|
|
|
|
|
Kimberly J. Sidora-Arcoleo, MPH, School of Nursing, University of Rochester Medical Center, 255 Crittenden Blvd, Rochester, NY 14620, 585-275-7420, kimberly_sidora@urmc.rochester.edu
Objective: To determine the interaction of home visiting intervention, maternal depression, child activity level on unintentional injury.
Design: Analysis of data from a longitudinal, randomized trial of nurse home visitation. Program implementation was from pregnancy through the child’s second birthday. Follow-up assessments were conducted at 6 months and 1, 2, 3, and 4 years postpartum. Medical record reviews done at 2 and 4 years of age.
Setting: The study was conducted in Elmira, NY. Subjects were recruited from a clinic offering free antepartum care sponsored by the county health department and the offices of private obstetricians.
Participants: Women were eligible if they had no previous live births, registered prior to 25 weeks gestation, and were: <19 years old, unmarried, or low socioeconomic status. 400 women were enrolled in the initial study. A total of 280 subjects who had complete data were included for these analyses.
Main Outcome Measure: Number of unintentional injuries between ages two and four years.
Results: There was a main effect for treatment (χ2 = 7.88, p=.02) and a treatment by child activity level interaction (χ2 = 9.64, p=.008).Within the comparison group, children with high activity level whose mothers were depressed had twice the number of injuries as those with high activity whose mothers were not depressed (estimated mean=1.37 versus 0.69, respectively). Among low activity children, mother’s depression did not affect number of injuries. Within the nurse-visited group, there was a reduction in the mean number of estimated injuries with increasing activity levels, irrespective of depression level (-.14 non-depressed and -.59 depressed).
Conclusions: Mothers suffering depression had children with high injury rates. However, the nurse visitation intervention had a protective effect in preventing injuries, irrespective of depression levels, which was concentrated among those mothers with highly active children.
Key words: Nurse home visiting, child temperament, maternal depression, unintentional injury
Learning Objectives:
Keywords: Injuries, Maternal and Child Health
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.