Child Rearing, Reproductive Behavior, Risk Reduction Behavior
Conditions
Keywords
nurse, home visits, pregnancy, welfare, child development
Brief summary
To examine the impact of prenatal and infancy home visiting by nurses from child age 2 through 12.
Detailed description
This study is a longitudinal follow-up of 679 low-income women (89% African American) and their firstborn and subsequent children who have participated in a randomized trial of prenatal and infancy home visiting by nurses in Memphis, Tennessee since 1988. The study was conducted when the first-born children completed sixth grade, at around their 12th birthday. The current follow-up was designed to determine whether: a) nurse-visited women differ from comparison group women in their life-course outcomes (the number and spacing of subsequent pregnancies and births; the rates of marriage and cohabitation with the father of the child; their employment, career growth, economic self-sufficiency, and welfare dependence; and behavioral problems due to substance abuse; arrests for serious misdemeanors and felonies); b) children of nurse-visited women differ from comparison-children in their academic achievement, placements in special education, rates of grade retention, conduct in school, and academic achievement; c) there are lower rates of developmental disability, grade retention, placement in special education, and school disciplinary actions among subsequent children born to nurse-visited women; d) nurse-visited families have fewer government expenditures and higher taxes paid; e) the effects of the program on child outcomes are concentrated on children born to women with low psychological resources; f) the effects of the program on maternal life course and government costs are concentrated on women with high psychological resources; g) the effects of the program on children are greater in schools and neighborhoods that contain greater risks for academic and behavioral problems; h) the effect of the program on children's disruptive behavior problems is explained by the combined effects of the program on maternal life-course, qualities of parental care-giving, and children's sequential processing skills, and aggressive and violent themes, reliance on adults, and story incoherence in their responses to the McArthur Story Stem Battery at earlier assessments. Data will be derived from maternal interviews and reviews of state administrative and school records. Results from this trial will provide policy makers with an estimate of likely long-term effects of this program when it is conducted in close to real-life conditions.
Interventions
BEHAVIORALhome visitation
Home visitation by nurses from midway through pregnancy until child age 12
Sponsors
University of Colorado, Denver
National Institute of Mental Health (NIMH)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Healthy volunteers
Yes
Inclusion criteria
* Women \<29 weeks gestation * No previous live births * At least 2 socio-demographic risk characteristics; e.g. unmarried, \<12 years of education, unemployed.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| the number and spacing of subsequent pregnancies and births | When first child is 12 |
| the rates of marriage and cohabitation with the father of the child | When first child is 12 |
| mothers' employment, career growth, economic self-sufficiency, and welfare dependence | When first child is 12 |
| mothers' behavioral problems due to substance abuse | When first child is 12 |
| children's academic achievement, placements in special education, rates of grade retention, conduct in school, and academic achievement | At age 12 |
| rates of developmental disability, grade retention, placement in special education, and school disciplinary actions among subsequent children | At age 12 |
| mothers' arrests for serious misdemeanors and felonies | When first child is 12 |
Countries
United States
Outcome results
None listed