WWHV003485

Eckenrode, J., Zielinski, D., Smith, E., Marcynyszyn, L. A., Henderson, C. R., Kitzman, H., et al. (2001). Child maltreatment and the early onset of problem behaviors: Can a program of nurse home visitation break the link? Development and Psychopathology, 13(4), 873–890.

Citation Year
2001
Rating
Used in Implementation Reports
On
Study Participants

The sample included pregnant, first-time mothers who were fewer than 30 weeks pregnant. The study actively recruited and included pregnant, first-time mothers who were fewer than 25 weeks pregnant, were younger than 19 years old, were single parents, or had low socioeconomic status. Between April 1978 and September 1980, 500 women were interviewed and 400 were randomly assigned. At enrollment, on average, 47 percent were younger than 19 years old, 61 percent came from households in which the head of household was an unskilled or semiskilled worker, and 38 percent were married. This study measured the sample when the children were 15 years old. The study sample included 228 women, 91 in the program group and 137 in the comparison group. (Information on samples sizes for this study was received through communication with the authors.)

Setting

The study was conducted in and around Elmira, New York, a small city of 40,000 residents in a semirural county in the Appalachian region of New York. According to other studies of the Elmira sample, the county included approximately 100,000 residents.

Home Visiting Services

The study included two treatment groups, which were combined for the analyses. The first treatment group received home visits from a nurse during pregnancy. The nurse visited the family every other week and made nine visits, on average, which lasted one hour and 15 minutes. The treatment group also received the screening and transportation services described below for the comparison groups. The second treatment group received the same services as the first treatment group, but the home visiting continued until the child was 2 years old. Home visits were once a week for the first month after delivery, decreasing over time to once every 6 weeks when the child was 18-24 months. Home visits focused on parent education, enhancing the women’s support systems, and linkages to community services.

Comparison Conditions

The study included two comparison groups, which were combined for the analyses. The first comparison group did not receive any services during pregnancy. When the children were 12 and 24 months old, they were screened for sensory and developmental problems and referred to other specialists, as appropriate. The second treatment group received free transportation (through a contract with a local taxi company) for prenatal and well-child care at local clinics and doctors’ offices. The second comparison group also received the 12- and 24-month developmental screening.

Staff Characteristics and Training

All home visitors were nurses. No other information on training is provided.

Author Affiliation

David L. Olds, a study author, is a developer of this model.

Funding Sources

Prevention Research Branch of the National Institute of Mental Health (R01-MH49381); the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services (96ASPE278A); the Children’s Bureau, U.S. Department of Health and Human Services (90-CA1631); a Senior Research Scientist Award (1-K05-MH01382-01); and the Smith–Richardson Foundation.

Sample
Elmira, New York Sample
Attrition
Low
Reassignment
None
Citation short
Eckenrode, J., Zielinski, D., Smith, E., Marcynyszyn, L. A., Henderson, C. R., Kitzman, H., et al. (2001)
Confounding Factors
None
Baseline Equivalence
Established on race and SES (assuming same sample characteristics as reported in previous analyses using the 15 year follow-up).
Disposition
Not applicable
Screening Decision
Passes screens
Design Detail
Randomized controlled trial