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Member Research and Reports

Member Research and Reports

Home Visiting Programs Improve Maternal and Child Health, Says Kentucky Study

Researchers from the University of Kentucky College of Public Health have published the paper Kentucky Health Access Nurturing Development Services Home Visiting Program Improves Maternal and Child Health

The article by Dr. Corrine Williams, associate professor of Health, Behavior & Society and director of MPH Graduate Studies, Ms. Sarah Cprek, lecturer and director of Undergraduate Studies, and Ibitola Asaolu, a 2013 MPH alumnus, was published online ahead of print by the Maternal and Child Health Journal. Other authors were from the Kentucky Department of Public Health.

 
[Photo: Dr. Corrine Williams (left) and Ms. Sarah Cprek]

Home visitation programs are one of the numerous efforts to help reduce the rates of preterm birth and low birth weight as well as offering other improvements in maternal and child health and development. The Kentucky Health Access Nurturing Development Services (HANDS) is a voluntary, home visiting program serving first-time, high-risk mothers. This study’s objective was to evaluate the impact of HANDS on maternal and child health outcomes. Methods: HANDS administrative data, live birth certificate records and data from the Division of Child Protection and Safety were used in these analyses.

The researchers analyzed 2253 mothers who were referred to HANDS between July 2011 and June 2012 and received a minimum of one prenatal home visit (mean number of prenatal visits = 12.9) compared to a demographically similar group of women (n = 2253) who did not receive a visit. Chi square statistics and conditional logistic regression models were used to evaluate the impact of HANDS.

Results: HANDS participants had lower rates of preterm delivery (OR 0.74, 95 percent CI 0.61–0.88) and low birth weight infants (OR 0.54, 95 percent CI 0.44–0.67). HANDS participants also were significantly less likely to have a substantiated report of child maltreatment compared to controls (OR 0.53, 95 percent CI 0.43–0.65). HANDS participants also had an increase in adequate prenatal care and a reduction in maternal complications during pregnancy. Of particular important, outcomes improved as the number of prenatal home visits increased: among women receiving one to three prenatal home visits was 12.1 percent, the rate among women receiving four to six prenatal home visits was 13.2 percent, while the rate of PTB among those receiving seven or more prenatal home visits was 9.4 percent. Conclusions: HANDS program participation appears to result in significant improvements in maternal and child health outcomes, most specifically for those receiving seven or more prenatal home visits. As a state-wide, large scale home visiting program, this has significant implications for the continued improvement of maternal and child health outcomes in Kentucky.