Outcomes of a Healthy Start Program

Objectives. To determine whether participation in Healthy Babies Healthy Start (HBHS), a maternal health program emphasizing racial equity and delivering services through case management home visitation, was associated with improved birth outcomes for Black women relative to White women.

Methods. We used a matched-comparison posttest-only design in which we selected the comparison group using propensity score matching. Study data were generated through secondary analysis of Michigan State- and Kalamazoo County–level birth certificate records for 2008–2010. We completed statistical analyses, stratified by race, using a repeated-measures generalized linear model.

Results. Despite their smoking rate being double that of their matched counterparts, Black HBHS participants delivered higher birth-weight infants than Black nonparticipants (p=.05). White HBHS participants had significantly more prenatal care than White nonparticipants, but they had similar birth outcomes (p=.70 for birth weight, p=.55 for gestation).

Conclusions. HBHS participation is associated with increased birth weights among Black women but not among White women, suggesting differential program gains for Black women.