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Patterns of visit attendance in the nurse-family partnership program
Margaret L Holland1, Yinglin Xia, Harriet J Kitzman
1At the time of this study, Margaret L. Holland was with the School of Nursing, Yale University, West Haven, CT. Yinglin Xia was with the Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY. Harriet J. Kitzman was with the School of Nursing, University of Rochester. Ann M. Dozier was with the Department of Public Health Sciences, University of Rochester. David L. Olds was with the Department of Pediatrics, University of Colorado, Aurora.
Objectives:
We examined visit attendance patterns in the Memphis trial of the Nurse-Family Partnership and associations between these patterns and family characteristics, outcomes, and treatment-control differences in outcomes.
Methods:
We employed repeated measures latent class analysis to identify attendance patterns among the 228 mothers assigned to receive home nurse visits during pregnancy and until the child was aged 2 years, associated background characteristics, outcomes, and treatment-control differences by visit class. Home visits were conducted from June 1990 to March 1994. We collected outcome data from May 1992 to April 1994 and July 2003 to December 2006.
Results:
We identified 3 visit attendance patterns. High attenders (48%) had the most visits and good outcomes. Low attenders (33%) had the most education and the best outcomes. Increasing attenders (18%) had the fewest completed visits during pregnancy, the poorest intake characteristics, and the poorest outcomes. Treatment-control group differences varied by class, with high and low attenders having better outcomes on some measures than did their control group counterparts.
Conclusions:
Three patterns were associated with distinct groups of mothers with different long-term outcomes. Further examination and use of patterns to classify mothers and prioritize resources may improve efficiency in the Nurse-Family Partnership.
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