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

Sabo, Samantha; Wightman, Patrick; McCue, Kelly; Butler, Matthew J.; Pilling, Vern; Jiménez, Dulce; Celaya, Martín; Rumann, Sara

doi:10.1136/bmjopen-2020-045014

Cited by 9 publications

(12 citation statements)

References 43 publications

(38 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Arizona’s Health Start Program (HSP) is embedded within local and tribal health departments and federally qualified health centers throughout the state to improve maternal and child health outcomes among historically disadvantaged groups, including Hispanic/Latinx and American Indian women, and women of low socioeconomic status. [ 18 , 19 ] Given the heterogeneity of the intervention population, we also examined the impact on several subgroups with either a history of disadvantage or low vaccine uptake.…”

Section: Methodsmentioning

confidence: 99%

“…Given this composition, we also evaluate intervention impacts for the following subgroups: Hispanic/Latinx and American Indian children, children residing in rural border counties, children of teen mothers and those with less than a high school degree, and primipara mothers (Table 4 ). [ 18 ].…”

Section: Methodsmentioning

confidence: 99%

“…Baseline equivalence, the statistical similarity of the intervention and matched-control groups, was verified through t-tests and standardized differences. [ 18 ] This matching process was repeated for several distinctive subgroups whose socioeconomic status (e.g. low education) or demographic characteristics (e.g.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Community health worker intervention improves early childhood vaccination rates: results from a propensity-score matching evaluation

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background Arizona’s Health Start Program is a statewide community health worker (CHW) maternal and child health home visiting intervention. The objective of this study was to test if participation in Health Start during 2006–2016 improved early childhood vaccination completion rates. Methods This retrospective study used 11 years of administrative, birth certificate, and immunization records. Propensity score matching was used to identify control groups, based on demographic, socioeconomic, and geographic characteristics. Results are reported by historically disadvantaged subgroups and/or with a history of low vaccine uptake, including Hispanic/Latinx and American Indian children, and children of low socioeconomic status and from rural areas, children with teen mothers and first-born children. The average treatment-on-the-treated (ATT) effect estimated the impact of Health Start on timely completion of seven early childhood vaccine series: diphtheria/tetanus toxoids and acellular/whole-cell pertussis (DTaP/DTP), Haemophilus influenzae type b (Hib), hepatitis B (Hep. B), measles-mumps-rubella (MMR), pneumococcal conjugate vaccine (PCV13), poliovirus, and varicella. Results Vaccination completion rates (by age five) were 5.0% points higher for Health Start children as a group, and on average 5.0% points higher for several subgroups of mothers: women from rural border counties (ATT 5.8), Hispanic/Latinx women (ATT 4.8), American Indian women (ATT 4.8), women with less than high school education (ATT 5.0), teen mothers (ATT 6.1), and primipara women (ATT 4.5), compared to matched control groups (p-value ≤ 0.05). Time-to-event analyses show Health Start children complete vaccination sooner, with a hazard rate for full vaccination 13% higher than their matches. Conclusion A state-operated home visiting intervention with CHWs as the primary interventionist can effectively promote early childhood vaccine completion, which may reduce the incidence of preventable diseases and subsequently improve children’s health. Effects of CHW interventions on vaccination uptake is particularly relevant given the rise in vaccine-preventable diseases in the US and globally. Trial registration Approved by the University of Arizona Research Institutional Review Board (Protocol 1701128802), 25 January 2017.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Community health worker intervention improves early childhood vaccination rates: results from a propensity-score matching evaluation

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…In this paper, we describe the relationship between participation in the Health Start Program and the utilization of Extended author information available on the last page of the article prenatal care (PNC), including among participant subgroups associated with higher risks of adverse health outcomes, based on demographic or socioeconomic characteristics. This study is part of a larger research agenda evaluating the effect of the Arizona Health Start Program on newborn health, maternal healthcare utilization, and early child health from 2006 to 2016 (Sabo et al, 2019(Sabo et al, , 2021.…”

Section: Introductionmentioning

confidence: 99%

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

McCue

Sabo

Wightman

et al. 2022

Matern Child Health J

Self Cite

View full text Add to dashboard Cite

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.

show abstract

“…Using a logistic regression model, we calculated the propensity scores, that is, the probability of each individual being a beneficiary of the CCT, from the independent variables presented above. The maternal variable of formal years of education was used as a proxy for socioeconomic status in the model, as the family income variable was unavailable 33 34. The pairing was 1:1 (nearest neighbour) without replacement, and a maximum difference (caliper width) of 0.20 was adopted for the distance between the propensity score matched groups (CCT beneficiaries and non-beneficiaries) 35.…”

Section: Methodsmentioning

confidence: 99%

Effect of a conditional cash transfer programme on infant up-to-date and timely vaccination

Souza

Ferreira

Waldman

et al. 2022

J Epidemiol Community Health

View full text Add to dashboard Cite

BackgroundConditional cash transfer (CCT) programmes are one of the strategies to increase vaccination coverage among underprivileged families by conditioning cash transfer to the up-to-date immunisation of children. However, there are gaps in knowledge of its impact on vaccination at the recommended age (timely).MethodsWe performed two cross-sectional analyses of secondary data from a retrospective cohort, at the landmark ages of 12 and 24 months, to assess the effect of the Brazilian CCT on the up-to-date and timely vaccination in children born between 2014 and 2016 and resident in the city of Araraquara, São Paulo (Southeast Brazil). The Propensity Score Matching (PSM) was used to balance two pre-defined groups (beneficiaries and non-beneficiaries) according to the profile of socioeconomic and demographic characteristics.ResultsFrom a total of 7386 children within the cohort, 22.2% (1636) were from beneficiary families of the CCT. After the pairing by PSM, the final sample size included in the analyses was 1440 for each group. We found higher up-to-date vaccination coverage, at 12 (92.1%, 95% CI=90.6% to 93.5%) and 24 months (83.8%, 95% CI=81.8% to 85.7%), among the CCT beneficiaries compared with the non-beneficiaries (85.1%, 95% CI=83.2% to 86.9% at 12 months and 73.6%, 95% CI=71.2% to 75.8% at 24 months). The coverage of timely vaccination did not statistically differ between beneficiaries (41.5%, 95% CI=38.9% to 44.1% and 17.4%, 95% CI=15.4% to 19.4%) and non-beneficiaries (40.7%, 95% CI=38.1% to 43.3% and 17.1%, 95% CI=15.2% to 19.1%) at 12 and 24 months, respectively.ConclusionThe study highlights a positive effect of the CCT on vaccination coverage of the up-to-date infant vaccination schedule. However, there was no difference in timely vaccination.

show abstract

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

Cited by 9 publications

References 43 publications

Community health worker intervention improves early childhood vaccination rates: results from a propensity-score matching evaluation

Community health worker intervention improves early childhood vaccination rates: results from a propensity-score matching evaluation

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

Effect of a conditional cash transfer programme on infant up-to-date and timely vaccination

Contact Info

Product

Resources

About