Realizing the Potential of Nurse Home Visiting

In this issue of Pediatrics, Goldfeld et al¹ report maternal mental health outcomes after 3 years of follow-up from a randomized controlled trial of right@home, a nurse home visiting (NHV) program in Australia. The trial enrolled 722 pregnant women experiencing ≥2 risk factors for adversity, such as young age, limited social support, low income, and low educational attainment, and randomly assigned them to right@home (25 nurse home visits beginning antenatally) or usual care. After 2 years (when primary outcomes were to be collected), right@home produced benefits in parent care, parent responsivity, and home learning environment.² In the current study, the authors followed participant families to 3 years and compared maternal mental health outcomes across 255 right@home women and 240 controls. In this analysis, right@home mothers reported better mental health according to the Depression Anxiety Stress Scales, with effect sizes of 0.25 (95% confidence interval: 0.08–0.32) for depression and 0.20 (95% confidence interval: 0.05–0.30) for anxiety.¹

Methodologically, the study has significant strengths, most notably, a rigorous multisite design. The results, however, should be interpreted with caution, the primary reason being that the maternal mental health outcomes at 3 years do not appear to …

Address correspondence to Kelsey A. Egan, MD, Department of Pediatrics, Boston Medical Center, 801 Albany St, Boston, MA 02119. E-mail: kelsey.egan{at}bmc.org