This study tested the effect of prenatal and infancy home visits by nurses on 12-year-old, firstborn children's use of substances, behavioral adjustment, and academic achievement.
This study involved a randomized trial of the prenatal and infancy nurse home visits provided by the public system of obstetric and pediatric care in Memphis, Tennessee. The study involved 613 12-year-old, firstborn children of primarily African American economically disadvantaged women (N=743) randomized during pregnancy. The outcome measures for the children were the use of cigarettes, alcohol, or marijuana; manifestation of internalizing, externalizing, and total behavioral problems; and academic achievement. Internal. The study found that compared to the control group of children, those who were involved in the nurse home visits reported fewer days of having used cigarettes, alcohol, or marijuana during the 30 days before the interview, and they were less likely to report having internalizing disorders that met the borderline or clinical threshold (22.1 percent compared to 30.0 percent). Nurse-visited children born to mothers with low psychological resources, compared with their control group counterparts, scored higher on the Peabody Individual Achievement Tests in reading and math (88.78 vs 85.70, P = .009) and, during their first 6 years of education, scored higher on group-administered standardized tests of math and reading achievement (40.52 vs 34.85, P = .02). No statistically significant program effects were found on children's externalizing or total behavioral problems. The study's overall conclusion is that through age 12, the program of nurse home visits reduced children's use of substances and the presence of internalizing mental health problems while improving the academic achievement of children born to mothers with low psychological resources. (publisher abstract modified)