Behavior, Adaptive
Conditions
Brief summary
The Nurse-Family Partnership, a program of prenatal and infancy home visiting by nurses, has been examined in a series of 3 randomized trials since 1977. It has received considerable attention in the scientific and public policy communities for its replicated effects on a variety of maternal and child health outcomes across these 3 trials, including prenatal health, childhood injuries, rates of subsequent pregnancies, inter-birth intervals, as well as its long-term effects on maternal life-course, criminal behavior, and 15-year-olds' criminal and antisocial behavior in the first trial of the program conducted in Elmira, New York.
Detailed description
Although this program produced positive effects on maternal and child health from pregnancy through the child's fourth year of life, its long-term effects remain unexamined. The current study was conducted to determine the extent to which the beneficial effects of the program set in motion early in the life cycle altered the life-course trajectories of the mothers and the children's adaptive functioning through the first child's 15th birthday. This study examines the long-term effects of the program on two domains of maternal functioning: 1) maternal life course (subsequent children, use of welfare, employment, substance abuse, and encounters with the criminal justice system); and 2) perpetration of child abuse and neglect; and two domains of the children's behavior: 1) their functioning in schools, and 2) their criminal and antisocial behavior. The investigators hypothesized that the program effects in these domains of maternal and child functioning, as in earlier phases of the study, would be greater for families in which the mothers experienced a larger number of chronic stressors and had fewer resources to manage the challenges of living in poverty and being a parent.
Interventions
BEHAVIORALDevelopmental Screening
Child participants were screened for sensory and developmental problems and referred for further evaluation and treatment of suspected problems at 12 and 24 months of age
BEHAVIORALScreening plus Transportation
Child participants were screened for sensory and developmental problems and referred for further evaluation and treatment for suspected problems at 12 and 24 months of age; their mothers were provided with free transportation for prenatal and well-child care through child age 2.
BEHAVIORALScreening, Transport, Prenatal Visits
Child participants were screened for sensory and developmental problems and referred for further evaluation and treatment for suspected problems at 12 and 24 months of age; their mothers were provided with free transportation for prenatal and well-child care through child age 2, and were provided an average of 9 home visits by nurses during pregnancy.
BEHAVIORALScreen, Transport, Prenatal/Inf Visits
Child participants were screened for sensory and developmental problems and referred for further evaluation and treatment for suspected problems at 12 and 24 months of age; their mothers were provided with free transportation for prenatal and well-child care through child age 2, and were provided an average of 9 home visits by nurses during pregnancy and 23 during the child's first two years of life.
Sponsors
Cornell University
University of Colorado, Denver
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Masking description
Assessors were not given access to the participants' original treatment assignments
Eligibility
Sex/Gender
ALL
Age
15 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Must be offspring of mothers who enrolled in Elmira randomized clinical trial of the Nurse-Family Partnership (known as the Prenatal Early Infancy Project) -
Exclusion criteria
\-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Timing of Subsequent Births - Mothers | 15 years following birth of first child | Interval in days between birth date of first child and first subsequent child (self-reported) |
| Months Received Aid to Families with Dependent Children (AFDC) - Mothers | 15-year interval following birth of first child | Number of months mother received AFDC (self-reported) |
| Number of Months Employed - Mothers | 15-year interval following birth of first child | Number of months employed (self-reported) |
| Substance Abuse - Mothers | 15-year period following birth of first child | Count of behavioral impairments due to use of substances (self-reported) |
| Arrests - Mothers | 15-year interval following birth of first child | Count of arrests (self-reported) |
| Child Maltreatment Reports - Mothers | 15-year interval following birth of first child | Count of substantiated reports of child abuse and neglect in which mother was perpetrator (review of records) |
| Running Away from Home - Children | 15-year interval following birth of first child | Count of times ran away from home - self-report |
| Person in Need of Supervision (PIN) - Children | 15-year period following their birth | Self report of ever having been adjudicated as a PIN |
| Arrests - Children | 15-year period following birth | Count of Arrests - self-report |
Outcome results
None listed