Estimating the effect of Prenatal Care Coordination in Wisconsin: A sibling fixed effects analysis

Mallinson, David C.; Larson, Andrea; Berger, Lawrence M.; Grodsky, Eric; Ehrenthal, Deborah B.

doi:10.1111/1475-6773.13239

Cited by 14 publications

(14 citation statements)

References 26 publications

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“…Finding an observed FE for the robustness test is data dependent. Birth registries are commonplace in sibling FE analyses [2][3][4]7,8,11 and may provide several candidate variables. For instance, United States birth records record maternal demographic information that are fixed and related to family health history, such as nativity and ethnicity.…”

Section: Discussionmentioning

confidence: 99%

“…Sibling fixed effects (FE) models are commonplace in observational epidemiologic research for estimating causal treatment effects while controlling for unobserved sibling-invariant confounding, such as shared genetic risk factors. [1][2][3][4][5][6][7][8][9][10][11] These models rely on strong assumptions-in particular, an individual's outcome cannot affect their sibling's treatment nor outcome. 1,5,10,11 Such assumptions are precarious because siblings' health are interdependent.…”

Section: Introductionmentioning

confidence: 99%

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Assessing Outcome-to-Outcome Interference in Sibling Fixed Effects Models

Mallinson¹

2021

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Sibling fixed effects (FE) models are useful for estimating causal treatment effects while offsetting unobserved sibling-invariant confounding. However, treatment estimates are biased if an individual's outcome affects their sibling's outcome. We propose a robustness test for assessing the presence of outcome-to-outcome interference in linear two-sibling FE models. We regress a gain-score-the difference between siblings' continuous outcomes-on both siblings' treatments and on a pre-treatment observed FE. Under certain restrictions, the observed FE's partial regression coefficient signals the presence of outcome-to-outcome interference. Monte Carlo simulations demonstrated the robustness test under several models. We found that an observed FE signaled outcome-to-outcome spillover if it was directly associated with an sibling-invariant confounder of treatments and outcomes, directly associated with a sibling's treatment, or directly and equally associated with both siblings' outcomes. However, the robustness test collapsed if the observed FE was directly but differentially associated with siblings' outcomes or if outcomes affected siblings' treatments.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessing Outcome-to-Outcome Interference in Sibling Fixed Effects Models

Mallinson¹

2021

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“…Shared variables were harmonized, although variables unique to the 2003 Revision are only available on 2011–2016 records. Further BD4LK methods can be found elsewhere [ 16 – 18 ].…”

Section: Methodsmentioning

confidence: 99%

Pregnancy complications and maternal birth outcomes in women with intellectual and developmental disabilities in Wisconsin Medicaid

et al. 2020

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Background Women with intellectual and developmental disabilities (IDD) may face greater risk for poor pregnancy outcomes. Our objective was to examine risk of maternal pregnancy complications and birth outcomes in women with IDD compared to women without IDD in Wisconsin Medicaid, from 2007–2016. Methods Data were from the Big Data for Little Kids project, a data linkage that creates an administrative data based cohort of mothers and children in Wisconsin. Women with ≥1 IDD claim the year before delivery were classified as having IDD. Common pregnancy complications and maternal birth outcomes were identified from the birth record. We calculated risk ratios (RR) using log-linear regression clustered by mother. We examined outcomes grouped by IDD-type and explored interaction by race. Results Of 177,691 women with live births, 1,032 (0.58%) had an IDD claim. Of 274,865 deliveries, 1,757 were to mothers with IDD (0.64%). Women with IDD were at greater risk for gestational diabetes (RR: 1.28, 95% CI: 1.0, 1.6), gestational hypertension (RR: 1.22, 95% CI: 1.0, 1.5), and caesarean delivery (RR 1.32, 95% CI: 1.2, 1.4) compared to other women. Adjustment for demographic covariates did not change estimates. Women with intellectual disability were at highest risk of gestational hypertension. Black women with IDD were at higher risk of gestational hypertension than expected under a multiplicative model. Conclusions Women with IDD have increased risk of pregnancy complications and adverse outcomes in Wisconsin Medicaid. Results were robust to adjustment. Unique patterns by IDD types and Black race warrant further exploration.

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“…The PNCC benefit has been shown to reduce the likelihood of prematurity and low birthweight in Wisconsin (Mallinson, Larson, Berger, Grodsky, & Ehrenthal, 2020; Van Dijk, Anderko, & Stetzer, 2011) and other states (Meghea, You, Raffo, Leach, & Roman, 2015; Ricketts, Murray, & Schwalberg, 2005; Skovholt et al, 1994). However, though PNCC has the potential to improve several infant health outcomes, there is limited research on the effectiveness or outcomes of PNCC on mothers .…”

Section: Introductionmentioning

confidence: 99%

Beyond Common Outcomes: Client’s Perspectives on the Benefits of Prenatal Care Coordination

Greene

Tran-Smith

Moua

2022

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Prenatal Care Coordination (PNCC) is a fee-for-service Medicaid benefit available in Wisconsin and several other states. It provides for home visiting, health education, care coordination and other supportive services to high-risk mothers. However, PNCC is not supported by an evidence-based model, its impact is not systematically evaluated, and the benefit is not currently reaching all eligible mothers. The purpose of this qualitative descriptive study was to describe PNCC clients' perspectives on the experience of receiving the benefit and the value and impact of PNCC in the context of their own lives. We interviewed recent clients of PNCC programs in two PNCC sites that varied by racial/ethnic community makeup, rural/urban geography, and health department size. PNCC clients identified two major benefits of PNCC: 1) social and emotional support from the PNCC nurse; and 2) assistance with obtaining or getting connected to other resources they needed. These two program benefits were especially meaningful to PNCC clients in the context of difficult life events and circumstances. Findings from this study highlight the impact of PNCC services on social and emotional health through trusting and supportive nurse-client relationships. Our findings also suggest that a longer program period and the development of standards to assess program effectiveness would improve PNCC client outcomes and reduce disparities in maternal health.

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Estimating the effect of Prenatal Care Coordination in Wisconsin: A sibling fixed effects analysis

Cited by 14 publications

References 26 publications

Assessing Outcome-to-Outcome Interference in Sibling Fixed Effects Models

Assessing Outcome-to-Outcome Interference in Sibling Fixed Effects Models

Pregnancy complications and maternal birth outcomes in women with intellectual and developmental disabilities in Wisconsin Medicaid

Beyond Common Outcomes: Client’s Perspectives on the Benefits of Prenatal Care Coordination

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