Improved Birth Weight for Black Infants: Outcomes of a Healthy Start Program.

HEALTH education evaluation; BIRTH weight; BLACK people; CHI-squared test; FISHER exact test; GESTATIONAL age; HEALTH behavior; RESEARCH methodology; PROBABILITY theory; RESEARCH funding; SELF-evaluation; STATISTICAL hypothesis testing; STATISTICS; LOGISTIC regression analysis; DATA analysis; SECONDARY analysis; REPEATED measures design; DATA analysis software; DESCRIPTIVE statistics; PREGNANCY

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. [ABSTRACT FROM AUTHOR]

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