Programmes with at least adequate quality study design that are cost saving: population and programme characteristics
| Programme number, programme name, author, city/state/country | Bias* | Nature of the control group | Population description (risk group¶) | First time mother | Type of visitor | Pre/post visiting | Scope† | Number of visits | Programme length (months) | Programme cost per family, A$ | Lifetime cost savings, A$‡ per child | Match between theory, population and programme | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 19 | Child and Youth Program module, Hardy et al,15 Baltimore, Maryland, USA | 1 | NR | 77% already had child, ≥18 years (mean 22 years), ethnic minority, low income (2) | No | Lay visitor | Post | 2 | 11 | 23 | 1700 | 298 000 | Partial |
| 13 | Home visiting, Quinlivan et al,16 Western Australia, Australia | 0 | S | Under 18 years, 25% indigenous, low income, some homeless, domestic violence and drug use (3–5) | Yes | Nurse; midwife | Post | 2–3 | 6§ | 6 | 2900 | 295 000 | Partial |
| 1 | Special Families Care Project, Christensen et al,17 18 Minnesota, USA | 1 | S | Four or more background indicators for very high risk, age 16–25 (5) | Yes | Multidisciplinary | Pre/post | 4 | 2–4 h/week | 24 | 30 100 | 161 000 | Yes |
| 16a | Nurse home visiting, Olds et al,19 20 Denver, Colorado, USA | 1 | P | All low income, mostly single, ethnic minority, young (mean 19 years), some drug use, domestic violence 20%, 100% conflict (2–5) | Yes | Nurse | Pre/post | 3–4 | 27 | 24 | 12 600 | 159 000 | Partial |
| 14 | Early Start, Fergusson et al,21 22 New Zealand | 1 | NR | 25% indigenous, 30% domestic violence, low income, 89% welfare dependent (3–5) | No | Nurse or social worker | Post | 2–3 | Not stated | 24 | 16 100 | 99 000 | Partial |
| 24b | Nurse Family Partnership, prenatal, Olds et al,23 27–30 Eckenrode et al,24–26 Elmira, New York, USA | 1 | P | 47% adolescent, 61% low income, 62% single parent, 23% all three (2–3) | Yes | Nurse | Pre | 3 | 9 | 6 | 3300 | 18 000 | Yes |
| 24a | Nurse Family Partnership, pre and postnatal, Olds et al,23 27–30 Eckenrode et al,24–26 Elmira, New York, USA | 1 | P | 47% adolescent, 61% low income, 62% single parent, 23% all three (2–3) | Yes | Nurse | Pre/post | 3 | 32 | 30 | 14 200 | 15 000 | Yes |
↵* 0, good quality; 1, adequate quality.
↵† 1, just home visiting; 2, home visiting plus some services (eg, phone contact, referral, clinic visits, transport); 3, home visiting plus a lot more services (eg, social work intervention, housing assistance, parenting groups); 4, ‘whatever it takes’ fully flexible approach.
↵‡ Cost savings when utilising a lifetime maltreatment cost with a current value of A$318 760.
↵§ Visits were 2–4 h in duration.
↵¶ 1, low risk, general population; 2, some elevated risk (adolescent mother, low socioeconomic status, social isolation); 3, medium risk (mental illness, unstable housing, ambivalence to pregnancy or two or more of ‘some elevated risk’); 4, high risk (criminal record, drug use, previous suspicion of abuse, three or more ‘medium risk’); 5, very high risk (current maltreatment or domestic violence).
NR, not reported; P, standard care plus low-intensity intervention; S, standard care.