Age-17 Follow-up of Home Visiting Intervention

17 岁家访干预后续行动

基本信息

批准号：
8024968
负责人：
DAVID L OLDS
金额：
$ 18.11万
依托单位：
UNIVERSITY OF ROCHESTER
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-05-15 至 2013-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8024968
关键词：
17 year old Achievement Adolescence Adolescent Affect African American Age Alcohol or Other Drugs use Alleles Anxiety Behavior Behavioral Birth Intervals Caring Charge Child Child Care Child Welfare Child health care Cognition Cognitive Control Groups Crime Development Disadvantaged Early treatment Economics Employment Enrollment Environmental Risk Factor Exhibits Female Fertility Genes Genetic Genetic Polymorphism Genetic Predisposition to Disease Genotype HIV HIV Infections Health Heterozygote Home visitation House Call Injury Interpersonal Violence Intervention Language Lead Life Life Cycle Stages Mental Depression Mental Health Mothers Neighborhoods Nurses Outcome Pattern Planned Pregnancy Pregnancy Pregnancy Outcome Psychopathology Randomized Controlled Trials Resources Risk Schools Sexually Transmitted Diseases Social Welfare Specific qualifier value Substance Use Disorder Substance abuse problem Synapses Violence Visiting Nurse Woman Work Youth anti social base cognitive function design disorder risk emerging adult executive function follow-up gang high risk sexual behavior improved infancy juvenile arrest male meetings neural circuit prenatal prenatal health programs promoter psychologic relating to nervous system serotonin transporter stressor success

项目摘要

DESCRIPTION (provided by applicant): 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.

描述（由申请人提供）：这项研究是对670名主要是非裔美国妇女的纵向随访，以及他们自1990年以来在一项非常重要的随机对照试验中，对护士的产前和婴儿期访问的一项非常重要的随机对照试验。该计划中的护士负责改善妊娠结局，儿童健康和发展以及孕产妇的经济自给自足。当前的研究旨在确定较早的计划对孕产妇和儿童功能的影响是否导致反社会行为，精神病学，药物滥用和艾滋病毒的风险较少。对于遗传和环境风险的人来说，这些影响是否更大；以及程序效应是否复制了与白人早期试验中发现的效果。迄今为止，该计划影响了妇女的产前健康，生育能力，伴侣关系和福利使用；儿童的伤害，认知，语言，成就，抑郁/焦虑以及到12岁的儿童使用物质。拟议的后续行动的假设基于迄今为止的结果模式。与对照组对应物相比：1）该计划将继续改善孕产妇的生活方式（短期间隔较少，使用福利，更稳定的伴侣关系），尤其是对于具有较高心理资源的母亲而言； 2）该计划将减少产妇使用障碍（SUD）和抑郁症，对a）患有低心理资源的母亲和b）居住在注册最弱势群体的社区的母亲更为明显； 3）该计划将改善将展示的长子儿童的健康和发展：a）优越的认知，语言和学术功能以及执行认知功能（ECF）； b）减少抑郁和焦虑； c）较少的行为成绩和学校纪律处分，d）较少的暴力行为和帮派成员资格，少年逮捕，少年拘留和定罪 - 尤其是对于涉及人际暴力的罪行； 4）该计划将降低儿童感染的风险，包括a）使用物质和肥皂水； b）有风险的性行为； c）性传播感染（性传播感染）和d）怀孕； 5）对儿童的程序影响将对a）男性，b）低资源母亲出生的男性和c）居住在注册最弱势的社区中的人； 6）在初步分析中，对母亲和儿童的计划影响对于患有遗传脆弱性的人将更加明显； 7）计划对青少年功能的影响将通过该计划在产前健康，对儿童的早期护理，孕产妇生活和早期儿童学术和行为功能的改善来解释。