A Randomized, Community-Based Trial of Home Visiting to Reduce Blood Lead Levels in Children

Brown, Mary Jean; McLaine, Pat; Dixon, Sherry; Simon, Peter

doi:10.1542/peds.2004-2880

Cited by 46 publications

(27 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…10 A scan of the literature reveals clinical trials of home visiting models focused on: birth outcomes, 11,12 immunization rates, 13 emergency department visits, 13 prenatal care, 14 breastfeeding, 15 accidental injury, 12,16 child maltreatment, 17 children' s dietary practices, 18 and lead levels. 19 Although models differ, most home visiting models have a structured protocol, materials, and goals and use a combination of direct information sharing or service provision and case management with referral to community resources. 20 Most address child health and development by targeting parenting; for example, encouraging sensitive caregiving, increasing parent knowledge on development, or recognizing child illnesses.…”

Section: What Is Home Visiting?mentioning

confidence: 99%

Effectiveness of Home Visiting in Improving Child Health and Reducing Child Maltreatment

2013

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVE: The Patient Protection and Affordable Care Act established the Maternal, Infant, and Early Childhood Home Visiting Program, which provides $1.5 billion to states over 5 years for home visiting program models serving at-risk pregnant women and children from birth to age 5. The act stipulates that 75% of the funds must be used for programs with evidence of effectiveness based on rigorous evaluation research. Home Visiting Evidence of Effectiveness reviewed the home visiting research literature and provided an assessment of the evidence of effectiveness for program models that serve families with pregnant women and children from birth to age 5. METHODS: Home Visiting Evidence of Effectiveness included a systematic search and screening process, a review of the research quality, and an assessment of program effectiveness. Reviewers rated studies’ capacity to provide unbiased estimates of program impacts and determined whether a program met the Department of Health and Human Services’ criteria for an evidence-based model. RESULTS: As of July 2012, 32 models were reviewed, of which 12 met the Department of Health and Human Services criteria. Most of these models were shown to have favorable effects on child development. Other common favorable effects included health care usage and reductions in child maltreatment. Less common were favorable effects on birth outcomes. CONCLUSIONS: Home visiting is a promising way to serve families who may be difficult to engage in supportive services. Existing rigorous research indicates that home visiting has the potential for positive results among high-risk families, particularly on health care usage and child development.

show abstract

Section: What Is Home Visiting?mentioning

confidence: 99%

Effectiveness of Home Visiting in Improving Child Health and Reducing Child Maltreatment

2013

View full text Add to dashboard Cite

show abstract

“…Environmental lead exposure occurs predominantly by ingestion of lead-contaminated household dust or soil in older houses that contain leadbased paint; the degree of exposure often increases with deterioration or renovation of the houses. Smelters and tap water are two other important potential sources of lead exposure (Brown et al, 2006). The current screening threshold established by the Centers for Disease Control and Prevention for an elevated blood lead level in a child is 10 µg/dl (Bellinger, 2004), but this value should not be interpreted as a level below which adverse effects do not occur.…”

Section: Introductionmentioning

confidence: 99%

Effects of environmental lead exposure on T-helper cell-specific cytokines in children

Hsiao

Wan³

2011

Journal of Immunotoxicology

View full text Add to dashboard Cite

Lead (Pb) may alter T-lymphocyte reactivity in situ by preferentially enhancing the development of T-helper 2 (T(H)2)- and inhibiting T(H)1-lymphocyte development. These effects could result in dysregulation of the presence/availability of T(H)1- and T(H)2-associated cytokines. The aim of this study was two-fold, that is, to assess whole blood Pb levels in schoolchildren from Taiwanese communities that varied in degree of potential for Pb exposure and then ascertain if there were relationships between Pb exposure and changes in levels of key T(H)1 and T(H)2 cytokines. Grades 5 and 6 students were selected from four different community schools, i.e., one from: urban area with new homes; urban area with old homes; rural site with old homes; and area located near an oil refinery. Students at each site were further divided into healthy and respiratory allergy subgroups. Blood was collected and whole blood Pb levels and serum interferon (IFN)-γ, interleukin (IL)-12, -4, and -5 levels were determined. The results indicate no differences in whole blood Pb levels (<4 µg/dl) among students from urban and rural sites; these values were similar in the healthy and allergic subjects. Serum T(H)1 and T(H)2 cytokine levels also did not differ among/within the groups. In contrast, refinery children had significantly increased Pb levels (5.2-8.8 µg/dl) relative to any of the other sets' levels. Of these, children with allergies had serum T(H)2 cytokine levels significantly higher and T(H)1 cytokine levels significantly lower than their healthy counterparts. Oddly, though having elevated Pb levels, healthy refinery students did not display altered T(H)1 or T(H)2 cytokine levels relative to control student values. From this, we conclude that substantively increased whole blood Pb levels may promote T(H) cell dysregulation and alter the availability of key T(H)1 and T(H)2 cytokines, effects that could ultimately contribute to development of pulmonary allergic diseases.

show abstract

“…Bloodlead levels of children were not followed in this study and actual impact is difficult to determine. However, as mentioned before, studies have found that even control groups that only receive pamphlets or flyers on lead prevention show some meaningful reduction in blood-lead levels [21].…”

Section: Discussionmentioning

confidence: 85%

“…Well-designed programs have been shown to be effective at reducing blood-lead levels for young children anywhere from 1 lg/dl to 5 lg/dl. In general, these successful lead intervention programs have been grassroots programs with nurses and community members conducting repeated door-to-door education meetings and demonstration with residents [19][20][21][22]. Studies have found that the majority of the blood-lead level reduction typically occurs in the first three to 6 months of a program and even control groups that only receive pamphlets or flyers show some meaningful reduction in blood-lead levels [21].…”

Section: Introductionmentioning

confidence: 99%

An Education Initiative Concerning Lead in an Arkansas Community: Results from Pre- and Post-Surveys

Ferguson

Gilkey²,

Kern

et al. 2011

J Community Health

View full text Add to dashboard Cite

The Arkansas People Participating in Lead Education (APPLE) Program is a collaborative effort between six Arkansas state, national and community organizations to provide lead awareness, training, and municipal legislation to needy communities in Arkansas. Under this program, APPLE organized and hosted well-designed, hands-on, and effective "call to action" lead awareness workshops for parents and community members in 10 needy communities over a 2 year period. Pre- and post-surveys were given to community members to access knowledge, attitudes and effectiveness of lead workshop activities, with demographic and another 13 and 11 questions on pre- and post-surveys, respectively. There were 709 adult attendees across the 10 workshop (Many children also attended.), with 460 completing pre-surveys, and 199 completed post-survey. Post-surveys were limited to four cities. The majority of those who completed surveys were African-American, reported as 78% on pre-surveys, with the majority also being parents (61%) and females. Although, 71% reported knowing that lead paint was bad for their health, more than 60% reported knowing little about lead exposure, and another 25% did not know the age of their residence. On the post-surveys, the majority of respondents found the workshop to be pleasant and informative (98%), while 45% had changed something in their lives to prevent lead exposure for a child and another 53% planned to make a change to prevent lead exposure for a child.

show abstract

A Randomized, Community-Based Trial of Home Visiting to Reduce Blood Lead Levels in Children

Cited by 46 publications

References 32 publications

Effectiveness of Home Visiting in Improving Child Health and Reducing Child Maltreatment

Effectiveness of Home Visiting in Improving Child Health and Reducing Child Maltreatment

Effects of environmental lead exposure on T-helper cell-specific cytokines in children

An Education Initiative Concerning Lead in an Arkansas Community: Results from Pre- and Post-Surveys

Contact Info

Product

Resources

About