groups. Several of the outcomes the investigators will evaluate are required as part of the Medicaid waiver and pay-for-success financing model.

Conditions

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Preterm Birth Injuries Maternal Behavior

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The Nurse-Family Partnership (NFP) was launched by pediatrician David Olds in the early 1970s in response to the observation that low-income mothers are less likely to engage in positive health and parenting behaviors that are associated with better child development outcomes (Olds et al. 1986). NFP is a prenatal and infancy home visiting program for low-income, first-time mothers and their families. Registered nurses begin visiting their clients as early in the pregnancy as possible, helping the mother-to-be make informed choices. The nurses continue visiting regularly until the child is two years old.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Treatment-NFP

NFP is a prenatal and infancy home visiting program for low-income, first-time mothers and their families. Registered nurses begin visiting their clients as early in the pregnancy as possible, helping the mother-to-be make informed choices. The nurses continue visiting regularly until the child is two years old.

Group Type EXPERIMENTAL

Nurse-Family Partnership

Intervention Type BEHAVIORAL

Control

Control group members have access to the standard of care and whatever other programs and services are available in the community.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Nurse-Family Partnership

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Female
* No previous live births
* Currently pregnant
* Gestation period less than 28 weeks (i.e. less than or equal to 27 weeks, 6 days) at time of recruitment
* Ages 15-55
* Income level meets Medicaid eligibility criteria
* Live within an area serviced by a NFP Implementing Agency
* Not currently enrolled in the study
* Not incarcerated or living in lock down facilities

Exclusion Criteria

* Men
* Women who have had a previous live birth
* Women who are not currently pregnant
* Women who are past their 28th week of gestation (i.e. greater than or equal to 28 weeks, 0 days) at time of recruitment
* Women who are younger than 15 or older than 55 years of age
* Women whose income level does not meet Medicaid eligibility criteria
* Women who live outside of an area serviced by a NFP Implementing Agency
* Women who are currently enrolled in the study
* Women who are currently incarcerated or living in a lock down facility
Minimum Eligible Age

15 Years

Maximum Eligible Age

55 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Abdul Latif Jameel Poverty Action Lab

OTHER

Sponsor Role collaborator

University of Chicago

OTHER

Sponsor Role collaborator

Harvard School of Public Health (HSPH)

OTHER

Sponsor Role lead

Responsible Party

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Margaret McConnell

Associate Professor of Global Health Economics

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Margaret McConnell, PhD

Role: PRINCIPAL_INVESTIGATOR

Harvard School of Public Health (HSPH)

Locations

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Nurse-Family Partnership of Anderson County

Anderson, South Carolina, United States

Site Status

NFP of Berkeley/Charleston/Dorchester Counties

Charleston, South Carolina, United States

Site Status

Nurse-Family Partnership of Lexington-Richland Co.

Columbia, South Carolina, United States

Site Status

Nurse-Family Partnership of Horry County

Conway, South Carolina, United States

Site Status

McLeod Health NFP

Florence, South Carolina, United States

Site Status

Nurse-Family Partnership of Greenville County

Greenville, South Carolina, United States

Site Status

Carolina Health Centers NFP

Greenwood, South Carolina, United States

Site Status

Family Solutions of the Lowcountry NFP

Orangeburg, South Carolina, United States

Site Status

Spartanburg Regional Hospital NFP

Spartanburg, South Carolina, United States

Site Status

Countries

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United States

References

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Rokicki S, Oviedo D, Perreault N, Bates MA, Zhou RA, Baicker K, McConnell MA. Impact of nurse home visiting on take-up of social safety net programs in a Medicaid population. Health Aff Sch. 2025 Apr 2;3(4):qxaf038. doi: 10.1093/haschl/qxaf038. eCollection 2025 Apr.

Reference Type DERIVED
PMID: 40177469 (View on PubMed)

Swanson K, Ayers S, Oviedo D, Zhou RA, Bates MA, Baicker K, Chien AT, McConnell M. Intensive Nurse Home Visiting and Early Childhood Outcomes: A Randomized Clinical Trial. JAMA Pediatr. 2025 Aug 1;179(8):857-866. doi: 10.1001/jamapediatrics.2025.1600.

Reference Type DERIVED
PMID: 40522648 (View on PubMed)

Rokicki S, Oviedo D, Perreault N, Zera C, McGregor AJ, Bates MA, Zhou RA, Baicker K, McConnell MA. Home Visits and the Use of Routine and Emergency Postpartum Care Among Low-Income People: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2024 Dec 2;7(12):e2451605. doi: 10.1001/jamanetworkopen.2024.51605.

Reference Type DERIVED
PMID: 39714843 (View on PubMed)

Steenland MW, Oviedo D, Bates MA, Zhou A, Zera C, Baicker K, McConnell MA. Effect of an Intensive Nurse Home Visiting Program on Postpartum Contraceptive Use and Birth Spacing: A Randomized Controlled Trial. Obstet Gynecol. 2025 Jan 1;145(1):3-12. doi: 10.1097/AOG.0000000000005786. Epub 2024 Nov 14.

Reference Type DERIVED
PMID: 39671266 (View on PubMed)

McConnell MA, Rokicki S, Ayers S, Allouch F, Perreault N, Gourevitch RA, Martin MW, Zhou RA, Zera C, Hacker MR, Chien A, Bates MA, Baicker K. Effect of an Intensive Nurse Home Visiting Program on Adverse Birth Outcomes in a Medicaid-Eligible Population: A Randomized Clinical Trial. JAMA. 2022 Jul 5;328(1):27-37. doi: 10.1001/jama.2022.9703.

Reference Type DERIVED
PMID: 35788794 (View on PubMed)

McConnell MA, Zhou RA, Martin MW, Gourevitch RA, Steenland M, Bates MA, Zera C, Hacker M, Chien A, Baicker K. Protocol for a randomized controlled trial evaluating the impact of the Nurse-Family Partnership's home visiting program in South Carolina on maternal and child health outcomes. Trials. 2020 Dec 4;21(1):997. doi: 10.1186/s13063-020-04916-9.

Reference Type DERIVED
PMID: 33276816 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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IRB15-2939

Identifier Type: -

Identifier Source: org_study_id

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