This study is a longitudinal follow-up of 670 primarily African-American women and their 17-year-old first-born children enrolled since 1990 in a highly significant randomized controlled trial of prenatal and infancy home visiting by nurses. Nurses in this program are charged with improving pregnancy outcomes, child health and development, and maternal economic self-sufficiency. The current study is designed to determine whether earlier program effects on maternal and child functioning lead to less violent antisocial behavior, psychopathology, substance abuse, and risk for HIV;whether these effects are greater for those at both 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 use of welfare;children's injuries, cognition, language, achievement, depression/anxiety, and use of substances through child age 12. Hypotheses for the proposed follow-up are based upon the pattern of results found to date. Compared to control-group counterparts: 1) the program will continue to improve maternal life-course (fewer short inter-birth intervals, less use of welfare, more stable partner relations), especially for mothers with higher psychological resources;2) the program will reduce maternal substance use disorders (SUDs) and depression, effects that will be more pronounced for a) mothers with low psychological resources, and b) those living in the most disadvantaged neighborhoods at registration;3) the program will improve the health and development of firstborn children who will exhibit: a) superior cognitive, language, and academic functioning, and executive cognitive functioning (ECF);b) less depression and anxiety;c) fewer failed conduct grades and school disciplinary actions, d) less violent behavior and gang membership, and fewer arrests, juvenile detentions, and convictions - especially for crimes involving interpersonal violence;4) the program will reduce children's risk for HIV infection, including a) use of substances and SUDs;b) risky sexual behaviors;c) sexually transmitted infections (STIs) and d) pregnancies;5) program effects on children will be more pronounced for a) males, b) those born to low-resource mothers, and c) those living in the most disadvantaged neighborhoods at registration;6) Program effects on mothers and children, in preliminary analyses, will be more pronounced for those with genetic vulnerabilities;and 7) program effects on adolescent functioning will be explained by the program's improvement in prenatal health, early care of the child, maternal life-course, and earlier child academic and behavioral functioning.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
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Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Lloyd, Jacqueline
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University of Rochester
Schools of Nursing
United States
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Groth, Susan W; Holland, Margaret L; Smith, Joyce A et al. (2017) Effect of Gestational Weight Gain and Prepregnancy Body Mass Index in Adolescent Mothers on Weight and Body Mass Index of Adolescent Offspring. J Adolesc Health 61:626-633
Groth, Susan W; Rhee, Hyekyun; Kitzman, Harriet (2016) Relationships among obesity, physical activity and sedentary behavior in young adolescents with and without lifetime asthma. J Asthma 53:19-24
Miller, Ted R (2015) Projected Outcomes of Nurse-Family Partnership Home Visitation During 1996-2013, USA. Prev Sci 16:765-77
Miller, Ted R; Hendrie, Delia (2015) Nurse Family Partnership: Comparing Costs per Family in Randomized Trials Versus Scale-Up. J Prim Prev 36:419-25
LeCuyer, Elizabeth A; Christensen, Julie J; Kreher, Donna et al. (2015) African American mothers' self-described discipline strategies with young children in 1992 and 2012. J Pediatr Health Care 29:28-37
Holland, Margaret L; Groth, Susan W; Kitzman, Harriet J (2015) Gestational Weight Gain and Health Outcomes 18 Years Later in Urban Black Women. Matern Child Health J 19:2261-71
Olds, David L; Kitzman, Harriet; Knudtson, Michael D et al. (2014) Effect of home visiting by nurses on maternal and child mortality: results of a 2-decade follow-up of a randomized clinical trial. JAMA Pediatr 168:800-6
Groth, Susan W; Holland, Margaret L; Kitzman, Harriet et al. (2013) Gestational weight gain of pregnant African American adolescents affects body mass index 18 years later. J Obstet Gynecol Neonatal Nurs 42:541-50
Bentley, Mary Jane; Lin, Haiqun; Fernandez, Thomas V et al. (2013) Gene variants associated with antisocial behaviour: a latent variable approach. J Child Psychol Psychiatry 54:1074-85
Kitzman, Harriet J; Olds, David L; Cole, Robert E et al. (2010) Enduring effects of prenatal and infancy home visiting by nurses on children: follow-up of a randomized trial among children at age 12 years. Arch Pediatr Adolesc Med 164:412-8

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