Age-27 Follow-up of Early Preventive Intervention

这项研究是对340名年轻男性和女性的纵向随访，他们参加了一项随机对照试验，自1977年至1980年期间他们的母亲在试验中登记以来，纽约埃尔迈拉的护士进行了产前和婴儿期家访。这项研究将在这些第一个孩子年满27岁时进行。它的目的是确定在这些年轻人15岁时，用这个样本进行护士家访的非常有希望的效果是否会持续到27岁。具体地说，目前的提案旨在确定Elmira方案在2岁儿童结束25年后是否：1)接受护士访问的年轻成年子女在以下方面不同：a)他们的经济生产力(例如，失业、从事职业发展机会有限的工作、使用福利；非婚生率)；b)他们伴侣关系的质量(人际暴力发生率、承诺和沟通质量)；c) 他们虐待儿童和忽视自己子女的比率；d)他们的犯罪行为、逮捕、定罪和监禁的比率；以及e)他们的心理健康和滥用药物：2)该方案对年轻人经济生产力的影响集中在那些母亲低收入和 3)在前期研究中，该计划对成人犯罪、暴力行为以及第二代儿童虐待和忽视的影响集中在那些行为失调的遗传易感性个体身上(编码MAOA的基因、多巴胺转运体基因和尼古丁受体基因的功能多态性)，并结合环境风险(产前烟草暴露和儿童虐待)；4)该计划对青少年适应功能的影响是通过该计划对其母亲的产前健康相关行为、生命历程(结婚率、后续子女和福利使用率)以及他们虐待和忽视儿童的经历的综合影响来解释的；以及5)护士访视 与被分配到对比条件下的年轻人相比，年轻人产生的政府支出更少，税收更高。这项研究增加了有关早期干预的长期影响的文献，并标志着这项研究计划进入了一个新的阶段，在初步研究中，通过检查干预的影响在多大程度上集中在由于联合遗传和环境风险而处于成人犯罪双重风险的个人身上。

This study is a longitudinal follow-up of 340 young men and women who have participated in a randomized controlled trial of prenatal and infancy home visiting by nurses in Elmira, New York since their mothers registered in the trial during their pregnancies between 1977 and 1980. The study will be conducted when these first-born children turn 27 years of age. It is designed to determine whether highly promising effects found for nurse home visiting with this sample when these young adults were 15 years of age endure through age 27. Specifically, the current proposal is designed to determine, 25 years after the Elmira program ended at child age 2, whether: 1) nurse-visited young adult offspring differ from comparison-group young adults in: a) their economic productivity (e.g., unemployment, employment in jobs with limited opportunities for career growth, use of welfare; rates of out-of wedlock births); b) the quality of their partnered relationships (rates of interpersonal violence, commitment, and quality of communication); c) their rates of child abuse and neglect perpetrated on their own children; d) their rates of criminal behavior, arrests, convictions, and imprisonment; and e) their mental health and abuse of substances: 2) the effects of the program on the young adults' economic productivity are concentrated on those individuals born to mothers who were low-income and unmarried at registration during their pregnancies; 3) the effects of the program on adult criminality, violent behavior, and second-generation child abuse and neglect, in prcliminary studies, are concentrated on those individuals with genetic vulnerabilities for behavioral dysregulation (functional polymorphisms in the gene that encodes MAOA, the dopamine transporter gene, and the (7 nicotine receptor gene) in combination with environmental risks (prenatal tobacco exposure and child maltreatment); 4) the effect of the program on young adults' adaptive functioning is explained by the combined effects of the program on their mothers" prenatal health-related behaviors, life-course (rates of marriage, subsequent children, and welfare use), and their experience of child abuse and neglect; and 5) nurse-visited young adults produced fewer government expenditures and higher tax revenues compared to young adults assigned to the comparison condition. This study adds to the literature on the long-term effects of early intervention and marks a new phase in this program of research by examining, in preliminary studies, the extent to which the effects of the intervention are concentrated in individuals who are at dual risk for adult criminality because of combined genetic and environmental risks.