Using an urban, primarily African-American sample, this study examined the effect of prenatal and infancy home visits by nurses on 12-year-old first-born children's use of substances, behavioral adjustment, and academic achievement.
The sample consisted of 613 12-year-old first-born children of 743 economically disadvantaged women randomized during pregnancy while participating in a public system of obstetric and pediatric care in Memphis, Tennessee. The intervention evaluated was a program of prenatal and infancy home visits by nurses. The outcomes measured were the use of tobacco, alcohol, and marijuana; internalizing, externalizing, and total behavioral problems; and academic achievement. By the time the first-born child was 12 years of age, those visited by nurses, compared to those in the control group, reported fewer days of having used tobacco, alcohol, and marijuana during the 30-day period prior to the 12-year interview (0.03 versus 0.18, p=.019), and were less likely to report having internalizing disorders that met the clinical/borderline threshold (22 percent versus 31 percent, p=.043). Nurse-visited children born to mothers with low psychological resources, compared to control-group counterparts, scored higher on the PIAT achievement tests in reading and math (88.78 versus 85.70, p =.009) and, over their first 6 years of education, scored higher on group-administered standardized tests of math and reading achievement (40.52 versus 34.85, p=.023). There were no statistically significant program effects on children's externalizing or total behavioral problems. Based on these findings, the study concluded that through child age 12, the program reduced children's use of substances and the occurrence of internalizing mental health problems and improved the academic achievement of children born to mothers with low psychological resources. 5 tables and 35 references (publisher abstract modified)