TY - JOUR
T1 - Impact of a Community Health Worker (CHW) Home Visiting Intervention on Any and Adequate Prenatal Care Among Ethno-Racially Diverse Pregnant Women of the US Southwest
AU - McCue, Kelly
AU - Sabo, Samantha
AU - Wightman, Patrick
AU - Butler, Matthew
AU - Pilling, Vern
AU - Jiménez, Dulce
AU - Annorbah, Rebecca
AU - Rumann, Sara
N1 - Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - Objectives: Social and structural barriers drive disparities in prenatal care utilization among minoritized women in the United States. This study examined the impact of Arizona’s Health Start Program, a community health worker (CHW) home visiting intervention, on prenatal care utilization among an ethno-racially and geographically diverse cohort of women. Methods: We used Health Start administrative and state birth certificate data to identify women enrolled in the program during 2006–2016 (n = 7,117). Propensity score matching was used to generate a statistically-similar comparison group (n = 53,213) of women who did not participate in the program. Odds ratios were used to compare rates of prenatal care utilization. The process was repeated for select subgroups, with post-match regression adjustments applied where necessary. Results: Health Start participants were more likely to report any (OR 1.24, 95%CI 1.02–1.50) and adequate (OR 1.08, 95%CI 1.01–1.16) prenatal care, compared to controls. Additional specific subgroups were significantly more likely to receive any prenatal care: American Indian women (OR 2.22, 95%CI 1.07–4.60), primipara women (OR 1.64, 95%CI 1.13–2.38), teens (OR 1.58, 95%CI 1.02–2.45), women in rural border counties (OR 1.45, 95%CI 1.05–1.98); and adequate prenatal care: teens (OR 1.31, 95%CI 1.11–1.55), women in rural border counties (OR 1.18, 95%CI 1.05–1.33), primipara women (OR 1.18, 95%CI 1.05–1.32), women with less than high school education (OR 1.13, 95%CI 1.00-1.27). Conclusions for Practice:: A CHW-led perinatal home visiting intervention operated through a state health department can improve prenatal care utilization among demographically and socioeconomically disadvantaged women and reduce maternal and child health inequity.
AB - Objectives: Social and structural barriers drive disparities in prenatal care utilization among minoritized women in the United States. This study examined the impact of Arizona’s Health Start Program, a community health worker (CHW) home visiting intervention, on prenatal care utilization among an ethno-racially and geographically diverse cohort of women. Methods: We used Health Start administrative and state birth certificate data to identify women enrolled in the program during 2006–2016 (n = 7,117). Propensity score matching was used to generate a statistically-similar comparison group (n = 53,213) of women who did not participate in the program. Odds ratios were used to compare rates of prenatal care utilization. The process was repeated for select subgroups, with post-match regression adjustments applied where necessary. Results: Health Start participants were more likely to report any (OR 1.24, 95%CI 1.02–1.50) and adequate (OR 1.08, 95%CI 1.01–1.16) prenatal care, compared to controls. Additional specific subgroups were significantly more likely to receive any prenatal care: American Indian women (OR 2.22, 95%CI 1.07–4.60), primipara women (OR 1.64, 95%CI 1.13–2.38), teens (OR 1.58, 95%CI 1.02–2.45), women in rural border counties (OR 1.45, 95%CI 1.05–1.98); and adequate prenatal care: teens (OR 1.31, 95%CI 1.11–1.55), women in rural border counties (OR 1.18, 95%CI 1.05–1.33), primipara women (OR 1.18, 95%CI 1.05–1.32), women with less than high school education (OR 1.13, 95%CI 1.00-1.27). Conclusions for Practice:: A CHW-led perinatal home visiting intervention operated through a state health department can improve prenatal care utilization among demographically and socioeconomically disadvantaged women and reduce maternal and child health inequity.
KW - Home visiting
KW - community health worker
KW - prenatal care
KW - propensity score matching
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U2 - 10.1007/s10995-022-03506-2
DO - 10.1007/s10995-022-03506-2
M3 - Article
C2 - 36269498
AN - SCOPUS:85140301573
SN - 1092-7875
VL - 26
SP - 2485
EP - 2495
JO - Maternal and Child Health Journal
JF - Maternal and Child Health Journal
IS - 12
ER -