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.
