Kitzman Harriet J, Olds David L, Cole Robert E, Hanks Carole A, Anson Elizabeth A, Arcoleo Kimberly J, Luckey Dennis W, Knudtson Michael D, Henderson Charles R, Holmberg John R
University of Colorado-Denver, 13121 E 17th Ave., Aurora, CO 80045, USA.
Arch Pediatr Adolesc Med. 2010 May;164(5):412-8. doi: 10.1001/archpediatrics.2010.76.
To test 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.
Randomized controlled trial.
Public system of obstetric and pediatric care in Memphis, Tennessee.
We studied 12-year-old, firstborn children (n = 613) of primarily African American, economically disadvantaged women (743 randomized during pregnancy).
Program of prenatal and infancy home visits by nurses.
Use of cigarettes, alcohol, and marijuana; internalizing, externalizing, and total behavioral problems; and academic achievement.
By the time the firstborn child was 12 years of age, those visited by nurses, compared with those in the control group, reported fewer days of having used cigarettes, alcohol, and marijuana during the 30-day period before the 12-year interview (0.03 vs 0.18, P = .02) and were less likely to report having internalizing disorders that met the borderline or clinical threshold (22.1% vs 30.9%, P = .04). 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.
Through age 12, the program reduced children's use of substances and internalizing mental health problems and improved the academic achievement of children born to mothers with low psychological resources.
测试护士进行产前及婴儿期家访对12岁的头胎孩子物质使用、行为调适及学业成绩的影响。
随机对照试验。
田纳西州孟菲斯市的公共产科和儿科护理系统。
我们研究了主要为非裔美国人、经济上处于不利地位的女性所生育的12岁头胎孩子（n = 613）（孕期随机分组743人）。
护士进行产前及婴儿期家访项目。
香烟、酒精和大麻的使用情况；内化、外化及总体行为问题；学业成绩。
在头胎孩子12岁时，与对照组相比，接受护士家访的孩子在12岁访谈前30天内报告使用香烟、酒精和大麻的天数较少（0.03天对0.18天，P = 0.02），且报告患有达到临界或临床阈值的内化障碍的可能性较小（22.1%对30.9%，P = 0.04）。心理资源匮乏的母亲所生的接受护士家访的孩子，与对照组同龄人相比，在皮博迪个人成就测试的阅读和数学方面得分更高（88.78分对85.70分，P = 0.009），并且在其接受教育的前6年里，在集体施测的数学和阅读成绩标准化测试中得分更高（40.52分对34.85分，P = 0.02）。未发现该项目对孩子的外化或总体行为问题有统计学上的显著影响。
到12岁时，该项目减少了孩子的物质使用和内化心理健康问题，并提高了心理资源匮乏的母亲所生孩子的学业成绩。
