Lessons learned: Recommendations for data collection and management from Stanislaus County's Healthy Birth Outcomes Program

The Healthy Birth Outcomes (HBO) program, a California Proposition 10 funded partnership beginning in 2004 between Stanislaus County Health Services Agency (HSA) and ten local family resource centers, was created to improve infant mortality and morbidity rates in Stanislaus County. HBO targets women at risk for adverse pregnancy events due to age and medical or psychosocial factors, helping them to build sustainable parenting skills and knowledge. The program, which is administered by HSA public health nurses and community health workers, operates in three domains: intensive case management via home visits; community support groups; and provider outreach/education. In addition, parenting education and resource referrals are provided though community support groups. HBO tracks over 35 indicators of program success via questionnaire and coordination with family resource center staff, including birth weight, gestational age, breastfeeding and level of case manager/client engagement. Early program data remains analytically inaccessible due to data collection errors, necessitating several renovations in data collection and management. Improvements include compilation of a global database; streamlined data collection by case managers; and revision of indicators for maximum evaluative value. This experience highlighted the importance of incorporating rigorous outcome measures at the beginning of the program design process. These can be easily and effectively integrated into the data collection for increased evaluative success.