254390 Does home visiting improve birth outcomes? Findings from the 2007-2008 Virginia PRAMS

Tuesday, October 30, 2012

Monisha Shah, MPH , Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
  
Background: Home visiting programs have gained momentum with the recent appropriation of federal funds for states to implement evidence-based maternal and child health home visiting programs. However, currently, the effects of having a home visit are unknown at the state level.

Methods: Using cross-sectional data from 2007-2008 VA PRAMS, several maternal and infant health outcomes were examined. Women who reported receiving a home visit by a healthcare worker or nurse during pregnancy were assigned into the Home Visiting (HV) participation group. Those who did not but had risk factors similar were assigned to the comparison group. Multivariate logistic regression was used to measure the association between HV and the selected outcomes of interest. Characteristics of the HV participation and comparison groups were compared using chi-square tests.

Results: Controlling for a variety of characteristics, women who had a home visit by a healthcare worker or nurse during pregnancy showed a 87.5% reduction in the risk of having a low birth weight infant [0.13, 95% CI: (0.02, 0.78)], a 4.5 times greater odds of initiating breastfeeding [AOR: 4.50 95% CI: (1.05, 19.54)], and a 38.6 times greater odds of using contraceptives postpartum [AOR: 38.55, 95% CI: (3.14, 473.21)] than women in the comparison group.

Conclusions: Receiving home visiting services during pregnancy increased breastfeeding initiation and postpartum contraceptive use and reduced the risk of low birth weight.

Public Health Implications: These findings demonstrate that home visiting services have positive effects on the health and development of women and infants.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
1. Articulate the procedure for assessing the home visiting participation and it's relation to improving pregnancy and birthoutcomes 2. Explain how we assessed home visiting participation. 3. Explain how we compared those who participated and those who did not by their characteristics and their birth and pregnancy outcomes.

Keywords: Home Visiting, Birth Outcomes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been working in the field of analyzing MCH data for the past 1 year. I worked under the guidance of the state MCH epidemiologist and MCH analyst when I did this research analysis. I have been working in MCH Epi field for over 4 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4268.0: Home Visiting Initiatives: Poster Session