Legacy for Children, an Early Intervention Study to Promote Optimal Child Development in Low-income Families (Legacy)

Legacy for Children, The CDC Parenting Research Projects

The purpose of this study is to determine if an intervention focused on promoting parent-child interaction, parental responsibility, parental commitment of time and energy, and sense of community results in better developmental outcomes for low-income children.

Study Overview

• Status: Completed
• Conditions: Child Development
• Intervention / Treatment: Behavioral: Parenting group

Detailed Description

The early years of life (birth to age 5 years) are crucial in a child's development. Parents play a critical role in their children's development and are responsible for the environment in which they grow up. Past research shows that the personal characteristics of successful children consistently correlate to parental influences and behavior. Thus, the theoretical foundation in the Legacy study is that parents can positively influence their child's development. Also, parents are more likely to maintain positive parenting behaviors if they are part of a community greater than themselves. Legacy intervention activities are designed to enhance sensitive and responsive parenting, parent/child interaction, and promote a sense of community. Other activities include verbal and cognitive stimulation through parent and parent/child group meetings, visits to the home, and participation in community events. Legacy has both a pilot phase and a main study phase. There are 180 intervention and 120 comparison families in the main study phase and 60 of each in the pilot phase at each study site, Miami and Los Angeles. The 720 participating families are those whose children, on average, would be expected to fall below national norms on a range of developmental outcomes. Process, cost, and short- and long-term outcome data are being collected.

Comparison group: In addition to the current standard of care, the comparison families receive regular comprehensive child development and maternal assessments at 6 months, 1 yr, 2 yr, 3 yr, 4 yr, and 5 yr.

• Study Type: Interventional
• Enrollment (Actual): 547
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • California
    • Los Angeles, California, United States, 90095
      • UCLA Department of Pediatrics
  • Florida
    • MIami, Florida, United States, 33101
      • University of Miami School of Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• English speaking
• Live within 10 miles of UCLA
• 18 years of age or older
• Receive their prenatal and well-baby care from MediCal
• Live within 50 minutes of the three community intervention sites
• Reside within zip codes corresponding to the lowest performing schools in the broad Miami area
• Give birth to the target child at participating hospitals

Exclusion Criteria:

• Multiple birth greater than twins
• Existing Substance abuse
• Existing Mental Health issues

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: 1; Parenting group	Behavioral: Parenting group; Weekly and periodic (10 weeks blocks with 6 week break) parenting group meetings (2.5-3 hr), periodic one-on-one meetings (2 hr), visits to community resources (2-3 hr per event). Legacy intervention activities are designed to enhance sensitive and responsive parenting, parent/child interaction, and promote a sense of community. Other activities include verbal and cognitive stimulation through parent and parent/child group meetings, visits to the home, and participation in community events.; Other Names: Behavioral
No Intervention: 2; Families in this "usual care" comparison group were not prevented from utilizing any service that would otherwise be available to them, even if the service was similar to the services received in the intervention arm of the study.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
child behavior	1yr, 2 yr, 3 yr, 4 yr, 5 yr
child social skills	1yr, 2 yr, 3 yr, 4 yr, 5 yr
child cognition	1 yr, 3 yr, 5 yr
child language/communication	2 yr, 4 yr, 5 yr
child attachment	2 yr
child peer relationships	5 yr
child academics	4 yr, 5 yr
parent-child interaction	6 months, 5 yr

Secondary Outcome Measures

Outcome Measure	Time Frame
child physical growth	baseline, 6 month, 1 yr, 2 yr
child violence exposure	2 yr, 4 yr, 5 yr
parenting	baseline, 6 mos, 2 yr, 3 yr 5 yr
maternal health	baseline, 1 yr 3 yr, 5 yr
maternal mental health	baseline, 1yr, 2yr, 3yr, 4 yr, 5 yr
sense of community	baseline, 1yr, 2yr, 3yr, 4 yr, 5 yr
community involvement	baseline, 6 mos, 2yr, 3yr, 5 yr
coping	6mos, 2yr, 3 yr, 5 yr
HOME environment	1 yr

Collaborators and Investigators

• Sponsor: Centers for Disease Control and Prevention
• Collaborators: University of California, Los Angeles; University of Miami; RTI International
• Investigators: Principal Investigator: Ruth Perou, PhD, Centers for Disease Control and Prevention

Publications and helpful links

General Publications

• Barry CM, Robinson LR, Kaminski JW, Danielson ML, Jones CL, Lang DL. Behavioral and Socioemotional Outcomes of the Legacy for Children Randomized Control Trial to Promote Healthy Development of Children Living in Poverty, 4 to 6 Years Postintervention. J Dev Behav Pediatr. 2022 Jan 1;43(1):e39-e47. doi: 10.1097/DBP.0000000000000962.
• Perou R, Elliott MN, Visser SN, Claussen AH, Scott KG, Beckwith LH, Howard J, Katz LF, Smith DC. Legacy for ChildrenTM: a pair of randomized controlled trials of a public health model to improve developmental outcomes among children in poverty. BMC Public Health. 2012 Aug 23;12:691. doi: 10.1186/1471-2458-12-691.

Helpful Links

• Click here for information about this study: Legacy for Children

Study record dates

Study Major Dates

• Study Start: October 1, 1999
• Primary Completion (Actual): February 1, 2013
• Study Completion (Actual): February 1, 2013

Study Registration Dates

• First Submitted: September 13, 2005
• First Submitted That Met QC Criteria: September 13, 2005
• First Posted (Estimate): September 14, 2005

Study Record Updates

• Last Update Posted (Estimate): February 3, 2016
• Last Update Submitted That Met QC Criteria: February 2, 2016
• Last Verified: September 1, 2012

More Information

Terms related to this study

• Keywords: Child Development; Parenting; Parent-Child Relations; Child Rearing
• Other Study ID Numbers: CDC-NCBDDD-2524; 200-94-0828; 200-98-0110; 200-98-0111

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO