Online Program

First-time versus Multigravida Outcomes from the Kentucky Health Access Nurturing Development Services (HANDS) Program

Wednesday, November 4, 2015 : 11:30 a.m. - 11:50 a.m.

Corrine Williams, ScD, Department of Health Behavior, College of Public Health; Department of Obstetrics and Gynecology, College of Medicine, University of Kentucky, Lexington, KY
Sarah Cprek, MPH, College of Public Health- Department of Health, Behavior & Society, University of Kentucky, Lexington, KY
Brenda English, Kentucky Department for Public Health, Frankfort, KY
Kylen Smith, MPH, CPH, Kentucky Department for Public Health, Frankfort, KY
Susan Burgan, Kentucky Department for Public Health, Frankfort, KY
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.  However, these programs traditionally only serve first-time parents. The Kentucky Health Access Nurturing Development Services (HANDS) program is a state-developed home visitation program for expectant and new at-risk parents. In 2011, the HANDS Program expanded to serve women who were not first-time mothers (multigravida). As part of this expansion, an unanswered question is whether multigravidas benefit from home visitation services as much as first-time families do. This presentation will compare the outcomes of first-time mothers receiving home visiting services to multigravidas, specifically examining maternal and child health outcomes of receiving adequate prenatal care, maternal complications during delivery, low birth weight, preterm deliveries, and NICU admissions. HANDS administrative data and live birth certificate records from will be used. We will analyze approximately 4,000 mothers who were referred to HANDS between October 1, 2011 and September 30, 2014 and received at least one prenatal home visit. Chi-square statistics and conditional logistic regression models will be used to evaluate the impact of HANDS on MCH outcomes. We expect to show that the HANDS program produces favorable outcomes for all families, not just first-time mothers, resulting in significant improvements in maternal and health outcomes among high-risk women.  If the outcomes for multigravida women are equal to that of first-time mothers, home visiting programs may need to revisit the restriction to serve only first-time parents.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Public health or related research

Learning Objectives:
Differentiate outcomes experienced by first time versus multigravida women served by home visiting programs

Keyword(s): Maternal and Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have my doctoral degree in public health and have been conducting research on various aspects of maternal and child health, intimate partner violence, and dating violence for almost 15 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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