Do Multigravida Women Benefit from Home Visiting? An Evaluation of the Kentucky Health Access Nurturing Development Services (HANDS) Program

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. This presentation will present the results of delivering home visiting services to this population, 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 compared to a demographically similar group of women who did not receive a home visit, selected from birth certificate records. 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 expanding the HANDS program to include all families, not just first-time mothers, results in significant improvements in maternal and health outcomes among high-risk women.  As a state-wide, large scale home visiting program, this has significant implications for the continued improvement of MCH outcomes in Kentucky, as well as informing developing home visitation programs.