This study is a longitudinal follow-up of 670 primarily African-American women and their 17-year-old firstborn children enrolled since 1990 in a highly significant randomized controlled trial (RCT) of prenatal and infancy home visiting by nurses. Nurses in this program are charged with improving pregnancy outcomes, child health and development, and maternal economic self-sufficiency. This follow-up examines whether earlier program effects on maternal and child functioning lead to less violent antisocial behavior, psychopathology, substance use and use-disorders, and risk for HIV; whether these effects are greater for those at both genetic and environmental risk; and whether program effects replicate those found with whites in an earlier trial.
Name: Nurse Home VisitingDescription: Visits from nurses from mid-pregnancy to child age 2 years.Type: Behavioral
Nurse Home Visiting through Age 2 Transportation, Child Screening/Referral
Description: Public benefit expenditures estimated from review of state administrative records and maternal report of all children's birth dates. Program effects on public-benefit expenditures hypothesized to be especially pronounced for mothers with higher psychological resources.Measure: Maternal life-course (reflected in reduced total public benefit expenditures for SNAP, AFDC/TANF, and Medicaid). Time: through first child age 18
Description: Direct tests of youth cognitive, language, and academic functioning. Program effects in this domain hypothesized to be most pronounced for children born to mothers with low psychological resources.Measure: Cognitive, language, and academic functioning among first-born children. Time: at youth age 18
Description: Measure of internalizing disorders based upon youth self-report.Measure: Youth depression and anxiety Time: at youth age 18
Description: Self-reported involvement with criminal justice system and antisocial behavior. Program effects on arrests and convictions hypothesized to be greater for females.Measure: Youth gang membership, arrests, convictions, and self-reported antisocial behavior, especially for crimes involving interpersonal violence. Time: at youth age 18
Description: Outcomes based upon self-report and urine assays for STI's and substance use.Measure: Youth risk for HIV infection, pregnancies, births, use of substances, and SUDs. Time: at youth age 18.
Description: Based upon maternal self-report of SUDs and depression.Measure: Reduced maternal substance use disorders (SUDs) and depression. Time: at youth age 18
Description: Based upon direct tests of risky decision making, impulsivity, facial recognition, verbal working memory) and records of high school graduation. Program effects in this domain hypothesized to be more pronounced for children born to mothers with low psychological resources.Measure: Improved child executive cognitive functioning, and rates of high school graduation. Time: at youth age 18
Description: Self-reported number of subsequent pregnancies, pregnancy outcomes, live births, low-birth weight newborns, and birth dates. Program effects on cumulative pregnancies and births hypothesized to be more pronounced among mothers with high psychological resources.Measure: Cumulative subsequent pregnancies - mothers Time: through youth age 18
Description: Self-reported pregnancies and pregnancy outcomes.Measure: Pregnancies - youth Time: through youth age 18
Description: Self-reported duration and quality of relationship, cohabitation, marriage, partner employment, and relationship to first-born childMeasure: Relationship with Current Partner Time: at youth age 18
There is one SNP
2. Effects on youth violent antisocial behavior, SUDs, and risky sexual behavior will be more pronounced among males with the MAOA-LPR low activity alleles compared to males with MAOA-LPR high activity alleles, and among both males and females with 2 copies of the high-activity Val allele of the COMT Val158Met polymorphism compared to those with 2 copies of the low-activity met allele or heterozygotes. --- Val158Met ---