Black or African American
39%
Source
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.
Model(s) Reviewed
Funding Sources
The study was funded in part by the Michigan Department of Community Health.
Study Design
| 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 |
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.
Home Visiting 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
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)
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.
Home Visiting 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
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)
Findings that rate moderate or high in this manuscript
| 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 |
This study included participants with the following characteristics at enrollment:
Race/Ethnicity
Maternal Education
Other Characteristics
This study included participants from the following locations:
- Michigan