Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #98636

Janelle C. Peralez, MPH, RD¹, Pandora White, RN, CNP², Abbey C. Sidebottom, MPH¹, and Megan K. Ellingson, MHA¹. (1) Minneapolis Department of Health and Family Support, 250 South 4th Street, Room 510, Minneapolis, MN 55415, 612-673-3815, janelle.peralez@ci.minneapolis.mn.us, (2) NorthPoint Health and Wellness Center, 1313 Penn Ave N, Minneapolis, MN 55411

The objective of the Maternal Case Management Excellence (MCME) group, in collaboration with NorthPoint Health and Wellness Center (a racially/ethnically diverse urban community clinic) is to reduce disparities in infant mortality and preterm birth. The MCME concept is to establish quality perinatal case management to address both the medical and social needs of low-income families who are at risk, especially families of color. Previous local studies demonstrated a need to integrate medical and social case management to improve birth outcomes; the goal of this project is to provide comprehensive care coordination. The presentation outlines a prenatal care coordination model to assign a program tier to clients who have been identified as medically and socially at high risk, based on a comprehensive screening and assessment process. An interdisciplinary care team of community providers and local public health oversees the design and implementation. The model provides core services (i.e., advocacy, health education, monitoring of prenatal appointments, social support, and reassessment each trimester) regardless of tier assignment. Tiers vary on the basis of contact intensity, including frequency, type of visit (i.e., home, office, or telephone), amount of service integration, and whether a case is reviewed during interdisciplinary care team meetings. The project will provide a model for other clinics.

The presentation will include evaluation results of process measures that indicate how effective the system was implemented and how accurately the system reflects the needs of the client. Initial risk factor and birth outcomes and client and provider satisfaction results will also be discussed.

Learning Objectives:

• To define a process for developing a system to meet the medical and social needs of prenatal clients who are high risk.
• To describe lessons learned from a pilot study that integrates medical and social risks of prenatal care coordination.
• To list the most common social and medical risk factors for a diverse urban OB population and care coordination services received.

Keywords: Case Management, Pregnancy Outcomes

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation