The 130th Annual Meeting of APHA

Abstract #36294

Judith T. Gonzalez-Calvo, PhD¹, Connie Woodman, BS, RN, PHN², and Centhy Hansford, MSN, FNP, RN, PH². (1) Sociology Department, California State University Fresno, 5340 N. Campus Dr., M/S SS 107, Fresno, CA 93740, 559-278-2234, judithg@evalustats.com, (2) Department of Community Health, Human Services System, Fresno County, Brix Building, 4th Floor, 1121 Fulton Mall, Fresno, CA 93721

This paper will describe the evaluation of a public health nursing case management and home visiting program as part of the National Healthy Start Initiative. The 150 women in this study were enrolled in the Public Health Case Management intervention from 1997 to 2001. The evaluation found statistically significant negative associations between birth weight or preterm delivery and exposure to second-hand tobacco smoke, presence of reported high stress levels, inadequate housing, partner abuse, and substance use (chi-squares ranged from 15.052 to 3.563, p from < .001 to <.06). Home visiting and specific nursing interventions—encouragement of verbalization of feelings, defining social support systems, health promotion, perinatal education and assisting with housing were significantly correlated to higher birth weight, greater gestational age in weeks at delivery, and reduction of psycho-social problems (all correlations at p < .05 or less). Public health nursing case management was effective in improving psycho-social risk factors that effect birth outcomes among high-risk perinatal populations. The importance of policy aimed at development of case management and home visitation programs was underscored in this evaluation study. Both of these combine to greatly increase the chances of good birth outcomes in high-risk populations.

Learning Objectives:

• *Recognize how public health home visiting contributes to improved birth outcomes in a high-risk population
• *List and describe specific interventions that contribute to improved birth outcomes.
• *Identify the role of program evaluation and public health policy in developing effective interventions to improve birth outcomes.

Keywords: Home Visiting, Birth Outcomes

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Human Services System, Department of Community Health, Maternal Child and Adolescent Health, Fresno County, California--Healthy Start Phase II Program (Babies First)
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Under contract as program evaluator