142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Improvement in Cognitive Outcomes for Children Living in Poverty in the Legacy for ChildrenTM Parenting Intervention Five Years Post-Intervention

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 1:00 PM - 1:15 PM

Lara R. Robinson, Phd MPH , National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
Ruth Perou, PhD , Division of Human Development and Disability, CDC, Atlanta, GA
Melissa Danielson, MSPH , Child Development Studies Team, Centers for Disease Control and Prevention, Atlanta, GA
Angelika Claussen, PhD , National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA

The Legacy for ChildrenTM (Legacy) group-based parenting model was developed to address developmental disparities associated with childhood poverty. A set of randomized controlled trials of Legacy tested two implementations, prenatal to age 3 (Los Angeles [LA]) and  birth to child age 5 (Miami),  for their impact on parenting and maternal wellbeing, child development (cognitive, language, socioemotional) and health. Third grade follow-up data were also collected.


Cognitive outcomes from 246 Legacy participants in Miami and 233 participants in LA were analyzed when the children were 3 and 5 years old, and in third grade.  These assessments included the Kauffman Assessment Battery for Children-II (KABC) and Woodcock-Johnson III Tests of Achievement (WJ). An intent-to-treat approach was used and t-tests compared unadjusted mean scores of the intervention and comparison groups by site.  


In LA, the intervention group scored on average 4 points higher  than the comparison group on the KABC at both age 3 years and third grade time points (Age 3: 83.7 vs. 79.3, p=0.02; Third Grade: 94.2 vs. 89.9, p=0.03).  The intervention group also scored higher on third grade WJ Letter-Word (103.8 vs. 97.7, p=0.01) and Applied Problems (96.5 vs. 92.3, p=0.04) subtests. There were no statistically significant cognitive differences at the Miami site.


Children of mothers participating in the LA site of Legacy had significantly higher IQ through third grade, five years post intervention.  Shifting the developmental trajectory of early cognitive development has immediate and long term implications for child health, educational achievement, and wellbeing.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Implementation of health education strategies, interventions and programs
Social and behavioral sciences

Learning Objectives:
Describe the Legacy for ChildrenTM model and its implementations Discuss the site specific longitudinal Legacy for ChildrenTM cognitive outcomes Explain the public health implications of the Legacy for ChildrenTM modelís outcomes

Keyword(s): Child Health, Poverty

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Lara Robinson, PhD, MPH, is a behavioral scientist position at the Centers for Disease Control and Prevention (CDC), National Center on Birth Defects and Developmental Disabilities. Dr. Robinson serves as the Project Lead for the Legacy for ChildrenTM Dissemination Project. Her expertise is in early childhood development, parenting, and research translation/implementation science. She received her Masterís of Public Health at Tulane University and her PhD in Applied Developmental Psychology from the University of New Orleans.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.