Impact of a Nurse Home Visiting Intervention on the Development of Physically Aggressive Behavior in Children

Objective: To examine the impact of a nurse home visiting intervention on the development of physical aggression (PA) among children ages 2 – 12 years.

Methods: Secondary data analysis from a longitudinal, randomized trial of a nurse home visiting intervention among low income African-American women and their children. Negative parenting attitudes measured by the Adult-Adolescent Parenting Inventory, physical aggression at 2, 6 and 12 years measured by PA items from the Child Behavior Checklist and social competency by Peer Social Skills and Assertive Social Skills subscales of the Teacher-Child Rating Scales.

Results: Repeated measures analyses revealed significant time x treatment x gender effects for PA from 2 – 12 years of age (F=5.30, df 495, p=.02) after controlling for negative parenting and children's social competency. Effects were concentrated among females from ages 2 – 6. At age 2, comparison females' PA scores were 1.5 times higher than the nurse-visited females (p=.0008). By age 6, both groups demonstrated reductions in PA but differences were still statistically significant (p=.009). By age 12, the groups were equivalent and exhibited very low PA scores. There was no impact of the intervention on males.

Conclusions: Nurse home visiting intervention was effective in reducing early PA among females potentially interrupting development of academic problems, substance use, delinquency and violence - shown to be linked to early aggression. This model, highlighting parenting style and children's social competence, failed to show any differences among the males. Future research needs to identify factors relating to PA in males potentially amenable to intervention.