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A Community-Based Home Visitation Program's Impact on Birth Outcomes

Guo, Yuqing PhD, RN; Pimentel, Pamela RN; Lessard, Jared PhD; Rousseau, Julie PhD, CNM, RN; Lee, Jung-Ah PhD, RN; Bojorquez, Yvette RN; Silva, Michele; Olshansky, Ellen PhD, RN, FAAN

MCN, The American Journal of Maternal/Child Nursing: January/February 2016 - Volume 41 - Issue 1 - p 16–23
doi: 10.1097/NMC.0000000000000203
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Background: MOMS Orange County is a coordinated home visitation program in which trained paraprofessional home visitors work under the close supervision of registered nurses. This model was developed to address health disparities in birth outcomes in a Hispanic community in Orange County, CA.

Purpose: The primary objective was to test the impact of MOMS Orange County on birth outcomes. The second objective was to examine the breadth of prenatal health education topics as a mediator of the relationship between home visits and birth outcomes.

Methods: A retrospective cohort design was used. Paraprofessional home visitors collected prenatal and postnatal data during home visits. Only those whose birth outcomes were obtained were included in the analysis (N = 2,027 participants). Regression models were conducted to test the associations between prenatal home visits and birth outcomes, adjusting for 10 covariates.

Results: Number of prenatal home visits predicted higher birthweight and greater gestational age at birth. Breadth of health education topics partially mediated the associations between home visits and birthweight. The same mediation was revealed with gestational age at birth.

Clinical Implications: The MOMS Orange County prenatal home visitation program may be a promising approach to decrease adverse birth outcomes in disadvantaged communities. Rigorously designed studies are needed to further test this model.

Home visiting programs are a promising approach to decrease adverse births outcomes in disadvantaged communities.

Yuqing Guo is an Assistant Professor, University of California Irvine, Program in Nursing Science, Irvine, CA. The author can be reached via e-mail at gyuqing@uci.edu

Pamela Pimentel is the Chief Executive Officer, MOMS Orange County, Santa Ana, CA.

Jared Lessard is a Postdoctoral Fellow, Research Institute on Addictions, University at Buffalo, NY.

Julie Rousseau is an Assistant Clinical Professor, University of California Irvine, Program in Nursing Science, Irvine, CA.

Jung-Ah Lee is an Assistant Professor, University of California Irvine, Program in Nursing Science, Irvine, CA.

Yvette Bojorquez is the Chief Program Officer, MOMS Orange County, Santa Ana, CA.

Michele Silva is the Chief Development Officer, MOMS Orange County, Santa Ana, CA.

Ellen Olshansky is a Professor, University of California Irvine, Program in Nursing Science, Irvine, CA.

With help from an award by University of California Irvine's (UCI) Campus-Community Research Incubator (CCRI), MOMS Orange County and the UCI Program in Nursing Science established a community-based participatory research partnership. Inherent in this process is collaboration between academic researchers and community members at all stages of the research, including publication. These findings are of interest to the stakeholders who are from MOMS Orange County, but it is important to emphasize that consensus was reached to objectively meet criteria for deriving objective results and applying the scientific process to this rich data set.

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