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May 1, 2010Archives of Pediatrics and Adolescent Medicine248 citations

Enduring Effects of Prenatal and Infancy Home Visiting by Nurses on Children

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HKHarriet KitzmanDODavid L. OldsRCRobert E. Cole

Key Points

  • The study aims to evaluate the long-term effects of nurse-led prenatal and infancy home visiting programs on children's substance use, behavior, and academic outcomes.
  • Randomized controlled trial involving 743 pregnant women, primarily African American and economically disadvantaged.
  • Participants included firstborn children assessed at age 12 for substance use, behavioral adjustment, and academic performance.
  • Intervention consisted of nurse home visits during prenatal and infancy periods.
  • Children visited by nurses reported fewer days of substance use (0.03 vs 0.18, P = .02) and lower rates of internalizing disorders (22.1% vs 30.9%, P = .04).
  • Nurse-visited children born to mothers with low psychological resources scored higher on the Peabody Individual Achievement Tests in reading and math (88.78 vs 85.70, P = .009).
  • No significant program effects were found on children's externalizing or total behavioral problems.

Abstract

OBJECTIVE: To test the effect of prenatal and infancy home visits by nurses on 12-year-old, firstborn children's use of substances, behavioral adjustment, and academic achievement. DESIGN: Randomized controlled trial. SETTING: Public system of obstetric and pediatric care in Memphis, Tennessee. PARTICIPANTS: We studied 12-year-old, firstborn children (n = 613) of primarily African American, economically disadvantaged women (743 randomized during pregnancy). INTERVENTION: Program of prenatal and infancy home visits by nurses. OUTCOME MEASURES: Use of cigarettes, alcohol, and marijuana; internalizing, externalizing, and total behavioral problems; and academic achievement. RESULTS: By the time the firstborn child was 12 years of age, those visited by nurses, compared with those in the control group, reported fewer days of having used cigarettes, alcohol, and marijuana during the 30-day period before the 12-year interview (0.03 vs 0.18, P = .02) and were less likely to report having internalizing disorders that met the borderline or clinical threshold (22.1% vs 30.9%, P = .04). Nurse-visited children born to mothers with low psychological resources, compared with their control group counterparts, scored higher on the Peabody Individual Achievement Tests in reading and math (88.78 vs 85.70, P = .009) and, during their first 6 years of education, scored higher on group-administered standardized tests of math and reading achievement (40.52 vs 34.85, P = .02). No statistically significant program effects were found on children's externalizing or total behavioral problems. CONCLUSIONS: Through age 12, the program reduced children's use of substances and internalizing mental health problems and improved the academic achievement of children born to mothers with low psychological resources.

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Cite This Study

Kitzman et al. (2010) studied this question.

synapsesocial.com/papers/6a1aefbb4dcca2706385de41https://doi.org/10.1001/archpediatrics.2010.76
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