Model Family Programs for Delinquency Prevention
 
Rating * Exemplary Target * 0-5 Speciality * Family In-Home Support
 
Program * The Prenatal and Early Childhood Nurse Home Visitation Program
 
Description *




 
  The Prenatal and Early Childhood Nurse Home Visitation Program is a well tested model that improves the health and social functioning of low-income first-time mothers and their babies. Nurse home visitors develop a supportive relationship with the mother and family which emphasizes education, mutual goal setting, and the development of the parents' own problem-solving skills and sense of self-efficacy. Beginning in pregnancy, the nurses help women to improve their health behaviors related to substance abuse (smoking, drugs, alcohol) and nutrition, significant risk factors for pre-term delivery, low birth weight, and infant neurodevelopmental impairment. After delivery, the emphasis is on enhancing qualities of caregiving for infants and toddlers, thereby preventing child maltreatment, childhood injuries, developmental delay, and behavioral problems. Among the mothers, the program also focuses on preventing unintended subsequent pregnancies, school drop out, and failure to find work resulting in ongoing welfare dependence - factors that conspire to enmesh families in poverty and that increase the likelihood that women will have poor subsequent pregnancies and increase the likelihood for suboptimal care of children. In order to achieve maximum outcomes in the preceding domains of functioning, nurses work to improve environmental contexts by enhancing informal support and by liking families with needed health and human services.

Using developmentally established protocols, nurses visit families as follows: (a) weekly during the first month following enrollment, (b) every other week throughout the remainder of the woman's pregnancy, (c) weekly for the first six weeks postpartum, (d) every other week thereafter through the child's 21st month, and (e) then monthly until the child reaches age two. Visit protocols focus on five domains of functioning: personal health, environmental health, maternal role, maternal life course development, and family and friend support.

A summary of the major findings on maternal and child outcomes from two randomized clinical trials show a 25 % reduction in cigarette smoking during pregnancy among women who smoked cigarettes at registration; 25 % reduction in the rates of hypertensive disorders of pregnancy and less severe cases among those with the condition; 80% reduction in rates of child maltreatment among at-risk families from birth through the child's second year; 56% reduction in the rates of children's health-care encounters for injuries and ingestions from birth through child's second birthday; 43 % reduction in subsequent pregnancy among low-income, unmarried women by first child's birthday; 83 % increase in the rates of labor force participation by first child's fourth birthday; 30-month reduction in AFDC utilization among low-income, unmarried women by first child's 15th birthday.

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    Contact * Ruth A. O'Brien, Ph.D., RN 
 
    Address* Kempe Prevention Research Center
for Family and Child Health
1825 Marion Street 
        Denver, CO  80218
 
    Phone * 303 864-5210
 
    Email  *  obrien.ruth@tchden.org 
 
         
 
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    Dept. of Health Promotion and Education

Funded by - Office of Juvenile Justice and Delinquency Prevention