Implementation Evaluation of the California Black Infant Health (BIH) Program

The Black Infant Health Program (BIH) was created in 1989 to reduce African-American infant mortality in California. In 2007, after a formal program assessment, the California Department of Public Health (CDPH) improved the BIH program to reflect current knowledge about the causes of poor birth outcomes and health disparities affecting African-American women and infants. The revised BIH program features group sessions complemented with individual case management, and aims to increase social support, build personal capacity, and increase healthy behaviors among participants. Eight sites piloted the revised program from July 2010 through November 2011.

CDPH conducted a process evaluation that relied on qualitative data collected from BIH pilot-site staff during regular conference calls, an online survey, written feedback, and site reports. Limited quantitative data were collected on client caseload and characteristics.

The revised program was implemented successfully at pilot sites despite challenges related to variation across sites in prior service models, staffing and resources. Key aspects contributing to implementation success included a strong collaborative relationship between CDPH and local partners, staff trainings, strengthening staff capacity and team building. Preliminary findings indicate that the revised program has had intended benefits for clients, staff and communities. Four areas were identified to focus efforts for effective implementation: program content, program delivery, data collection and reporting, and program promotion.

Findings from this evaluation are being applied to the continued implementation of the revised program at all sites statewide. Findings may also provide useful guidance for other programs implementing public health interventions.