Carole Hanks

Enduring effects of prenatal and infancy home visiting by nurses on children: follow-up of a randomized trial among children at age 12 years.

OBJECTIVE To test the effect of prenatal and infancy home visits by nurses on 12-year-old, firstborn childrens 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 childrens externalizing or total behavioral problems. CONCLUSIONS Through age 12, the program reduced childrens use of substances and internalizing mental health problems and improved the academic achievement of children born to mothers with low psychological resources.

Effect of prenatal and infancy nurse home visitation on government spending.

A completed series of reports on a randomized trial (N=400) indicated that, in contrast to comparison services, prenatal and infancy nurse home visitation improved a wide range of maternal and child health outcomes among poor, unmarried, and teenaged women bearing first children in a semirural county in upstate New York. Eighty-nine percent of the sample was white, and all analyses focused on this group. In this article, an analysis of the net cost of the home-visitation program from the perspective of government spending is presented. The average per-family cost of the program in 1980 dollars was

Implementing the Coach Relationship Model: Health promotion for mothers and children

3,246 for the sample as a whole, and

Effect of Prenatal and Infancy Home Visitation by Nurses on Pregnancy Outcomes, Childhood Injuries, and Repeated Childbearing: A Randomized Controlled Trial

3,133 for low-income families. Treatment differences in government expenditures for Aid to Families with Dependent Children, Food Stamps, Medicaid, and Child Protective Services, minus tax revenues due to maternal employment (also expressed in 1980 dollars), were conceived as government savings. By the time the children were 4 years of age, government savings were

Effects of Nurse Home-Visiting on Maternal Life Course and Child Development: Age 6 Follow-Up Results of a Randomized Trial

1,772 (95% confidence interval [CI]: -

Effects of nurse home visiting on maternal and child functioning: age-9 follow-up of a randomized trial.

557,

Enduring effects of nurse home visitation on maternal life course: a 3-year follow-up of a randomized trial.

4,102) for the sample as a whole, and

Enduring Effects of Prenatal and Infancy Home Visiting by Nurses on Maternal Life Course and Government Spending: Follow-up of a Randomized Trial Among Children at Age 12 Years

3,498 (95% CI:

Prenatal and early childhood home-visitation program processes: A case illustration

569,

Implementing nurse home visitation programs.

6,427) for low-income families. Within 2 years after the program ended, after discounting, the net cost of the program (program costs minus savings) for the sample as a whole was