Catherine L Kothari1, Ruth Zielinski, Arthur James, Remitha M Charoth, Luz del Carmen Sweezy. 1. Catherine L. Kothari is with the Department of Emergency Medicine, Western Michigan University School of Medicine, Kalamazoo. Ruth Zielinski is with the Western Michigan University School of Nursing, Kalamazoo. Arthur James is with the Department of Obstetrics and Gynecology, Ohio State University, Columbus. Remitha M. Charoth is with the Department of Psychiatry, Western Michigan University School of Medicine. Luz del Carmen Sweezy is with Healthy Babies Healthy Start, Kalamazoo County Department of Health and Community Services, Kalamazoo.
Abstract
OBJECTIVES: We determined whether participation in Healthy Babies Healthy Start (HBHS), a maternal health program emphasizing racial equity and delivering services through case management home visitation, was associated with improved birth outcomes for Black women relative to White women. METHODS: We used a matched-comparison posttest-only design in which we selected the comparison group using propensity score matching. Study data were generated through secondary analysis of Michigan state- and Kalamazoo County-level birth certificate records for 2008 to 2010. We completed statistical analyses, stratified by race, using a repeated-measures generalized linear model. RESULTS: Despite their smoking rate being double that of their matched counterparts, Black HBHS participants delivered higher birth-weight infants than did Black nonparticipants (P = .05). White HBHS participants had significantly more prenatal care than did White nonparticipants, but they had similar birth outcomes (P = .7 for birth weight; P = .55 for gestation). CONCLUSIONS: HBHS participation is associated with increased birth weights among Black women but not among White women, suggesting differential program gains for Black women.
OBJECTIVES: We determined whether participation in Healthy Babies Healthy Start (HBHS), a maternal health program emphasizing racial equity and delivering services through case management home visitation, was associated with improved birth outcomes for Black women relative to White women. METHODS: We used a matched-comparison posttest-only design in which we selected the comparison group using propensity score matching. Study data were generated through secondary analysis of Michigan state- and Kalamazoo County-level birth certificate records for 2008 to 2010. We completed statistical analyses, stratified by race, using a repeated-measures generalized linear model. RESULTS: Despite their smoking rate being double that of their matched counterparts, Black HBHS participants delivered higher birth-weight infants than did Black nonparticipants (P = .05). White HBHS participants had significantly more prenatal care than did White nonparticipants, but they had similar birth outcomes (P = .7 for birth weight; P = .55 for gestation). CONCLUSIONS: HBHS participation is associated with increased birth weights among Black women but not among White women, suggesting differential program gains for Black women.
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