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Follow-up of a Randomized Trial Among Children at Age 12 Years

Harriet J. Kitzman, RN, PhD; David L. Olds, PhD; Robert E. Cole, PhD; Carole A. Hanks, RN, DrPH; Elizabeth A. Anson, MS; Kimberly J. Arcoleo, PhD, MPH; Dennis W. Luckey, PhD; Michael D. Knudtson, MS; Charles R. Henderson Jr, MA; John R. Holmberg, PsyD

Arch Pediatr Adolesc Med. 2010;164(5):412-418.

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.

Trial Registration  clinicaltrials.gov Identifier: NCT00438165

Author Affiliations: School of Nursing, University of Rochester, Rochester, New York (Drs Kitzman and Cole and Ms Anson); Department of Pediatrics, Anschutz Medical Campus, University of Colorado Denver, Aurora (Drs Olds and Holmberg and Mr Knudtson); Louise Herrington School of Nursing, Baylor University, Dallas, Texas (Dr Hanks); College of Nursing and Health Innovation, Arizona State University, Phoenix (Dr Arcoleo); Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Denver (Dr Luckey); and Department of Human Development, Cornell University, Ithaca, New York (Mr Henderson).

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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
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Arch Pediatr Adolesc Med. 2010;164(5):419-424.
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