Effectiveness of a home intervention for perceived child behavioral problems and parenting stress in children with in utero drug exposure

Arlene Manns Butz, Margaret Pulsifer, Nicole Marano, Harolyn M Edith Belcher, Mary Kathleen Lears, Richard Royall

Research output: Contribution to journalArticle

Abstract

Objective: To determine if a home-based nurse intervention (INT), focusing on parenting education/skills and caregiver emotional support, reduces child behavioral problems and parenting stress in caregivers of in utero drug-exposed children. Design: Randomized clinical trial of a home-based INT. Settings: Two urban hospital newborn nurseries; homes of infants (the term infant is used interchangeably in this study with the term child to denote those from birth to the age of 36 months); and a research clinic in Baltimore, Md. Participants: In utero drug-exposed children and their caregivers (N = 100) were examined when the child was between the ages of 2 and 3 years. Two groups were studied: standard care (SC) (n=51) and INT (n=49). Intervention: A home nurse INT consisting of 16 home visits from birth to the age of 18 months to provide caregivers with emotional support and parenting education and to provide health monitoring for the infant. Main Outcome Measures: Scores on the Child Behavior Checklist and the Parenting Stress Index. Results: Significantly more drug-exposed children in the SC group earned t scores indicative of significant emotional or behavioral problems than did children in the INT group on the Child Behavior Checklist Total (16 [31%] vs 7 [14%]; P = .04), Externalizing (19 [37%] vs 8 [16%]; P = .02), and Internalizing (14 [27%] vs 6 [12%]; P = .05) scales and on the anxiety-depression subscale (16 [31%] vs 5 [10%]; P = .009). There was a trend (P = .06) in more caregivers of children in the SC group reporting higher parenting distress than caregivers of children in the INT group. Conclusions: In utero drug-exposed children receiving a home-based nurse INT had significantly fewer behavioral problems than did in utero drug-exposed children receiving SC (P = .04). Furthermore, those caregivers receiving the home-based INT reported a trend toward lower total parenting distress compared with caregivers of children who received SC with no home visits.

Original languageEnglish (US)
Pages (from-to)1029-1037
Number of pages9
JournalArchives of Pediatrics and Adolescent Medicine
Volume155
Issue number9
StatePublished - 2001

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Parenting
Caregivers
Pharmaceutical Preparations
Community Health Nurses
Nonprofessional Education
House Calls
Child Behavior
Checklist
Problem Behavior
Hospital Nurseries
Parturition
Baltimore
Urban Hospitals
Anxiety
Randomized Controlled Trials
Outcome Assessment (Health Care)
Newborn Infant
Depression

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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Effectiveness of a home intervention for perceived child behavioral problems and parenting stress in children with in utero drug exposure. / Butz, Arlene Manns; Pulsifer, Margaret; Marano, Nicole; Belcher, Harolyn M Edith; Lears, Mary Kathleen; Royall, Richard.

In: Archives of Pediatrics and Adolescent Medicine, Vol. 155, No. 9, 2001, p. 1029-1037.

Research output: Contribution to journalArticle

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abstract = "Objective: To determine if a home-based nurse intervention (INT), focusing on parenting education/skills and caregiver emotional support, reduces child behavioral problems and parenting stress in caregivers of in utero drug-exposed children. Design: Randomized clinical trial of a home-based INT. Settings: Two urban hospital newborn nurseries; homes of infants (the term infant is used interchangeably in this study with the term child to denote those from birth to the age of 36 months); and a research clinic in Baltimore, Md. Participants: In utero drug-exposed children and their caregivers (N = 100) were examined when the child was between the ages of 2 and 3 years. Two groups were studied: standard care (SC) (n=51) and INT (n=49). Intervention: A home nurse INT consisting of 16 home visits from birth to the age of 18 months to provide caregivers with emotional support and parenting education and to provide health monitoring for the infant. Main Outcome Measures: Scores on the Child Behavior Checklist and the Parenting Stress Index. Results: Significantly more drug-exposed children in the SC group earned t scores indicative of significant emotional or behavioral problems than did children in the INT group on the Child Behavior Checklist Total (16 [31{\%}] vs 7 [14{\%}]; P = .04), Externalizing (19 [37{\%}] vs 8 [16{\%}]; P = .02), and Internalizing (14 [27{\%}] vs 6 [12{\%}]; P = .05) scales and on the anxiety-depression subscale (16 [31{\%}] vs 5 [10{\%}]; P = .009). There was a trend (P = .06) in more caregivers of children in the SC group reporting higher parenting distress than caregivers of children in the INT group. Conclusions: In utero drug-exposed children receiving a home-based nurse INT had significantly fewer behavioral problems than did in utero drug-exposed children receiving SC (P = .04). Furthermore, those caregivers receiving the home-based INT reported a trend toward lower total parenting distress compared with caregivers of children who received SC with no home visits.",
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AU - Lears, Mary Kathleen

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