Rhode Island Nurses Study

Project Partner: Rhode Island Department of Health; Care New England Health System

Project Funder: U.S. Centers for Disease Control and Prevention (CDC)

Project Contact: Jonathan Wilson, jwilson@nchh.org, 443.539.4162

Project Description: NCHH and its partners undertook this study to measure the effectiveness of intensive case management on children’s blood lead levels (BLLs) in children. We conducted a community-based, randomized trial of comprehensive education and home visiting for 175 families of children in Rhode Island with BLLs 15 to 19 µg/dL. The study compared the BLLs of children whose families received individualized education during five visits over one year, with BLLs of children whose families received customary care, usually one or two educational visits. Environmental samples were collected at baseline and after one year of follow-up for intervention group children and compared with those of comparison group children, collected only at the end of study.

Parents in the case-management group successfully decreased dust lead levels and significantly improved parent-child interaction and family housekeeping practices compared with comparison group children. Overall geometric mean BLLs declined by 47%, but the difference in BLL by group was not significant (9 versus 8.3 µg/dL for intervention versus comparison group children, respectively.) After one year, nearly half of enrolled children had BLLs less than 10 µg/dL. The evaluators concluded that educating families with personalized information regarding lead contamination may have a role in lead exposure prevention, but such case management has little benefit once BLLs are elevated.

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