TY - JOUR
T1 - Prenatal and infancy nurse home visiting and 18-year outcomes of a randomized trial
AU - Kitzman, Harriet
AU - Olds, David L.
AU - Knudtson, Michael D.
AU - Cole, Robert
AU - Anson, Elizabeth
AU - Smith, Joyce A.
AU - Fishbein, Diana
AU - DiClemente, Ralph
AU - Wingood, Gina
AU - Caliendo, Angela M.
AU - Hopfer, Christian
AU - Miller, Ted
AU - Conti, Gabriella
N1 - Funding Information:
The current phase of this research was supported by the National Institute on Drug Abuse (1R01DA021624). Mr Knudtson had full access to all the data in the study and takes responsibility for the integrity of the data and accuracy of the analysis. We thank Evelyn Collins for tracing and engaging the study participants and managing the Memphis study office since 1991, Benjamin Jutson (University of Colorado Anschutz Medical Campus) for helping prepare this article, and Wendy Gehring (University of Colorado Anschutz Medical Campus) for her help with data management. Evelyn Collins, Benjamin Jutson, and Wendy Gehring received compensation from research grants for their work.
Funding Information:
FUNDING: Supported by the National Institutes of Health (research grant R01DA021624). Funded by the National Institutes of Health (NIH).
Publisher Copyright:
© 2019 by the American Academy of Pediatrics.
PY - 2019/12/1
Y1 - 2019/12/1
N2 - OBJECTIVES: Given earlier effects found in randomized clinical trials of the Nurse-Family Partnership, we examined whether this program would improve 18-year-old first-born youths' cognition, academic achievement, and behavior and whether effects on cognitiverelated outcomes would be greater for youth born to mothers with limited psychological resources (LPR) and on arrests and convictions among females. METHODS: We enrolled 742 pregnant, low-income women with no previous live births and randomly assigned them to receive either free transportation for prenatal care plus child development screening and referral (control; n = 514) or prenatal and infant home nurse visit (NV) plus transportation and screening (n = 228). Assessments were completed on 629 18- year-old first-born offspring to evaluate these primary outcomes: (1) cognitive-related abilities (nonverbal intelligence, receptive language, and math achievement) and (2) behavioral health (internalizing behavioral problems, substance use and abuse, sexually transmitted infections, HIV risk, arrests, convictions, and gang membership). RESULTS: Compared with control-group counterparts, NV youth born to mothers with LPR had better receptive language (effect size = 0.24; 95% confidence interval [CI]: 0.00 to 0.47; P = .05), math achievement (effect size = 0.38; 95% CI: 0.14 to 0.61; P = .002), and a number of secondary cognitive-related outcomes. NV females, as a trend, had fewer convictions (incidence ratio = 0.47; 95% CI: 0.20 to 1.11; P = .08). There were no intervention effects on other behaviors. CONCLUSIONS: The program improved the cognitive-related skills of 18-year-olds born to mothers with LPR and, as a trend, reduced female convictions but produced no other effects on youth behavioral health.
AB - OBJECTIVES: Given earlier effects found in randomized clinical trials of the Nurse-Family Partnership, we examined whether this program would improve 18-year-old first-born youths' cognition, academic achievement, and behavior and whether effects on cognitiverelated outcomes would be greater for youth born to mothers with limited psychological resources (LPR) and on arrests and convictions among females. METHODS: We enrolled 742 pregnant, low-income women with no previous live births and randomly assigned them to receive either free transportation for prenatal care plus child development screening and referral (control; n = 514) or prenatal and infant home nurse visit (NV) plus transportation and screening (n = 228). Assessments were completed on 629 18- year-old first-born offspring to evaluate these primary outcomes: (1) cognitive-related abilities (nonverbal intelligence, receptive language, and math achievement) and (2) behavioral health (internalizing behavioral problems, substance use and abuse, sexually transmitted infections, HIV risk, arrests, convictions, and gang membership). RESULTS: Compared with control-group counterparts, NV youth born to mothers with LPR had better receptive language (effect size = 0.24; 95% confidence interval [CI]: 0.00 to 0.47; P = .05), math achievement (effect size = 0.38; 95% CI: 0.14 to 0.61; P = .002), and a number of secondary cognitive-related outcomes. NV females, as a trend, had fewer convictions (incidence ratio = 0.47; 95% CI: 0.20 to 1.11; P = .08). There were no intervention effects on other behaviors. CONCLUSIONS: The program improved the cognitive-related skills of 18-year-olds born to mothers with LPR and, as a trend, reduced female convictions but produced no other effects on youth behavioral health.
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U2 - 10.1542/peds.2018-3876
DO - 10.1542/peds.2018-3876
M3 - Article
C2 - 31748254
AN - SCOPUS:85076062643
SN - 0031-4005
VL - 144
JO - Pediatrics
JF - Pediatrics
IS - 6
M1 - e20183876
ER -