Factors Associated With Availability of Nurse-Family Partnership Programs in the State of Texas [27K

Abstract

INTRODUCTION: Current teen pregnancy rates generate significant social and economic costs, with highest rates in Hispanic, African American and socioeconomically disadvantaged youth. Their children are more likely to face health problems, incarcerations, unemployment, and to perpetuate teen pregnancies. Research-supported Nurse-Family Partnerships (NFPs) involving antepartum and postpartum nurse-home visits significantly improve teen pregnancy outcomes in Texas. Our objective was to evaluate socioeconomic, obstetrical, and perinatal outcomes of Texas counties currently served by NFPs. METHODS: We analyzed Texas and national population statistics, birth rates, socioeconomic factors, and obstetrical and neonatal outcomes extracted from federal and state databases. RESULTS: Currently, 21 Texas NFPs serve eligible women in 34 out of 254 Texas counties. These counties have higher average teen birth rates (44 per 1000) and higher average maternal poverty rates (33%) than the state of Texas (34 per 1000; 30%) and the United States (21 per 1000; 27%). They also have a higher proportion of absent prenatal care (4.5%), and infants with very low birth weights (1.7%). Across Texas, access to prenatal care decreases with decreasing maternal age, and teens have the highest rate of absent prenatal care (6.6-8.5%) and lowest rate of care starting the first trimester (6.6-8.5%). Absent prenatal care was also correlated with higher representation of birth defects. CONCLUSION: Texas NFPs serve counties with relatively high rates of teen pregnancies, maternal poverty, and absent prenatal care. This baseline data allows for advocacy, funding, and expansion of NFPs in Texas counties with comparably high levels of low-income, first-time mothers, including critically underserved Texas-Mexico border counties.