Long-term Effects of Prenatal and Infancy Nurse Home Visitation on the Life Course of Youths 19-Year Follow-up of a Randomized Trial
Long-term Effects of Prenatal and Infancy Nurse Home Visitation on the Life Course of Youths 19-Year Follow-up of a Randomized Trial
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DOI：
10.1001/archpediatrics.2009.240
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发表时间：
2010-01-01
影响因子：
--
通讯作者：
Olds, David
中科院分区：
文献类型：
--
作者：
Eckenrode, John;Campa, Mary;Olds, David
目的：探讨产前、婴儿期护士家访对母亲参与的19岁青少年生命历程发展的影响。设计：随机试验。背景：纽约的半乡村社区。参与者：来自400个家庭的310名青年参加了埃尔米拉护士家庭合作项目。干预：家庭在怀孕期间平均接受9次家访（范围0-16），从出生到孩子的第二个生日平均接受23次家访（范围0-59）。主要结果测量：青少年自我报告的教育成就、生育行为、福利使用和犯罪参与。结果：与对照组相比，孕妇和婴儿护士探访组的女孩被逮捕（10% vs 30%；相对风险[RR]， 0.33； 95%可信区间[CI]， 0.13-0.82）和被定罪（4% vs 20%; 0.20; 0.05-0.85）的可能性更低，终身被捕（平均值：0.10 vs 0.54；发病率RR[IRR]， 0.18; 95% CI, 0.06-0.54）和被定罪（0.04 vs 0.37; 0.11; 0.02-0.51）的可能性更低。与对照组相比，接受护士探视的未婚和低收入母亲所生女孩的子女较少（11%对30%；RR, 0.35; 95% CI, 0.12-1.02），医疗补助使用较少（18%对45%；0.40;0.18-0.87）。结论：产前和婴儿期家访降低了女孩进入刑事司法系统的比例。对于高风险母亲所生的女孩，有额外的积极项目效果，与本试验早期阶段的结果一致。对男孩的影响很小。
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.