Nurse Visitation for Chronic Disease

DO
AL
Overseen ByAnna Lindberg, MPH
Age: Any Age
Sex: Any
Trial Phase: Academic
Sponsor: University of Colorado, Denver
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to assess the impact of prenatal and early child home visits by nurses on the long-term health of mothers and their children. It examines two groups: one receives free rides to prenatal check-ups and child development screenings, while the other also receives nurse visits during pregnancy and until the child turns two. Women who are less than 29 weeks pregnant, have never given birth, and face social challenges such as being unmarried or unemployed may be suitable candidates. The trial seeks to determine if these services help prevent chronic diseases in mothers and children. As an unphased trial, this study provides a unique opportunity to contribute to valuable research that could enhance maternal and child health services.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, if you have chronic illnesses like hypertensive disorders that require treatment, you may not be eligible to participate.

What prior data suggests that this program of nurse visitation and developmental screening is safe?

Research has shown that nurse visits during pregnancy and early childhood are generally safe and well-received. Studies have found positive health benefits without major safety issues. For example, one study with 742 participants found that children whose mothers had nurse visits were less likely to be obese by age 12. Another study found that these visits reduced negative birth outcomes to 26.9%, which is better than with usual care.

Overall, no significant reports of harmful effects from these nurse visits exist. Instead, they often lead to better pregnancy outcomes and fewer childhood injuries. This suggests that the program is safe for both mothers and their children. These findings can reassure those considering joining a trial.12345

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores an innovative approach to managing chronic disease through supportive services. Unlike standard care options, which often focus on medical treatments and occasional check-ups, this trial combines free transportation, developmental screening, and nurse visits during pregnancy and early childhood. The nurse-visitation component is particularly promising, as it offers personalized, ongoing support that can address both medical and social needs, potentially improving outcomes for both mothers and children. This holistic approach could pave the way for more comprehensive care models that extend beyond traditional healthcare settings.

What evidence suggests that this trial's treatments could be effective for chronic disease?

This trial will compare two approaches: one arm will provide transportation and developmental screening, while the other will include transportation, screening, and nurse visitation during pregnancy and infancy. Research has shown that nurse visits during pregnancy and early childhood can improve health. Specifically, these programs have been found to lower the risk of death for mothers and prevent deaths from avoidable causes in children. Nurse visits are also associated with lower obesity rates in girls and better mental health and language skills, as reported by mothers. Additionally, these visits can reduce the chances of premature births. This suggests that nurse-visitation programs could effectively support the health of mothers and children.12456

Are You a Good Fit for This Trial?

This trial is for first-time pregnant women under 29 weeks with no severe chronic illnesses. It's aimed at those who have participated in a nurse home visiting program and face socioeconomic challenges, such as being unmarried, having less than a high school education, or being unemployed.

Inclusion Criteria

I am pregnant, less than 29 weeks along, and have never had a live birth.
Mothers who participated in a randomized clinical trial of nurse home visiting and their first-born offspring
At least two of the following sociodemographic risk conditions: unmarried, less than 12 years of education, and unemployed
See 1 more

Exclusion Criteria

I refused earlier data gathering assessments.
I am more than 29 weeks pregnant.
Previous live births
See 1 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks
1 visit (in-person)

Prenatal and Early Childhood Home-Visiting

Intensive nurse home-visitation services during pregnancy and through the child's second birthday, including developmental screening and referral services for the child at the 6th, 12th, and 24th months of the child's life.

Approximately 2 years
Multiple visits (in-person)

Long-term Follow-up

Participants are monitored for chronic disease and mortality outcomes approximately 30 years after delivery.

30 years
1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

  • Transportation and Developmental Screening
  • Transportation, Screening, and Nurse-Visitation during Pregnancy and Infancy
Trial Overview The study examines the long-term effects of prenatal and early childhood home visits by nurses on reducing risks for chronic diseases in mothers and their children. Participants receive transportation support and developmental screenings.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Arm 2. Transportation, Screening, and Nurse-Visitation during Pregnancy and InfancyExperimental Treatment1 Intervention
Group II: Arm 1. Transportation and ScreeningActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Colorado, Denver

Lead Sponsor

Trials
1,842
Recruited
3,028,000+

Medpace, Inc.

Industry Sponsor

Trials
98
Recruited
30,400+

Dr. August J. Troendle

Medpace, Inc.

Chief Executive Officer since 1992

MD from the University of Maryland, School of Medicine; MBA from Boston University

Dr. Reinilde Heyrman

Medpace, Inc.

Chief Medical Officer since 2017

MD

University of Rochester

Collaborator

Trials
883
Recruited
555,000+

Published Research Related to This Trial

The Nurse Home Visitation Program significantly benefits low-income unmarried mothers by reducing rates of childhood injuries and neglect, helping them delay subsequent pregnancies, and improving their economic self-sufficiency, as shown in randomized trials in Elmira and Memphis.
Long-term follow-up indicates that mothers who received nurse visits were less likely to abuse their children and had children who experienced fewer arrests and substance use, highlighting the program's effectiveness in promoting healthier family dynamics and outcomes.
Prenatal and infancy home visitation by nurses: recent findings.Olds, DL., Henderson, CR., Kitzman, HJ., et al.[2022]
Home-visitation programs for socially disadvantaged women and children can significantly improve maternal health behaviors, birth outcomes, and child development, while also reducing child abuse and hospital visits.
The most effective programs involved nurses who started visits during pregnancy, maintained frequent contact, and focused on addressing behavioral and psychosocial factors, particularly for families at higher risk due to poverty.
Can home visitation improve the health of women and children at environmental risk?Olds, DL., Kitzman, H.[2022]

Citations

Early Home Visits and Health Outcomes in Low-Income ...In this clinical trial follow-up at offspring ages 12 and 18, nurse-visited female offspring had lower rates of obesity and mothers of females ...
Study Details | NCT06160037 | Influence of Prenatal and ...This study is a longitudinal cohort study that follows participants in a randomized clinical trial of a program of prenatal and early child home visiting.
Effect of Home Visiting by Nurses on Maternal and Child ...Prenatal and infant/toddler home visitation by nurses is a promising means of reducing all-cause mortality among mothers and preventable-cause mortality in ...
Community Health Worker Home Visiting, Birth Outcomes ...Participation in a home visiting program significantly associated with reduced risk of preterm birth (13.3% vs 15.5%), very preterm birth (1.8% vs 3.0%), very ...
Effectiveness of nurse‐home visiting in improving child and ...NFP did not reduce child injuries or subsequent maternal pregnancies but did improve maternal-reported child language and mental health (problem ...
Effect of an Intensive Nurse Home Visiting Program on ...The Nurse Family Partnership program of intensive nurse home visits compared with usual care resulted in a composite adverse birth outcome incidence of 26.9% ...
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