Objective:To examine the effect of prenatal and infancy nurse home visitation on the life course development of 19-year-old youths whose mothers participated in the program.Design: Randomized trial.Setting: Semirural community in New York.Participants: Three hundred ten youths from the 400 families enrolled in the Elmira Nurse-Family Partnership program.Intervention: Families received a mean of 9 home visits (range, 0-16) during pregnancy and 23 (range, 0-59) from birth through the child's second birthday. Main Outcome Measures:Youth self-reports of educational achievement, reproductive behaviors, welfare use, and criminal involvement.Results: Relative to the comparison group, girls in the preg- For editorial comment see page 92Journal Club slides available at www.archpediatrics.com

Previous research indicates that children of adolescent mothers are more likely to experience an adolescent birth than are children of older mothers. Using a longitudinal sample of 293 high-risk mothers and their 19-year-old children, we investigated mediators of the intergenerational pattern of adolescent childbearing. Results from multigroup path models indicate that the intergenerational effect is (a) significant for children of unmarried mothers above and beyond mother's prebirth socioeconomic status and education level, (b) fully mediated through early sexual intercourse related to presence of a father figure and early home environment for girls, and (c) partially mediated by early physical development for boys. Relation of findings to current models of early sexual behavior and childbearing is discussed.

We examine maternal life-course mediators of the impact of a nurse home visitation program on reducing child maltreatment among participants in the Elmira trial of the Nurse Family Partnership program from the first child's birth through age 15. For women having experienced low to moderate levels of domestic violence, program effects on the number of confirmed maltreatment reports were mediated by reductions in numbers of subsequent children born to mothers and their reported use of public assistance. Together, the two mediators explained nearly one half of the total effect of nurse home visiting on child maltreatment. The long-term success of this program on reducing child maltreatment can be explained, at least in part, by its positive effect on pregnancy planning and economic self-sufficiency.

Findings suggest that adolescents in rural areas face greater barriers to accessing family planning services than adolescents in urban areas. Targeted efforts to increase awareness and use of family planning services among adolescents in rural areas and among other underserved populations are needed.

Central to attachment theory is the postulation of an inborn system to regulate attachment behavior. This system has been well studied in infancy and childhood, but much less is known about its functioning at later ages. The goal of this study was to explore the form and function of attachment behavior in the daily lives of young adults. Twenty eight days of online diary data were collected from a sample of 60 undergraduates. In addition to providing descriptive data on routine attachment behavior, the study tests the theorized function of attachment behavior-that is, affect regulation. With the exception of safe haven behaviors, results indicate that age-appropriate attachment behaviors are readily observable during this phase of development, tend to be preferentially directed toward attachment figures, and regulate affect in a theory consistent manner. Findings are discussed in terms of implications for normative developmental change and normative attachment processes.