Abstract
Objective The Sedgwick County Healthy Babies Healthy Start (HBHS) program provides community-based services (including care coordination, interconception care and home visiting) aimed at reducing racial/ethnic disparities in poor birth outcomes. The purpose of this study is to assess the effectiveness of the Sedgwick County HBHS program by comparing the birth outcomes of program participants who enrolled prenatally and those who did not participate while pregnant. Methods In this retrospective cohort study, we used data drawn from the Sedgwick County HBHS program. The sample included 280 clients who were enrolled in the Sedgwick County HBHS program between September 2014 and December 2015. We performed logistic regression analyses to assess the associations between enrollee type (prenatal enrollee vs. interconceptional enrollee) and birth outcomes (low birth weight, preterm birth). Results The majority of the sample consisted of racial/ethnic minority women (32.1% non-Hispanic black, 31.8% Hispanic). After adjusting for covariates, women who enrolled in the Sedgwick County HBHS program prenatally were less likely than women who were not enrolled during pregnancy to have a preterm birth (OR 0.19, [CI 08, 0.43]) and deliver a low birth weight infant (OR 0.31, [CI 0.10, 0.97]). Conclusions for Practice Women, particularly minority women, who participate in the HBHS program experienced better birth outcomes than women who did not participate in the program during pregnancy. However, findings also suggest that interconceptional enrollees may stand to benefit from continued participation in the program.
Highlights
IntroductionIn the United States, preterm birth (birth at >37 weeks gestation) and low birth weight (weighing >2500 g at birth) are leading causes of infant mortality and morbidity (Mathews and MacDorman 2013)
In the United States, preterm birth and low birth weight are leading causes of infant mortality and morbidity (Mathews and MacDorman 2013)
Our findings reveal that women who participated in the Sedgwick County Healthy Babies Healthy Start program had better birth outcomes than women who did not participate during their pregnancy
Summary
In the United States, preterm birth (birth at >37 weeks gestation) and low birth weight (weighing >2500 g at birth) are leading causes of infant mortality and morbidity (Mathews and MacDorman 2013). Among infants who survive preterm birth (PTB) or low birth weight (LBW), there is an increased. Disparities in birth outcomes are believed to be a result of differential exposures to biological, psychological and social events during pregnancy and over the lifespan (Halfon and Hochstein 2002; Lu et al 2010; Lu and Halfon 2003). Comprehensive approaches that incorporate multilevel intervention strategies, cross-sector collaboration (i.e., service coordination and integration to holistically address social determinants of health) and multidimensional systems integration across the life course are key in reducing disparities in birth outcomes (Institute of Medicine 2002; Lu 2014; Lu et al 2010; Williams 2012)
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