Grant: Operating Grant

Young, low-income mothers and their children are at high risk of suffering health and economic disparities. There is an urgent need for effective early interventions for two reasons: (1) pathways of risk are established early on and tend to be reinforced over time; and (2) the ability to change behaviour, biology and brain plasticity decreases over time, likely increasing costs of implementing successful programs. The Nurse Family Partnership (NFP) is a home visitation program that has been shown to prevent a range of child behavioural problems when evaluated in US randomized controlled trials (RCTs). Our study makes strategic use of a RCT of the NFP, funded by the British Columbia government (the BC Health Connections Project, BCHCP) which seeks to evaluate the impact of the NFP within a Canadian context. Participants for the proposed study (n = 600) will consist of a sub-sample drawn from the BCHCP. Women aged 24 or less are enlisted at 26 weeks gestation and their infants are followed to age 2 years. Our study has three objectives: (1) to determine whether the NFP has an effect on infant biological functions; (2) to investigate whether the NFP has an impact on maternal prenatal stress and whether this is associated with alterations in infant's biology; and (3) to examine whether alterations in biological markers explain the association between the NFP and infant health. We will collect samples from mothers and infants to measure levels of stress. Infant samples will be collected to examine markers that affect the expression of our genes. These measures will be related to child health at age two. Findings will be disseminated to researchers, policy makers and practioners. These findings will inform the design of effective preventive interventions aimed at the health of children born into adverse circumstances. To this point, the biology of change has been neglected, an important oversight given the mutual influence of biological and psychological processes.