Update on the National Healthy Start Evaluation

The results of an electronic survey of 95 Healthy Start grantees (funded in 2001-5) provide a “point-in-time snapshot” of the implementation of the Healthy Start program components. More grantees were non-profit organizations (44%) and local health departments (37%) than state health departments. Grantees implemented the required nine components in the following order: outreach (100%), case management (100%), health education (100%), coordination (100%), perinatal depression (99%), interconceptional care (98%), consortium (97%), local health systems action plan (84%) and sustainability plan (77%). Healthy Start grantees employed case management staff from a wide spectrum of disciplinary backgrounds, including lay/paraprofessional (71%), social work (66%), nursing (60%), and public health (14%). Grantees indicated that routine interconceptional care, such as a six-week postpartum visit and family planning, were relatively easy to obtain, while specialty care during the interconceptional period was viewed as difficult to obtain by the majority of grantees. Substance abuse treatment and dental care were the most difficult services to obtain for Healthy Start clients. Grantees were asked to report on their accomplishments, assess the relative contributions of the various program components in achieving their goals, and identify barriers to improved participant outcomes. Grantees were more likely to report improvements in services than systems-related activities, which is consistent with the finding that grantees devoted the majority of their grant funding to the services components. Grantees also were more likely to report that they achieved outcomes related to increasing awareness than increasing consumer involvement.