142nd APHA Annual Meeting and Exposition

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Maternal and Child Health Improvement by Kentucky's HANDS Home Visiting Program

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014 : 1:10 PM - 1:30 PM

Corrine Williams, ScD , Department of Health Behavior, College of Public Health; Department of Obstetrics and Gynecology, College of Medicine, University of Kentucky, Lexington, KY
Ibitola Asaolu, MPH , College of Public Health, University of Kentucky, Lexington, KY
Joyce Robl, EdD(c), MS, CGC , Division of Maternal Child Health, Kentucky Department for Public Health, Frankfort, KY
Brenda English , Kentucky Department for Public Health, Frankfort, KY
Kylen Smith, MPH, CPH , Kentucky Department for Public Health, Frankfort, KY
Tracey Jewell , Kentucky Department for Public Health, Frankfort, KY
Audio (mp3) recording Recorded Presentation (mp4)
INTRODUCTION: Home visitation programs are associated with reduced rates of low birth weight infants and decreased prevalence of preterm births among women at high risk for poor outcomes.  The Kentucky Health Access Nurturing Development Services (HANDS) program is a state-developed home visitation program for expectant and new at-risk parents. The study evaluated the maternal and child health (MCH) outcomes of HANDS participants compared to a matched comparison group.

METHODS: HANDS administrative data and live birth certificate records from were used in these analyses. We analyzed 2253 mothers who were referred to HANDS between July 1, 2011 and June 30, 2012 and received at least one prenatal home visit compared to a demographically similar group of women (n=2253) who did not receive a home visit. Chi-square statistics and conditional logistic regression models were used to evaluate the impact of HANDS on MCH outcomes. 

RESULTS: Women receiving at least one prenatal home visit had higher rates of receiving adequate prenatal care (73.6% vs. 71.0%) and fewer maternal complications during delivery (OR= 0.61, 95%CI=0.40-0.91). Further, HANDS participants had lower rates of preterm delivery (OR=0.74, 95%CI=0.61-0.88) and low birth weight infants (OR=0.54, 95%CI=0.44-0.67). HANDS participants also are significantly less likely to have a substantiated report of child maltreatment compared to controls (OR=0.53, 95%CI=0.43-0.65).

CONCLUSION: HANDS program participation results in significant improvements in maternal and health outcomes among high-risk women.  As a state-wide, large scale home visiting program, this has significant implications for the continued improvement of MCH outcomes in Kentucky.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Epidemiology

Learning Objectives:
Describe the state-wide, state-developed Kentucky HANDS home visiting program Assess the impact of the HANDS home visiting program on maternal and child health outcomes

Keyword(s): Child Health, Peer Education

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I received my doctorate in Maternal and Child Heath from the Harvard School of Public Health in 2006. I am an assistant professor at the University of Kentucky, and have been working in the field of maternal and child health for several 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.

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