Age-17 Follow-up of Home Visiting Intervention

描述（由申请人提供）：本申请是对资助号5R01DA021624-02（17岁家访随访干预）的修订，将数据收集范围扩大到不仅包括第一个孩子（由主要资助覆盖），还包括第一个孩子5年内出生的孩子。主要拨款包括对670名主要是非裔美国母亲和17岁的头胎儿童进行纵向随访，这些儿童自1990年以来被纳入一项非常重要的随机对照试验，由护士进行产前和婴儿家访。护士负责改善妊娠结局、儿童健康和发育以及产妇经济自给自足。初步拨款旨在确定早期项目对母亲和头胎儿童功能的影响是否会减少暴力反社会行为、精神病理、药物滥用和艾滋病毒感染风险；这些影响是否对那些有遗传和环境风险的人更大；以及项目的效果是否与之前在白人身上发现的效果相同。迄今为止，该方案影响了妇女的产前保健、生育能力、伴侣关系和福利使用；头胎儿童的损伤、认知、语言成就、抑郁/焦虑和12岁前的物质使用。尽管关于干预措施对后期出生的儿童的延续效应的文献有限，但有重要的理由期待这种干预措施的效果。这一补充（修订）利用了为父母补助而开发的基础设施，并请求支持收集后续儿童14-17岁时的相同数据，以确定干预的影响在多大程度上延续到年幼的兄弟姐妹，因为他们进入青春期——这是反社会行为、药物使用和滥用、暴力和艾滋病毒暴露风险极高的时期。将进行直接评估，以获得对较年幼儿童的遗留影响的有效估计。该研究解决了以下问题：1)在认知、语言、学术和执行认知功能（ECF）方面，该计划在多大程度上改善了后续儿童的健康和发展；B)抑郁和焦虑；C)品行不及格，d)暴力行为和帮派成员，e)被捕、青少年拘留和定罪，尤其是暴力犯罪；2)减少儿童随后感染艾滋病毒的风险，包括a)使用和滥用药物；B)危险的性行为；c)性传播感染（sti）和d)怀孕；3)对后代的影响在以下几个方面更为明显：a)男性，b)资源丰富的母亲所生，以及c)在登记时生活在最贫困社区的人；4)对后续儿童功能的影响可以通过以下因素来解释：a)后续出生的时间和比率；B)家庭对福利相关服务的使用；C)伴侣关系的稳定性；D)社区环境的改善；e)长子的反社会行为。

DESCRIPTION (provided by applicant): This application is a revision to grant number 5R01DA021624-02 (Age-17 Follow-up of Home Visiting Intervention) extending data collection to cover not only first-born children (covered by the primary grant) but children born within 5 years of the first child. The primary grant consists of a longitudinal follow-up of 670 primarily African-American mothers and 17 year old first-born children enrolled since 1990 in a highly significant randomized controlled trial of prenatal and infancy home visits by nurses. Nurses were charged with improving pregnancy outcomes, child health and development, and maternal economic self-sufficiency. The primary grant is designed to determine whether earlier program effects on maternal and first-born child's functioning lead to less violent antisocial behavior, psychopathology, substance abuse, and risk for HIV; whether these effects are greater for those at genetic and environmental risk; and whether program effects replicate those found in an earlier trial with whites. To date, the program affected women's prenatal health, fertility, partner relations, and welfare use; first-born children's injuries, cognition, language achievement, depression/anxiety, and use of substances through child age 12. Despite the limited literature on the carry over effects of interventions on later born children, there are important reasons to expect effects for this intervention. This supplement (revision) takes advantage of the infrastructure developed for the parent grant and request support to gather the same data on subsequent children when they are 14-17 years of age to determine the extent to which the impact of the intervention carries over to younger siblings as they enter adolescence - a period of great risk for antisocial behavior, substance use and abuse, violence, and risk for HIV exposure. Direct assessments will be conducted to obtain valid estimates of carryover effects to younger children. The study addresses questions about the degree to which the program: 1) improves the health and development of subsequent children in terms of their a) cognitive, language, academic, and executive cognitive function (ECF); b) depression and anxiety; c) failed conduct grades, d) violent behavior and gang membership, and e) arrests, juvenile detentions, and convictions, especially for violent crimes; 2) reduces subsequent children's risk for HIV infection, including a) use and abuse of substances; b) risky sexual behaviors; c) sexually transmitted infections (STIs) and d) pregnancies; 3) effects on subsequent children are more pronounced for a) males, b) those born to high-resource mothers, and c) those living in the most disadvantaged neighborhoods at registration; 4) effects on subsequent children's functioning is explained by its earlier impact on a) the timing and rates of subsequent births; b) families' use of welfare-related services; c) stability in partner relationships; d) improvements in neighborhood contexts; and e) antisocial behavior among first-borns.