A registered nurse visited participants at home during pregnancy and their child’s infancy. The nurse promoted healthy prenatal behaviors, parent–child interactions, and practices to encourage the child’s emotional and cognitive development. The nurse helped participants address barriers that prevented them from completing education and finding work. Mothers also received free transportation to and from scheduled prenatal care appointments. After the child was born, the child received developmental screening and referral services when they were 6, 12, and 24 months old.

Twenty-four grantees offered the RExO program, including national nonprofits, faith-based community organizations, community health organizations, and local or regional nonprofits. The exact bundle of services each grantee provided varied significantly. In all programs, case managers coordinated service delivery and supported participants. Most grantees offered group mentoring for participants, and a smaller subset offered individual mentoring.

Participants received home visits from a team of nurse practitioners and community workers who provided participants with insights into their children’s development and informed them about additional services, such as Early Head Start. Home visitors provided relevant information and insights after assessing children using the Ages and Stages Questionnaire. Participants received up to 11 home visits over 3 years; the final home visit occurred when the child turned 33 months.