Overview of The Rhode Island Nurses Study

Intensive education is provided, tailored to the child's risk and home environment.

This ongoing randomized, community-based clinical trial measures the impact of a careful protocol of assessment and intensive lead education in the home provided by visiting nurses to families of children with moderately elevated blood lead levels (Pb 15-19ug/dl). This study will evaluate the effectiveness of this approach with families by measuring changes in lead dust and blood lead levels over one year. This study will also evaluate the costs and benefits of intensive case management.  

 Study children receive a

Through education, the nurses provide simple, clear messages such as: Keep it clean!

total of five visits to the house. The initial assessment includes a thorough visual assessment of the family's house, a standardized assessment of the child's food intake, and a standardized observation of parent-child interactions. An individualized plan is developed for each family based on the assessment and discussed thoroughly with the family on all follow-up visits. Dust samples are collected at five times throughout the study. Blood lead samples are collected three times during the study by the child's primary care provider, in accordance with Centers for Disease Control recommendations. A standardized low literacy lead education package is provided to all families and reviewed as part of the intensive in home education. A comparison group of children receives one or two nurse visits, the current standard of care provided by the State of Rhode Island to all children with blood lead levels 15-19.

In 2006, Pediatrics (official journal of The American Academy of Pediatrics) published A Randomized Community Based Trial of Home Visiting to Reduce Blood Lead Levels in Children. Authors are Brown MJ, McLaine P, Dixon, S, and Simon, P 117(1):147-53, 2006.

Lead Poisoning in Rhode Island

The rate of childhood leading (blood leads > 10 ug/dl) is more than double the rate seen nationally. In Providence, the rate is four times higher than the rest of the country. This is a burden not equally shared, and lead problems fall more heavily on members of minority groups living in urban areas. 

In Rhode Island in1999, eight percent of white children tested had blood lead levels > 10 ug/dl, compared to16 percent for Hispanic children and 24 percent for African-American and Southeast Asian children. In the core cities of Central Falls, Newport, Pawtucket, Providence, and Woonsocket, the average prevalence rate of lead poisoning in 2001 was 13.2% compared to 4.1% for the rest of the state excluding these cities.

Poisoned children face potentially lifelong effects resulting from their lead exposure including decreased IQ and an increased risk for behavioral and learning difficulties.

For more information, please contact Jonathan Wilson at 443.539.4162 or email at jwilson@centerforhealthyhousing.org

Research and Evaluation
(Active Projects)

Research and Evaluation
(Completed Projects)

Training and Technical Assistance
(Active Projects)

Training and Technical Assistance
(Completed Projects)

Demonstration

Policy