Background: Home visitation is a widely employed strategy to improve maternal and child health outcomes in the United States and other countries. While efficacy has been established, not all programs have been found to be effective. Inconsistencies in program effectiveness may be due to differences in service delivery. Few studies examine the variation in implementation of home visitation programs. Aims: To assess variation in implementation of the program in terms of service delivery processes and health outcomes. Design: Evaluation of a prospective cohort study of 1,202 participants in the Healthy Start Resource Mothers program in six Virginia communities. Outcomes: Service delivery outcomes: late enrollment (2nd -3rd trimester), early closure (< 1 year) and the type and number of service contacts. Health outcomes evaluated were low birth weight (<2500 grams) and very low birth weight (<1500 grams). Analysis: Multiple logistic regression was used to distinguish clients in terms of program and health outcomes. Findings: Significant differences across sites were found for all outcomes. Low birth weight and very low birth weight varied significantly across sites (LBW: 2.7% to 16%; V: LBW: 0 to 2.9%). Women more likely to be enrolled late were: Medicaid recipients, enrolled in prenatal care, and had less than 12 years of education. Women more likely to drop out of the program were: non-Medicaid recipients, not enrolled in prenatal care, and had less than 2 years of education.
Learning Objectives: (1)Describe variation in home visitation service delivery (2) Discuss factors associated with differences in home visitation outcome
Keywords: Home Visiting, Pregnancy Outcomes
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.