JAMA Pediatrics

A randomized clinical trial evaluated the Nurse-Family Partnership (NFP) program among -eligible pregnant people in South Carolina to determine its impact on early and health care utilization outcomes.

Assignment to intensive nurse home visiting did not result in statistically significant improvements in the composite primary outcome of child mortality, injury, or concern for abuse or neglect, nor in emergency department utilization or receipt of guideline-recommended well-child visits. These findings contrast with earlier, smaller trials and highlight the challenges of improving adverse childhood experiences through large-scale interventions within Medicaid.

JAMA Pediatrics Editor in Chief Dimitri Christakis, MD, MPH, selected this for its rigor, contemporary relevance, and potential to guide and decision-making around home visiting programs. The study demonstrates the value of large, population-based randomized controlled trials in shaping evidence-based practice, including when findings are negative.

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