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)
| 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 | None | None | Not assessed in manuscripts reviewed before 2021 |
| 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
| 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 | HomVEE calculated the effect size based on the study-reported odds ratio. 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 | HomVEE calculated the effect size based on the study-reported odds ratio. 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 | HomVEE calculated the effect size based on the study-reported odds ratio. 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 | HomVEE calculated the effect size based on the study-reported odds ratio. Negative effect is favorable to the intervention. |