Online Program

How Community Health Workers can drive maternal and child outcomes in perinatal home visiting programs, independent of the home visiting model selected

Tuesday, November 3, 2015 : 4:45 p.m. - 5:00 p.m.

Barbara Hadley, Maternity Care Coalition, Philadelphia, PA


An MCH community-based agency developed a home visiting model to support low income pregnant and newly parenting families 25 years ago. The model uses highly trained Community Health Workers to serve high risk neighborhoods in a large, urban city.Today, the agency uses six unique home visiting models, including two that are recognized by the federal government as evidence-based, and its original home grown model. Recently, the agency partnered with experts from a national university to conduct an external evaluation of program effectiveness.


Data from administrative records were extracted for clients served 2012 - 2014. Statistical analyses were conducted for each outcome.



The results were consistent across all six models and were very favorable: Maternal depression was reduced by 63% over the course of participation; Breastfeeding initiation was 83% versus 49% in a comparison group; and 98% of participants practiced safe sleep with their infants versus 65% in a comparison group.


Existing home visiting models, including national evidence-based ones, do not fully define how to develop highly productive relationships with clients. The agency has developed an approach to home visiting that is centered on the relationship between client and health worker.This approach is uniformly applied to all models. First, the approach preserves the community health worker’s ability to remain responsive to client needs.Second, the approach includes a comprehensive system of supports for community health workers, including expert training and regularly scheduled reflective supervision, that promote positive relationships among coworkers and with clients.Community health workers can implement different home visiting models with fidelity and achieve consistent and positive MCH outcomes.

Learning Areas:

Administer health education strategies, interventions and programs
Administration, management, leadership
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
Public health or related research

Learning Objectives:
Identify key service components in perinatal home visiting that promote positive maternal behavioral health outcomes. Describe how to perform a rigorous program evaluation in a community agency. Formulate research questions to investigate how to support community health workers in multiple perinatal home visiting models to achieve positive maternal and child outcomes.

Keyword(s): Community Health Workers and Promoters, Outcomes Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have led MCC's program evaluation efforts since 2012. I conduct quantitative analysis and qualitative research to understand client outcomes in each of its six unique perinatal home visiting programs,and worked closely with independent evaluators at Georgetown University. I have extensive experience using continuous quality and process improvement practices, in non-profit and for-profit settings.I have a BS Degree from MIT, an MBA from Stanford University and an MS in Social Policy from University of Pennsylvania.
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.