Age 9 Follow-up of Preventive Intervention

描述(由申请人提供)：这项提案寻求支持对650名儿童及其家人进行为期9年的随访，这些儿童及其家人参加了一项由辅助专业人员和护士进行产前和婴儿家访的随机试验；参与试验的家庭被分配到对照、辅助专业人员或护士探视的条件下。早期阶段的评估发现，护士和准专业人员访问的家庭和儿童获得了显著的好处，尽管护士的影响往往更大。目前的随访阶段旨在确定护士和准专业计划的影响是否持续并发展到9.5岁的儿童。 该提案围绕七个问题展开： 1.护士和准职业家访方案是否对以下方面产生了持久的影响：a)母亲的生命历程；b)父母为孩子提供的护理质量；c)儿童的早发性行为问题；d)儿童对故事根源的反应不连贯和攻击性/破坏性；e)儿童的执行、语言和智力功能以及学习成绩？ 2.这些项目对父母照顾和儿童发展的有益影响在多大程度上集中在心理资源较少的母亲所生的孩子身上？ 3.墨西哥裔美国人和欧洲裔美国人在多大程度上受益于母亲和儿童？ 4.项目对反社会行为的影响在多大程度上集中在男孩身上？5.项目效果在多大程度上受到学校和邻里环境的调节？ 6.计划对儿童发展的影响在多大程度上是由计划对妇女产前吸烟、母亲的生命历程、父母照顾的质量以及儿童早期语言发展、执行功能和情绪调节的影响来解释的？ 7.在第一个孩子生命的前九年，通过减少其他政府服务的支出，这些方案的初始成本在多大程度上得到了收回？ 进行经济评估(AIMS 7)、审查学校记录和评估教师关于儿童行为的报告(AIMS 1a和Lc的一部分)将由其他资金来源支付，以便生活在NIH对R-01申请设定的每年500,000美元的直接费用限制之内。

DESCRIPTION (provided by applicant): This proposal seeks support for a 9-year follow-up of 650 children and their families who were enrolled in a randomized trial of prenatal and infancy home visiting by paraprofessionals and by nurses; participating families were assigned to control, paraprofessional-, or nurse-visited conditions. Earlier phases of assessment found significant benefits for nurse- and paraprofessional-visited families and children, although the nurse effects tended to be larger. The current phase of follow-up is designed to determine whether the effects of the nurse and paraprofessional programs endure and grow through the child age 9.5. The proposal is organized around seven questions: 1. Do the programs of nurse and paraprofessional home-visiting produce enduring effects on: a) mothers' life-course; b) qualities of care parents provide to their children; c) children's early-onset behavior problems; d) children's incoherence and aggression/destruction in response to story stems; e) children's executive, language, and intellectual functioning and school achievement? 2. To what extent are the beneficial effects of the programs on parental care-giving and children's development concentrated on those born to mothers with few psychological resources? 3. To what extent are the benefits of the programs on mothers and children equivalent for Mexican- Americans and European-Americans? 4. To what extent are the effects of the programs on antisocial behavior concentrated on boys? 5. To what extent are program effects moderated by school and neighborhood contexts? 6. To what extent are the effects of the programs on children's development explained by impacts of the programs on women's prenatal smoking, maternal life-course, qualities of parental caregiving, and children's earlier language development, executive functioning, and emotional regulation? 7. To what extent are the initial costs of the programs recovered in reduced expenditures for other government services during the first nine years of the first child's life? The conduct of the economic evaluation (aim 7), the review of school records, and the assessment of teacher reports of child behavior (part of aims la and lc) will be covered by other funding sources in order to live within the $500,000 per year direct cost limitation set by NIH on R-01 applications.