Long-term effects of nurse home visitation on children's criminal and antisocial behavior - 15-year follow-up of a randomized controlled trial
Long-term effects of nurse home visitation on children's criminal and antisocial behavior - 15-year follow-up of a randomized controlled trial
复制标题
DOI：
10.1001/jama.280.14.1238
复制
发表时间：
1998-10-14
影响因子：
120.7
通讯作者：
Powers, J
中科院分区：
文献类型：
--
作者：
Olds, D;Henderson, CR;Powers, J
背景。-护士家访计划已被证明会影响产妇福利依赖率、犯罪率、因使用药物而产生的问题以及虐待和忽视儿童的问题。然而，这一计划对儿童反社会行为的长期影响尚未得到研究。要检查的长期影响的一个程序的产前和幼儿家访护士对儿童的反社会行为。随机试验的15年随访。访谈进行了青少年和他们的亲生母亲或监护父母。在纽约的半农村社区。在1978年4月至1980年9月期间，连续招募了500名以前没有活产的孕妇，其中400名被纳入研究。共有315名青少年子女在15岁时参加了后续研究; 280名（89%）出生于白色母亲，195名（62%）未婚母亲，151名（48%）出生于19岁以下的母亲，186名（59%）出生于怀孕期间登记时社会经济地位较低的家庭。接受家访的家庭在怀孕期间平均有9次（范围0 - 16次）家访，从出生到孩子第二个生日平均有23次（范围0 - 59次）家访。对照组在诊所接受标准的产前和良好的儿童护理。孩子们的自我报告逃跑，逮捕，定罪，被判处青少年矫正，开始性交，性伴侣的数量，和使用非法物质;学校的停学记录;教师报告的儿童在学校的破坏性行为;和父母的报告的儿童的逮捕和行为问题有关的儿童的使用酒精和其他药物。在怀孕期间和产后接受护士探视的未婚妇女和来自社会经济地位低下家庭的妇女所生的青少年（反社会行为的危险因素），与对照组相比，逃跑（0.24 vs 0.60; P = 0.003）、逮捕（0.20 vs 0.45; P = 0.03）、定罪和违反缓刑（0.09 vs 0.47; P = 0.003）的发生率减少。
Context.-A program of home visitation by nurses has been shown to affect the rates of maternal welfare dependence, criminality, problems due to use of substances, and child abuse and neglect. However, the long-term effects of this program on children's antisocial behavior have not been examined.Objective.-To examine the long-term effects of a program of prenatal and early childhood home visitation by nurses on children's antisocial behavior.Design.-Fifteen-year follow-up of a randomized trial. Interviews were conducted with the adolescents and their biological mothers or custodial parents.Setting.-Semirural community in New York.Participants.-Between April 1978 and September 1980, 500 consecutive pregnant women with no previous live births were recruited, and 400 were enrolled. A total of 315 adolescent offspring participated in a follow-up study when they were 15 years old; 280 (89%) were born to white mothers, 195 (62%) to unmarried mothers, 151 (48%) to mothers younger than 19 years, and 186 (59%) to mothers from households of low socioeconomic status at the time of registration during pregnancy.Intervention.-families in the groups that received home visits had an average of 9 (range, 0-16) home visits during pregnancy and 23 (range, 0-59) home visits from birth through the child's second birthday. The control groups received standard prenatal and well-child care in a clinic.Main Outcome Measures.-Children's self-reports of running away, arrests, convictions, being sentenced to youth corrections, initiation of sexual intercourse, number of sex partners, and use of illegal substances; school records of suspensions; teachers' reports of children's disruptive behavior in school; and parents' reports of the children's arrests and behavioral problems related to the children's use of alcohol and other drugs.Results.-Adolescents born to women who received nurse visits during pregnancy and postnatally and who were unmarried and from households of low socioeconomic status (risk factors for antisocial behavior), in contrast with those in the comparison groups, reported fewer instances (incidence) of running away (0.24 vs 0.60; P = .003), fewer arrests (0.20 vs 0.45; P = .03), fewer convictions and violations of probation (0.09 vs 0.47; P