Manuscript Details

Roman, L., Raffo, J. E., Zhu, Q., & Meghea, C. (2014). A statewide Medicaid enhanced prenatal care program: Impact on birth outcomes. JAMA Pediatrics, 168(3), 220–227.

Moderate rating
Study reviewed under: Handbook of Procedures and Standards, Version 1
Study design characteristics contributing to rating
Design Attrition Baseline equivalence Confounding factors? Valid, reliable measures?
Non-experimental comparison group design Not applicable

Established on race/ethnicity and SES; outcome(s) not feasible to assess at baseline

None

Not assessed in manuscripts reviewed under Handbook of Procedures and Standards, Version 1
Child Health
Outcome Measure Timing of Follow-Up Rating Direction of Effect Effect Size (Absolute Value) Stastical Significance Sample Size Sample Description
Low birth weight (<2500g) Immediately post-intervention Moderate
0.06 Statistically significant, p < 0.05 32088 infants Full sample; Michigan Medicaid 2010 birth cohort
Preterm birth (<37 weeks) Immediately post-intervention Moderate
0.06 Statistically significant, p < 0.05 32088 infants Full sample; Michigan Medicaid 2010 birth cohort
Very low birth weight (<1500g) Immediately post-intervention Moderate
0.21 Statistically significant, p < 0.05 32088 infants Full sample; Michigan Medicaid 2010 birth cohort
Very preterm birth (<32 weeks) Immediately post-intervention Moderate
0.14 Statistically significant, p < 0.05 32088 infants Full sample; Michigan Medicaid 2010 birth cohort
Effect rating key
Favorable finding / Statistically significant
Unfavorable finding / Statistically significant
Ambiguous finding / Statistically significant
No effect / Not statistically significant

This study included participants with the following characteristics at enrollment:

Race/Ethnicity

The race and ethnicity categories may sum to more than 100 percent if Hispanic ethnicity was reported separately or respondents could select two or more race or ethnicity categories.

Black or African American
39%
Hispanic or Latino
7%
White
51%
Unknown
3%

Maternal Education

Data not available

Other Characteristics

Enrollment in means-tested programs
63%

This study included participants from the following locations:

  • Michigan
Study Participants

Administrative data for 60,653 pregnant women who had a Medicaid-insured singleton birth in 2010 were drawn from the Michigan Department of Community Health. Participants in the MIHP home-visiting model were propensity-score matched with non-participants on maternal demographic characteristics, pregnancy behaviors, and chronic disease incidence. At baseline, among the matched sample, 51 percent of mothers in MIHP identified as white and 39 percent identified as black. The average age of mothers was 25.5. Seventeen percent had incomes at or below 33 percent of the federal poverty level.

Setting

The study took place across the state of Michigan.

Intervention condition
Comparison Conditions

Pregnant women in the non-participant comparison group did not receive any MIHP services but had access to other resources offered through Medicaid.

Subgroups examined

• Race/ethnicity (Black or non-Black) • Timing of enrollment in intervention (in first trimester or in second trimester or later)

Author Affiliation

None of the study authors are developers of the MIHP model.

Funding Sources

The study was funded in part by the Michigan Department of Community Health.