Long-term Effects of Prenatal and Infancy Nurse Home Visitation on the Life Course of Youths: 19-Year Follow-up of a Randomized Trial | Adolescent Medicine | JAMA Pediatrics | JAMA Network
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Journal Club
January 4, 2010

Long-term Effects of Prenatal and Infancy Nurse Home Visitation on the Life Course of Youths: 19-Year Follow-up of a Randomized Trial

Author Affiliations

Author Affiliations: Family Life Development Center (Dr Eckenrode) and Department of Human Development (Mr Henderson and Dr Powers), Cornell University, Ithaca, New York; Department of Psychology, Skidmore College, Saratoga Springs, New York (Dr Campa); Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver (Drs Luckey and Olds); School of Nursing, University of Rochester, Rochester, New York (Drs Cole and Kitzman and Ms Anson); and College of Nursing and Health Innovation, Arizona State University, Phoenix (Dr Sidora-Arcoleo).

Arch Pediatr Adolesc Med. 2010;164(1):9-15. doi:10.1001/archpediatrics.2009.240

Objective  To examine the effect of prenatal and infancy nurse home visitation on the life course development of 19-year-old youths whose mothers participated in the program.

Design  Randomized trial.

Setting  Semirural community in New York.

Participants  Three hundred ten youths from the 400 families enrolled in the Elmira Nurse-Family Partnership program.

Intervention  Families received a mean of 9 home visits (range, 0-16) during pregnancy and 23 (range, 0-59) from birth through the child's second birthday.

Main Outcome Measures  Youth self-reports of educational achievement, reproductive behaviors, welfare use, and criminal involvement.

Results  Relative to the comparison group, girls in the pregnancy and infancy nurse-visited group were less likely to have been arrested (10% vs 30%; relative risk [RR], 0.33; 95% confidence interval [CI], 0.13-0.82) and convicted (4% vs 20%; 0.20; 0.05-0.85) and had fewer lifetime arrests (mean: 0.10 vs 0.54; incidence RR [IRR], 0.18; 95% CI, 0.06-0.54) and convictions (0.04 vs 0.37; 0.11; 0.02-0.51). Nurse-visited girls born to unmarried and low-income mothers had fewer children (11% vs 30%; RR, 0.35; 95% CI, 0.12-1.02) and less Medicaid use (18% vs 45%; 0.40; 0.18-0.87) than their comparison group counterparts.

Conclusions  Prenatal and infancy home visitation reduced the proportion of girls entering the criminal justice system. For girls born to high-risk mothers, there were additional positive program effects consistent with results from earlier phases of this trial. There were few program effects for boys.

Trial Registration  clinicaltrials.gov Identifier: NCT00443638