Manuscript Detail | Home Visiting Evidence of Effectiveness

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: Maternal Infant Health Program (MIHP)

Manuscript screening details
Screening decision	Screening conclusion	HomVEE procedures and standards version
Passes screens	Eligible for review	Version 1

Study design details
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	None	None	Not assessed in manuscripts reviewed before 2021

Study characteristics
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 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	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). • Race/ethnicity (Black or non-Black) • Timing of enrollment in intervention (in first trimester or in second trimester or later)
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 the MIHP 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

Child health
Rating	Outcome measure	Effect	Sample	Timing of follow-up	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Moderate	Low birth weight (<2500g)	FavorableUnfavorable or ambiguousNo Effect	Full sample; Michigan Medicaid 2010 birth cohort	Immediately post-intervention	32,088 infants	Unadjusted proportion = 0.08	Unadjusted proportion = 0.09	OR = 0.91	HomVEE calculated = -0.06	Statistically significant, p < 0.05	Effect size based on study OR Submitted by barbara on Fri, 04/12/2019 - 18:55 HomVEE calculated the effect size based on the study-reported odds ratio. Negative effect is favorable Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
Moderate	Preterm birth (<37 weeks)	FavorableUnfavorable or ambiguousNo Effect	Full sample; Michigan Medicaid 2010 birth cohort	Immediately post-intervention	32,088 infants	Unadjusted proportion = 0.11	Unadjusted proportion = 0.12	OR = 0.91	HomVEE calculated = -0.06	Statistically significant, p < 0.05	Effect size based on study OR Submitted by barbara on Fri, 04/12/2019 - 18:55 HomVEE calculated the effect size based on the study-reported odds ratio. Negative effect is favorable Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
Moderate	Very low birth weight (<1500g)	FavorableUnfavorable or ambiguousNo Effect	Full sample; Michigan Medicaid 2010 birth cohort	Immediately post-intervention	32,088 infants	Unadjusted proportion = 0.01	Unadjusted proportion = 0.02	OR = 0.71	HomVEE calculated = -0.21	Statistically significant, p < 0.05	Effect size based on study OR Submitted by barbara on Fri, 04/12/2019 - 18:55 HomVEE calculated the effect size based on the study-reported odds ratio. Negative effect is favorable Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.
Moderate	Very preterm birth (<32 weeks)	FavorableUnfavorable or ambiguousNo Effect	Full sample; Michigan Medicaid 2010 birth cohort	Immediately post-intervention	32,088 infants	Unadjusted proportion = 0.02	Unadjusted proportion = 0.03	OR = 0.80	HomVEE calculated = -0.14	Statistically significant, p < 0.05	Effect size based on study OR Submitted by barbara on Fri, 04/12/2019 - 18:55 HomVEE calculated the effect size based on the study-reported odds ratio. Negative effect is favorable Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.