Online Program

Reducing poor birth outcomes among Medicaid-eligible Black mothers: Using GIS mapping to evaluate and target Nurse-Family Partnership intervention

Tuesday, November 3, 2015 : 10:45 a.m. - 11:00 a.m.

Elizabeth MacQuillan, MA, RD, Health Data Research, Analysis and Mapping (HDReAM) Center/College of Health and Human Services, Western Michigan University, Kalamazoo, MI
Amy B. Curtis, PhD, MPH, Interdisciplinary Health Sciences PhD Program/Health Data Research Analysis and Mapping (HDReAM) Center, Western Michigan University, Kalamazoo, MI
Virginia Vanderveen, BS, Department of Geography/Health Data Research Analysis and Mapping (HDReAM) Center, Western Michigan University, Kalamazoo, MI
Xiaojian Yang, BS, Department of Statistics/Health Data Research Analysis and Mapping (HDReAM) Center, Western Michigan University, Kalamazoo, MI
Background: In Michigan, the infant death rate among blacks was 13.5, versus 5.5 for whites (2012). For Calhoun County, the inequity was ever greater; at 20.2 versus 6.4, respectively (2010-2012). The Nurse-Family Partnership (NFP) was implemented in this county with a goal of reducing this racial inequity. We conducted an evaluation to determine if the program was recruiting those most in need across the entire community and whether outcomes were favorable.

Methods: We used geographic information systems (GIS) mapping (ArcGIS), and SAS and SPSS analysis of 2013-14 NFP and county birth records (2012, most recent year available) to evaluate recruitment and outcomes-related efforts in this high-risk population.

Results: Black women made up 16% of the total of all Medicaid-eligible first time mothers in 2012 in this county and 18.2% of low birth weight (LBW) infants born to Medicaid-eligible first time mothers were born to black women. The NFP program experienced no poor birth outcomes (pre-term birth, LBW, or infant death) to black participants (22.2% of NFP population) in 2013-14. Geographically, the NFP program reached black women in all of the top 5 census tracts with highest births to Medicaid-eligible mothers. 

Conclusion: The program is reaching a proportionally large percent of high-risk black women in all the geographic locations with the highest births and participants are having better outcomes than their peers in the community overall. GIS mapping provided an effective way to evaluate 1) whether the NFP program provided uniform coverage and 2) outcomes of a targeted population.

Learning Areas:

Planning of health education strategies, interventions, and programs

Learning Objectives:
Discuss the advantages of using GIS to evaluate Nurse-Family Partnership program recruitment and coverage. Compare Calhoun County, MI Nurse-Family Partnership program pregnancy outcomes and geographic location of black first-time mothers with the outcomes and location of all first-time, Medicaid-eligible mothers in the county.

Keyword(s): African American, Infant Mortality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral student and research associate of the Health Data Research, Analysis, and Mapping Center and conducted this study under guidance of my adviser and center director, Amy B. Curtis. I hold a masters degree in Nutrition Education and am a Registered Dietitian with 8 years experience teaching nutrition at the college level for Western Michigan University. I plan to write my dissertation in 2016 in the area of pregnancy outcomes health research.
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.