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The Prenatal/Early Infancy Project: An Adolescent Follow-up

Not Applicable
Completed
Conditions
Behavior, Adaptive
Interventions
Behavioral: Developmental Screening
Behavioral: Screening plus Transportation
Behavioral: Screening, Transport, Prenatal Visits
Behavioral: Screen, Transport, Prenatal/Inf Visits
Registration Number
NCT03079752
Lead Sponsor
University of Colorado, Denver
Brief Summary

The Nurse-Family Partnership, a program of prenatal and infancy home visiting by nurses, has been examined in a series of 3 randomized trials since 1977. It has received considerable attention in the scientific and public policy communities for its replicated effects on a variety of maternal and child health outcomes across these 3 trials, including prenatal health, childhood injuries, rates of subsequent pregnancies, inter-birth intervals, as well as its long-term effects on maternal life-course, criminal behavior, and 15-year-olds' criminal and antisocial behavior in the first trial of the program conducted in Elmira, New York.

Detailed Description

Although this program produced positive effects on maternal and child health from pregnancy through the child's fourth year of life, its long-term effects remain unexamined. The current study was conducted to determine the extent to which the beneficial effects of the program set in motion early in the life cycle altered the life-course trajectories of the mothers and the children's adaptive functioning through the first child's 15th birthday. This study examines the long-term effects of the program on two domains of maternal functioning: 1) maternal life course (subsequent children, use of welfare, employment, substance abuse, and encounters with the criminal justice system); and 2) perpetration of child abuse and neglect; and two domains of the children's behavior: 1) their functioning in schools, and 2) their criminal and antisocial behavior. The investigators hypothesized that the program effects in these domains of maternal and child functioning, as in earlier phases of the study, would be greater for families in which the mothers experienced a larger number of chronic stressors and had fewer resources to manage the challenges of living in poverty and being a parent.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
629
Inclusion Criteria

Must be offspring of mothers who enrolled in Elmira randomized clinical trial of the Nurse-Family Partnership (known as the Prenatal Early Infancy Project) -

Exclusion Criteria

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Developmental ScreeningDevelopmental ScreeningParticipants received sensory and developmental screening and referral for further evaluation and treatment of suspected problems at 12 and 24 months of age.
Screen, Transport, Prenatal/Inf VisitsScreen, Transport, Prenatal/Inf VisitsParticipants received regular sensory and developmental screening and referral for further evaluation and treatment of suspected problems at 12 and 24 months of age; their mothers received free transportation for regular prenatal and well-child care (through child age two), plus nurse home visiting during pregnancy and through child age two.
Screening plus TransportationDevelopmental ScreeningParticipants received sensory and developmental screening and referral for further evaluation and treatment of suspected problems at 12 and 24 months of age; their mothers received free transportation for regular prenatal and well-child care (through child age two).
Screen, Transport, Prenatal/Inf VisitsScreening plus TransportationParticipants received regular sensory and developmental screening and referral for further evaluation and treatment of suspected problems at 12 and 24 months of age; their mothers received free transportation for regular prenatal and well-child care (through child age two), plus nurse home visiting during pregnancy and through child age two.
Screen, Transport, Prenatal/Inf VisitsScreening, Transport, Prenatal VisitsParticipants received regular sensory and developmental screening and referral for further evaluation and treatment of suspected problems at 12 and 24 months of age; their mothers received free transportation for regular prenatal and well-child care (through child age two), plus nurse home visiting during pregnancy and through child age two.
Screening, Transport, Prenatal VisitsDevelopmental ScreeningParticipants received sensory and developmental screening and referral for further evaluation and treatment of suspected problems at 12 and 24 months of age; their mothers received free transportation for regular prenatal and well-child care (through child age two), plus nurse home visiting during pregnancy.
Screening, Transport, Prenatal VisitsScreening, Transport, Prenatal VisitsParticipants received sensory and developmental screening and referral for further evaluation and treatment of suspected problems at 12 and 24 months of age; their mothers received free transportation for regular prenatal and well-child care (through child age two), plus nurse home visiting during pregnancy.
Screening plus TransportationScreening plus TransportationParticipants received sensory and developmental screening and referral for further evaluation and treatment of suspected problems at 12 and 24 months of age; their mothers received free transportation for regular prenatal and well-child care (through child age two).
Screening, Transport, Prenatal VisitsScreening plus TransportationParticipants received sensory and developmental screening and referral for further evaluation and treatment of suspected problems at 12 and 24 months of age; their mothers received free transportation for regular prenatal and well-child care (through child age two), plus nurse home visiting during pregnancy.
Screen, Transport, Prenatal/Inf VisitsDevelopmental ScreeningParticipants received regular sensory and developmental screening and referral for further evaluation and treatment of suspected problems at 12 and 24 months of age; their mothers received free transportation for regular prenatal and well-child care (through child age two), plus nurse home visiting during pregnancy and through child age two.
Primary Outcome Measures
NameTimeMethod
Timing of Subsequent Births - Mothers15 years following birth of first child

Interval in days between birth date of first child and first subsequent child (self-reported)

Months Received Aid to Families with Dependent Children (AFDC) - Mothers15-year interval following birth of first child

Number of months mother received AFDC (self-reported)

Number of Months Employed - Mothers15-year interval following birth of first child

Number of months employed (self-reported)

Substance Abuse - Mothers15-year period following birth of first child

Count of behavioral impairments due to use of substances (self-reported)

Arrests - Mothers15-year interval following birth of first child

Count of arrests (self-reported)

Child Maltreatment Reports - Mothers15-year interval following birth of first child

Count of substantiated reports of child abuse and neglect in which mother was perpetrator (review of records)

Running Away from Home - Children15-year interval following birth of first child

Count of times ran away from home - self-report

Person in Need of Supervision (PIN) - Children15-year period following their birth

Self report of ever having been adjudicated as a PIN

Arrests - Children15-year period following birth

Count of Arrests - self-report

Secondary Outcome Measures
NameTimeMethod
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