Addressing maternal and child health equity through a community health worker home visiting intervention to reduce low birth weight: Retrospective quasi-experimental study of the Arizona Health Start Programme
AffiliationCenter for Population Science and Discovery, University of Arizona Health Sciences
Center for Biomedical Informatics and Biostatistics, University of Arizona
MetadataShow full item record
PublisherBMJ Publishing Group
CitationSabo, S., Wightman, P., McCue, K., Butler, M., Pilling, V., Jimenez, D. J., Celaya, M., & Rumann, S. (2021). Addressing maternal and child health equity through a community health worker home visiting intervention to reduce low birth weight: Retrospective quasi-experimental study of the Arizona Health Start Programme. BMJ Open, 11(6).
RightsCopyright © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC.
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at firstname.lastname@example.org.
AbstractObjective To test if participation in the Health Start Programme, an Arizona statewide Community Health Worker (CHW) maternal and child health (MCH) home visiting programme, reduced rates of low birth weight (LBW), very LBW (VLBW), extremely LBW (ELBW) and preterm birth (PTB). Design Quasi-experimental retrospective study using propensity score matching of Health Start Programme enrolment data to state birth certificate records for years 2006-2016. Setting Arizona is uniquely racially and ethnically diverse with comparatively higher proportions of Latino and American Indian residents and a smaller proportion of African Americans. Participants 7212 Health Start Programme mothers matched to non-participants based on demographic, socioeconomic and geographic characteristics, health conditions and previous birth experiences. Intervention A statewide CHW MCH home visiting programme. Primary and secondary outcome measures LBW, VLBW, ELBW and PTB. Results Using Health Start Programme's administrative data and birth certificate data from 2006 to 2016, we identified 7212 Health Start Programme participants and 53 948 matches. Programme participation is associated with decreases in adverse birth outcomes for most subgroups. Health Start participation is associated with statistically significant lower rates of LBW among American Indian women (38%; average treatment-on-the-treated effect (ATT): 2.30; 95% CI -4.07 to -0.53) and mothers with a pre-existing health risk (25%; ATT: -3.06; 95% CI -5.82 to -0.30). Among Latina mothers, Health Start Programme participation is associated with statistically significant lower rates of VLBW (36%; ATT: 0.35; 95% CI -0.69 to -0.01) and ELBW (62%; ATT: 0.31; 95% CI (-0.52 to -0.10)). Finally, Health Start Programme participation is associated with a statistically significant lower rate of PTB for teen mothers (30%; ATT: 2.81; 95% CI -4.71 to -0.91). Other results were not statistically significant. Conclusion A state health department-operated MCH home visiting intervention that employs CHWs as the primary interventionist may contribute to the reduction of LBW, VLBW, ELBW and PTB and could improve birth outcomes statewide, especially among women and children at increased risk for MCH inequity. © Author(s) (or their employer(s)) 2021.
NoteOpen access journal
VersionFinal published version
Except where otherwise noted, this item's license is described as Copyright © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC.
- Evaluation protocol to assess maternal and child health outcomes using administrative data: a community health worker home visiting programme.
- Authors: Sabo S, Butler M, McCue K, Wightman P, Pilling V, Celaya M, Rumann S
- Issue date: 2019 Dec 10
- A statewide Medicaid enhanced prenatal care program: impact on birth outcomes.
- Authors: Roman L, Raffo JE, Zhu Q, Meghea CI
- Issue date: 2014 Mar
- Impact of social capital, harassment of women and girls, and water and sanitation access on premature birth and low infant birth weight in India.
- Authors: Baker KK, Story WT, Walser-Kuntz E, Zimmerman MB
- Issue date: 2018
- Kentucky Health Access Nurturing Development Services Home Visiting Program Improves Maternal and Child Health.
- Authors: Williams CM, Cprek S, Asaolu I, English B, Jewell T, Smith K, Robl J
- Issue date: 2017 May
- Pathways community care coordination in low birth weight prevention.
- Authors: Redding S, Conrey E, Porter K, Paulson J, Hughes K, Redding M
- Issue date: 2015 Mar
Showing items related by title, author, creator and subject.
Using Participatory Methods to Enhance Youth Engagement in Substance Use ResearchValdez, Elizabeth S.; Valdez, Luis; Garcia, David O.; University of Arizona (SAGE Publications Inc., 2021-02-20)Youth engagement in substance use research is critical to the understanding of correlates that lead to detrimental health and social outcomes for adolescents. In addition to the documented challenges related to youth recruitment for substance use research, Latinx youth living on the U.S.–Mexico border may be difficult for researchers to engage in substance use research because they could face retributory harm if they identify their experiences to any entity perceived as an authority (e.g., researchers). Empirical findings that posit viable strategies to engage marginalized youth in substance use research are lacking. Participatory approaches show promise in increasing participation of historically underrepresented youth in research. Building on previously published work on our youth participatory action research mixed-methods study, this article discusses the youth-led participatory approach used to (1) develop and pilot test a culturally, regionally, and linguistically tailored substance use instrument and (2) engage 445 Latinx youth to participate in a cross-sectional study to assess epidemiological patterns of youth substance use on the U.S.–Mexico border. We share lessons learned related to the youth-led instrument design, youth-led recruitment strategy, and assuring participant confidentiality. © 2021 Society for Public Health Education.
Modeling the cost-effectiveness of a regional poison control center using decision analysisDraugalis, JoLaine R.; Harrison, Donald Lee, 1956- (The University of Arizona., 1996)Using decision analysis techniques, the cost-effectiveness of two alternatives for treating human poison exposures were modeled. The alternatives were the treatment of poisonings with the services of a regional poison control center versus without access to any poison control center. The relative cost-effectiveness was modeled based on two outcomes (morbidity and mortality) for each of four typical poison exposures: acetaminophen overdose, tricyclic antidepressant overdose, cleaning substance exposure in children, and cough/cold preparation overdose in children. Additionally, analyses were conducted to test the sensitivity of the cost-effectiveness ratio to outcome probability, average inpatient and emergency room charges, and proportion of poison exposures managed on site by the regional poison control center. This research was conducted from society's point of view.
Continuity of care for migrant farm workers utilizing computer disksEffken, Judith A.; Bayham-Hicks, Shirley Louise (The University of Arizona., 2000)Not much has changed for the migrant farmworker in the last thirty years. In one of the wealthiest countries on earth, migrant farmworker health status remains comparable to that found in Third World countries because of poor sanitation, poor nutrition and exposure. Current estimates show that migrant clinics are serving less than 20% of this population, leaving about 2,000,000 farmworkers without medical care. The barriers to health care for this population are numerous. This study will focus on the barrier to care resulting from lack of continuity in care due to poor inter-clinic communication. In this study it has been shown that computer disks and a standard word-processing program can be used to create a portable medical health history for the migrant to improve inter-clinic communication. In the process of carrying out this study, it was also shown how other barriers to care for this vulnerable population might be removed as well.