Nurse home visits reduced child abuse and neglect over a 15 year period
Question Do prenatal and postnatal home visits by nurses have long term effects on maternal life course and child abuse and neglect?
Design
Randomised controlled trial with 15 years follow up.
Setting
Public antenatal clinic and private obstetrics offices in a semirural area of central New York State, USA.
Participants
400 women (11% African-American) who were <25 weeks gestation, had no previous live births, and had ≥1 sociodemographic risk factor (<19 y, unmarried, or low socioeconomic status). Most were unmarried (62%), ≥19 years (52%), and had low socioeconomic status (59%). Follow up was 81%.
Intervention
Stratified by maternal race, marital status, and geographic region, women were allocated to 1 of 4 treatment groups: (1) sensory and developmental screening for children at 12 and 24 months (n=94); (2) treatment 1 plus free transportation to prenatal and child health care until the child's second birthday (n=90); (3) treatment 2 plus prenatal nurse home visits (mean 9 visits) (n=100); and (4) treatment 3 plus home visits (mean 23 visits) for 2 years after delivery (n=116).
Main outcome measures
Substantiated reports of child abuse or neglect, subsequent births, duration of welfare benefits, and mothers' substance abuse, arrests, and convictions.
Main results
Analysis was by intention to treat, …
