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JOURNAL CLUB
Long-term Effects of Prenatal and Infancy Nurse Home Visitation on the Life Course of Youths19-Year Follow-up of a Randomized Trial
John Eckenrode, PhD;
Mary Campa, PhD;
Dennis W. Luckey, PhD;
Charles R. Henderson Jr, MA;
Robert Cole, PhD;
Harriet Kitzman, RN, PhD;
Elizabeth Anson, MS;
Kimberly Sidora-Arcoleo, MPH, PhD;
Jane Powers, PhD;
David Olds, PhD
Arch Pediatr Adolesc Med. 2010;164(1):9-15.
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
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).
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