Health

Intervention efforts have been directed at providing primary and preventive care as a means of improving general health for children in adverse situations. Several studies have measured the effects of sustained contact with a primary physician or nurse on infant health. A study of infants up to eight months of age in low-income African-American families found that there were no differences between intervention and control subjects on measures of general health, morbidity, incidence of accidents, or immunization rates [21]. However, the intervention group performed significantly better on measures of gross motor skills and had significantly fewer upper respiratory symptoms than did the control group.

When public health nurses provide sustained services, the outcomes are not noticeably different. Ninety-eight infants up to nine months of age from low-income families participated in an intervention aimed at providing case management to facilitate child health clinic and immunization services [22]. Differences were found between the groups. Infants in the intervention group had significantly more adequate child-health clinic visits than the control group, who received segregated case-management services. Although there were no differences between the groups in rates of adequate immunization, differences in cost-effectiveness were identified between services provided by public health nurses and fragmented services.

Medical interventions have also been directed at infants with particular conditions. For example, interventions with low-birthweight (LBW) infants have attempted to reduce harmful stimulus in neonatal intensive care units and newborn nurseries [23]. Particularly, LBW infants are placed in soothing environments that promote behavioural and central nervous system organization. Short-term effects such as weight gain, decreased apnea, and positive changes in state organization have been found. However, long-term changes have not been detected [24].