The 130th Annual Meeting of APHA

5119.0: Wednesday, November 13, 2002 - 1:15 PM

Abstract #45325

Impact of community health workers on the self-determination, self-sufficiency, and decision-making skills of low income pregnant women and mothers of young children

Andrea Crivelli-Kovach, PhD, CHES, Department of Medical Science and Community Health, Arcadia University, 450 South Easton Road, Glenside, PA 19038, 215-572-4014, kovach@arcadia.edu, Julie A. Becker, PhD, MPH, Women's Health & Environmental Network, 704 N. 23rd Street, Philadelphia, PA 19130, and Heidi R Worley, MA, Women's Health, Children's Futures, Maternity Care Coalition, 2000 Hamilton Street, Suite 205, Philadelphia, PA 19130.

Philadelphia has one of the highest infant mortality rates in the United States. Pregnant women at high risk for adverse health outcomes can benefit from the services of community health workers. Maternity Care Coalition identifies at-risk women and provides links to health care and social services through the MOMobile Program. The purpose of this study was to explore a) the relationship formed between community health workers and pregnant women and b) the change over time in a mother's perceived level of empowerment as measured by self-sufficiency, self-determination, and decision-making skills. A multiphase study was developed to collect data. Focus group interviews with community health workers explored their professional role, their relationship with mothers, and the meaning of decision-making, self-sufficiency, and self-determination as empowerment constructs. A questionnaire was developed to measure each construct at time of registration and 3 months postpartum. A pilot study with 80 women was conducted. Scores for each construct and overall empowerment were calculated and the pre and post scores compared to measure change over time. Results of paired t-tests showed significant differences between the postpartum mean score for decision-making (P<.01), self-sufficiency (P<.01), self-determination (P<.001), and overall empowerment (P<.001) and the mean scores on each construct at registration. Results suggest that empowerment can be operationalized in community settings and increasing an at-risk pregnant woman’s sense of empowerment may positively impact the overall health of the mother and child. Further research is needed to assess the full impact of this variable as a health status indicator.

Learning Objectives: At the conclusion of the session, participants in the session will be able to

Keywords: Community Health Advisor, Evaluation

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Maternity Care Coalition, Philadelphia, PA evaluation of the MOMobile Program
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: I have worked (not significant financial interest) as a consultant with the Maternity Care Coalition. The evaluation was started under a grant funded through the William Penn Foundation from 1997-2000.

Impact of Home Visting Programs: Implications for Policy and Practice

The 130th Annual Meeting of APHA