Meghea, C. I., Raffo, J. E., Zhu, Q., & Roman, L. (2013). Medicaid home visitation and maternal and infant healthcare utilization. American Journal of Preventive Medicine, 45(4), 441–447.
Model(s) Reviewed:
Maternal Infant Health Program (MIHP)
| Screening decision | Screening conclusion | HomVEE procedures and standards version |
|---|---|---|
| Passes screens | Eligible for review | Version 1 |
| Rating | Design | Attrition | Baseline equivalence | Compromised randomization | Confounding factors | Valid, reliable measure(s) |
|---|---|---|---|---|---|---|
| Moderate | Non-experimental comparison group design | Not applicable | Established on race/ethnicity and SES; outcome(s) not feasible to assess at baseline | Not applicable | None | Not assessed in manuscripts reviewed before 2021 |
Notes:
| Study participants | The study population included women who were recipients of Medicaid and delivered a baby in Michigan in 2010. The authors obtained records from the state Medicaid program and the Michigan Department of Community Health to identify pregnant mothers who submitted a Medicaid claim identifying Maternal and Infant Health Program (MIHP) participation during pregnancy or an MIHP prenatal risk screening. These mothers were matched one-to-one with mothers in Medicaid claims data who did not participate in the MIHP program at pregnancy. Matching created groups similar on race, age, socio-economic status, marital status, and markers for maternal health. A total of 16,044 matched pairs of mothers were included in the analysis. Mothers were 26 years old, on average. One-third were married. About half were white, 39 percent were black, 7 percent were Hispanic, and 3 percent were another race. All mothers were eligible for Medicaid during pregnancy and 17 percent were living at or below 33 percent of the federal poverty level. |
|---|---|
| Setting | The study took place throughout the state of Michigan. |
| Intervention services | MIHP provides prenatal and postnatal home visiting to pregnant women and infants living in Michigan who are Medicaid beneficiaries. Participation is voluntary, and includes health risk screenings, care coordination, referrals to other services, and interventions that are tailored to the needs of each person. These interventions may address healthy pregnancies, positive birth outcomes, infant safety, and infant health and development. |
| Comparison conditions | Mothers in the comparison condition did not volunteer to participate in MIHP services or receive an MIHP prenatal risk screening during pregnancy. |
| Subgroups examined |
This field lists subgroups examined in the manuscript (even if they were not replicated in other samples and not reported on the summary page for this model’s report). Subgroups are not listed for manuscripts reviewed before 2021. |
| Funding sources | The study was funded in part by the Michigan Department of Community Health. |
| Author affiliation | None of the study authors are developers of this model. |
| Peer reviewed | Peer reviewed status is not listed for manuscripts reviewed before 2021. |
Study Registration:
Clinicaltrials.gov Identifier: None found. Study registration was assessed by HomVEE beginning with the 2014 review.
Findings that rate moderate or high
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Adequate prenatal care | FavorableUnfavorable or ambiguousNo Effect |
Full sample; Michigan Medicaid 2010 birth cohort | 12 months postpartum | 32,088 mothers | Unadjusted proportion = 0.65 | Unadjusted proportion = 0.63 | OR = 1.06 | HomVEE calculated = 0.04 | Statistically significant, p < 0.05 | HomVEE calculated the effect size based on the study-reported odds ratio. |
| Moderate | Any prenatal care | FavorableUnfavorable or ambiguousNo Effect |
Full sample; Michigan Medicaid 2010 birth cohort | 12 months postpartum | 32,088 mothers | Unadjusted proportion = 0.99 | Unadjusted proportion = 0.97 | OR = 2.94 | HomVEE calculated = 0.65 | Statistically significant, p < 0.05 | HomVEE calculated the effect size based on the study-reported odds ratio. |
| Moderate | Appropriate postnatal visit | FavorableUnfavorable or ambiguousNo Effect |
Full sample; Michigan Medicaid 2010 birth cohort | 12 months postpartum | 32,088 mothers | Unadjusted proportion = 0.50 | Unadjusted proportion = 0.41 | OR = 1.50 | HomVEE calculated = 0.25 | Statistically significant, p < 0.05 | HomVEE calculated the effect size based on the study-reported odds ratio. |