Adolescent Development Clinical Trial
Official title:
Follow-up of Families in Early Preventive Intervention
This project supports the post-third-grade assessment of 693 children and their families who were enrolled in a randomized trial of a program of prenatal and infancy home visitation by nurses that was epidemiologically and theoretically grounded. The project will determine whether the beneficial effects of the program on maternal, child, and family functioning extend through the early elementary school years, giving particular attention to maternal life-course and children's emerging antisocial behavior. Assessments of the children will be based on both mother and teacher reports. Teachers are independent, natural raters of the children's adaptation to an important social context. There are numerous reasons to expect that, from a developmental perspective, the effects of the program will increase as children experience the increased academic demands associated with entry into third grade. In addressing these questions, the current study will determine the extent to which this program of prenatal and infancy home visitation by nurses can produce enduring effects on maternal and child functioning (giving particular attention to the prevention of early-onset disruptive behavior disorders) in urban African Americans that are consistent with those achieved with whites in a central New York state county in a separate trial of this program conducted over the past 20 years.
This project supports the post-third-grade assessment of 693 children and their families who
were enrolled in a randomized trial of a program of prenatal and infancy home visitation by
nurses that was epidemiologically and theoretically grounded. The sample enrolled was
composed of low-income women who had no previous live births and who were largely African
American (92%), unmarried (98%), and adolescent (67%) at the time of registration during
pregnancy. In earlier phases of assessment, the program was found to improve the quality of
care patients provided to their children, to reduce children's health-care encounters in
which injuries were detected, to increase children's sequential processing skills as
measured by the KABC, to reduce the number of dysregulated aggressive and violent themes
expressed in their response to the MacArthur Story Stem Battery, and so to improve maternal
life-course as reflected in fewer subsequent pregnancies, reduced use of welfare, and
increases in the marriage and cohabitation with the biological father of the child. Many of
the benefits in the area of parental care-giving and child functioning were concentrated in
those children and their mothers who had few psychological resources (where psychological
resources was defined as the absence of mental disorder symptoms, adequate intellectual
functioning, and belief in their control over their life circumstances).
The project will determine whether the beneficial effects of the program on maternal, child,
and family functioning extend through the early elementary school years, giving particular
attention to maternal life-course and children's emerging antisocial behavior. Assessments
of the children will be based on both mother and teacher reports. Teachers are independent,
natural raters of the children's adaptation to an important social context. There are
numerous reasons to expect that, from a developmental perspective, the effects of the
program will increase as children experience the increased academic demands associated with
entry into third grade. In addressing these questions, the current study will determine the
extent to which this program of prenatal and infancy home visitation by nurses can produce
enduring effects on maternal and child functioning (giving particular attention to the
prevention of early-onset disruptive behavior disorders) in urban African Americans that are
consistent with those achieved with whites in a central New York state county in a separate
trial of this program conducted over the past 20 years.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Outcomes Assessor), Primary Purpose: Prevention
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