Online Program

Selected findings from the evaluation of the federal healthy start program

Monday, November 4, 2013 : 9:00 a.m. - 9:15 a.m.

Vonna L. Caleb-Drayton, DrPH, US Health Division, Abt Associates, Inc., Bethesda, MD
Deborah Klein Walker, EdD, US Health Division, Abt Associates, Inc., Cambridge, MA
Sara M.A. Donahue, DrPH, MPH, U.S. Health Division, Public Health and Epidemiology, Abt Associates, Cambridge, MA
Sarah W. Ball, MPH, ScD, US Health Division, Abt Associates, Inc., Cambridge, MA
Rebecca Fink, MPH, US Health Division, Abt Associates, Cambridge, MA
Keisher Highsmith, DrPH, HRSA/MCHB/DHSPS, Rockville, MD
David de la Cruz, PhD, MPH, Maternal and Child Health Bureau, HRSA/DHHS, Rockville, MD
Background: Initiated in 1991, the Federal Healthy Start Program includes 105 community-based projects in 39 states, the District of Columbia and Puerto Rico. Healthy Start projects work collaboratively with community stakeholders, leveraging existing resources to ensure participants' continuity of care during pregnancy through two years postpartum. We examined relationships between the required program components and long term program and birth outcomes in addition to factors that influence these relationships.

Methods: Program components and outcomes were examined using self-reported data from a 2010 Project Director Survey (N=104 projects) and 2009 performance measures data from the Maternal and Child Health Bureau Discretionary Grant Information System (N=99). We used descriptive statistics to explore bivariate relationships and multivariate linear and logistic regressions to assess independent associations between program components and achievement of long-term birth outcomes, adjusting for grantee characteristics and intermediate outcomes.

Results: In 2010, 57 projects implemented all 9 program components; 100% implemented core service components and 66% implemented core systems components. Projects implementing all program components were significantly more likely to report increased access to services; integration of prenatal, primary care, and mental health services; and screening for perinatal depression. Implementation of all program components was significantly associated with improvements in self-reported maternal and child health outcomes, but was not associated with singleton low birth weight and/or infant mortality rates.

Conclusion: The evaluation of Healthy Start programs using self-reported data and performance measures revealed a mixed set of relationships between program components and long-term maternal and child health outcomes.

Learning Areas:

Public health or related research

Learning Objectives:
Evaluate the overall effect of the Federal Healthy Start Program components on intermediate and long- term program outcomes and their impact on birth outcomes among program participants.

Keyword(s): Public Health Research, Healthy Start

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Drayton is a maternal and child health epidemiologist and Senior Associate at Abt Associates where she serves as Project Director and analytic lead for many federally funded evaluation projects including HRSA/MCHB cross-site evaluation of the Federal Healthy Start Program
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.