The proposed study tests the effectiveness of prenatal and postpartum nurse home visitation as a means of enhancing the health and well-being of socially disadvantaged women and their first-born children. 1468 poor, unwed, pregnant women bearing first babies will be recruited for the study through six public health department clinics; after stratification by clinic site, poverty level, smoking status, and age, the women will be randomly assigned to one of two treatment groups. In the first group, all 734 women will be provided transportation for regular prenatal care; a randomly selected subset of these (N=500) will be followed for purposes of research through the second year of the child's life, during which time they will be provided sensory and developmental screening services for their children. In the second group, 734 women will be provided intensive nurse home-visitation services during pregnancy, in addition to the transportation services provided to the first group; a randomly selected subset of these (N=250) will be followed for purposes of research through the child's second birthday, during which time they will be provided comprehensive nurse home-visitation services. (By following approximately half of the sample during the postpartum phase of the study, with fewer families followed in the experimental program than the comparison group, we meet our criteria for statistical power and simultaneously minimize costs.) Those women randomly assigned to the nurse home-visitation program will be assigned at random to one of the experimental home-visiting nurses. The evaluation is designed to determine whether the nurse home- visitation program improves the women's prenatal health habits, infant caregiving skills, social support, mental health functioning, use of community services, educational and occupational achievements, and helps them reduce unwanted additional pregnancies and their reliance on welfare. For the children, the evaluation is designed to determine whether the program prevents prematurity and low birthweight, growth and nutritional problems, accidents, ingestions, acute infectious illnesses, cognitive delays, behavioral problems, and child abuse and neglect. A cost-benefit analysis will be carried out. It is hypothesized that the home-visitation program will promote the health and well-being of the women and children, and that the effectiveness of the program will be greater for those at greater risk for the particular problem under consideration.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR001691-03
Application #
2256701
Study Section
Nursing Research Study Section (NURS)
Project Start
1988-09-30
Project End
1993-08-31
Budget Start
1990-09-01
Budget End
1991-08-31
Support Year
3
Fiscal Year
1990
Total Cost
Indirect Cost
Name
University of Rochester
Department
Pediatrics
Type
Schools of Dentistry
DUNS #
208469486
City
Rochester
State
NY
Country
United States
Zip Code
14627
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
Sidora-Arcoleo, Kimberly; Anson, Elizabeth; Lorber, Michael et al. (2010) Differential effects of a nurse home-visiting intervention on physically aggressive behavior in children. J Pediatr Nurs 25:35-45
Crittenden, Colleen P; Boris, Neil W; Rice, Janet C et al. (2009) The role of mental health factors, behavioral factors, and past experiences in the prediction of rapid repeat pregnancy in adolescence. J Adolesc Health 44:25-32
Groth, Susan W (2008) The long-term impact of adolescent gestational weight gain. Res Nurs Health 31:108-18
Olds, David L; Kitzman, Harriet; Hanks, Carole et al. (2007) Effects of nurse home visiting on maternal and child functioning: age-9 follow-up of a randomized trial. Pediatrics 120:e832-45
Olds, David L; Kitzman, Harriet; Cole, Robert et al. (2004) Effects of nurse home-visiting on maternal life course and child development: age 6 follow-up results of a randomized trial. Pediatrics 114:1550-9
Olds, David L (2002) Prenatal and infancy home visiting by nurses: from randomized trials to community replication. Prev Sci 3:153-72
Fiscella, K; Kitzman, H J; Cole, R E et al. (1998) Does child abuse predict adolescent pregnancy? Pediatrics 101:620-4
Fiscella, K; Kitzman, H J; Cole, R E et al. (1998) Delayed first pregnancy among African-American adolescent smokers. J Adolesc Health 23:232-7
Kitzman, H; Olds, D L; Henderson Jr, C R et al. (1997) Effect of prenatal and infancy home visitation by nurses on pregnancy outcomes, childhood injuries, and repeated childbearing. A randomized controlled trial. JAMA 278:644-52

Showing the most recent 10 out of 16 publications