The Nurse Home Visitation Program

In this chapter, the author examines nurse visitation programs. These programs arrange for nurses to pay regular visits to disadvantaged first-time mothers during and after their pregnancies to help them become better parents and to link them with social services and other support systems. They are the brainchild of David Olds, a professor of pediatrics, psychiatry, and preventive medicine at the University of Colorado Health Sciences Center, at the time this article was written.

Along with other foundations and the federal government, the Robert Wood Johnson Foundation funded a test of the idea in Elmira, N.Y., in 1978. When home visits by trained public health nurses appeared to improve the health of poor children and their mothers, the Foundation, among others, next funded a test in Memphis, Tenn. Since then, Olds and others have demonstrated and tested variants of the concept at various locations around the country.

A number of lessons emerge from three decades of experience with nurse home visitation programs:

  1. Evaluations of various approaches to home visits indicate that only the original model yielded unambiguously positive results.
  2. It is extremely important to test a new service delivery idea before advocating its widespread adoption.
  3. The value of a foundation's sticking with an idea for a long time.

The Robert Wood Johnson Foundation nurtured the nurse home visitation program for almost three decades. The field has gained valuable insights that would not have emerged with the three to five years of funding that normally characterizes grants from foundations.