Maternal and Infant Outcomes at One Year for a Nurse‐Health Advocate Home Visiting Program Serving African Americans and Mexican Americans

Abstract

This article describes the outcomes at 1 year for a randomized clinical trial of Resources, Education and Care in the Home-Futures: a program to reduce infant mortality through home visits by a team of trained community residents led by a nurse. Low-income, inner-city pregnant women who self-identified as African American or Mexican American were recruited in two university prenatal clinics in Chicago. Because African Americans and Mexican Americans differed greatly at intake, we compared their outcomes at 12 months and then examined the effects of the intervention separately for these two groups. Participants were randomly assigned to the intervention or control group and were interviewed during the last trimester of pregnancy and at 2, 6, and 12 months after birth. The effects of the program varied by race/ethnicity. For African Americans, the program was associated with better maternal documentation of infant immunizations, more developmentally appropriate parenting expectations, and higher 12-month infant mental development scores. For Mexican Americans, the program had positive effects on maternal daily living skills and on the play materials subscale of the Home Observation for the Measurement of the Environment assessment. This study, along with previous research, suggests that home visits by a nurse-health advocate team can improve maternal and infant outcomes even for inner-city, low-income, minority families. Effective programs must be culturally sensitive, intensive, and adequately staffed and financed.

Doulas as Community Health Workers: Lessons Learned from a Volunteer Program

“…Community outreach workers or paraprofessionals working as community advocates have been shown to have a positive effect on outcomes for selected populations of childbearing women (Norr et al, 2003). Models promoting the combination of these roles have received little research attention in the literature, but they represent an opportunity to maximize the positive effect of social support as an intervention to promote positive health outcomes for childbearing women and adolescents.…”

Intervention for infants with brain injury: Results of a randomized controlled study

“…Likewise, studies with human infants have supported the benefits of intervention/ stimulation on developmental outcome of children from impoverished backgrounds, as well as on high-risk children such as premature infants and drug-exposed infants (e.g. Fazzi et al, 1997;Norr et al, 2003;Parker, Zahr, Cole, & Brecht, 1992;Schuler, Nair, & Kettinger, 2003;Zigler & Muenchow, 1992). Therefore, a rich environment with intensive stimulation may well allow infants with brain injury to recover.…”

The Effects of a Healthy Families Home Visitation Program on Rapid and Teen Repeat Births

“…However, less encouraging results were reported by Barnet et al (2007), ElKamary et al (2004), Koniak-Griffin et al (2002, Norr et al (2003), and Stevens-Simon et al (2001). The results of these studies are summarized in Table 2.…”

“…Specifically, Koniak-Griffin et al (2002, due to small sample sizes, failed to achieve statistically significant results despite finding a nearly 50% reduction in rates of RRB and TRB among participants. Similarly, Norr et al (2003) reported that their results may have been distorted by a basal effect in that repeat pregnancy rates were so low across all intervention and control groups that they left little room for improvement.…”

“…In addition, when participants did have subsequent children, they delayed the birth of the second child by an average of six months relative to the comparison group. Klerman et al (2003), Olds (2002), Olds et al (1998) The Nurse-Family Partnership model was found to be effective in reducing or delaying the occurrence of repeat pregnancies Sangalang et al (2006) Mothers in the treatment group significantly delayed the timing of second births relative to the comparison group mothers Table 2 Studies of home visitation programs that did not find positive treatment effects for RRB and TRB Study Findings Barnet et al (2007) Home visitation had no impact on subsequent pregnancy and birth rates of adolescent mothers served by a community-based home visiting program at 1 or 2 years following the birth of the index child El-Kamary et al (2004) Mothers served by Hawaii's Healthy program did not differ in their rates of rapid repeat pregnancies from mothers in a control group Koniak-Griffin et al (2002 In a study of teen mothers, authors failed to find any significant difference in repeat pregnancy rates between home visited mothers and mothers in a control group Norr et al (2003) In a study of the nurse-health advocate program, authors found no significant impact of the program on the incidence of repeat pregnancy one year after the birth of the index child Stevens-Simon et al…”