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How Many Visits by Health Professionals are Needed to Make a Difference in Low Birthweight? A Dose-response Study of the Toronto Healthiest Babies Possible Program

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Abstract

The association of risk factors such as smoking, nutrition and adolescence with low birthweight has been well documented. What is less known is the extent to which certain program interventions can mediate the impact of these risks on low birthweight and the level of intervention necessary to have an impact. This study had two objectives: (a) to explore the role of the Toronto Healthiest Babies Possible (HBP) program as a mediator of the impact of smoking, adolescence, prepregnancy underweight and erratic weight gain/initial weight loss on LBW, and (b) to determine the dose-response relationship between the number of home visits and LBW. Study results suggest that the HBP strategy is making a difference for clients with the aforementioned three risk factors, and that the most effective intervention “dose” to reduce low birthweight is 9–11 visits. This type of study may serve as a benchmark in the evaluation of other similar programs.

Résumé

L’association qui existe entre d’une part des facteurs de risque tels que le tabagisme, la nutrition et l’adolescence, et d’autre part le faible poids à la naissance est bien connue. Ce que l’on connaît moins c’est la mesure dans laquelle certaines interventions peuvent atténuer l’impact de ces risques sur le faible poids à la naissance et le niveau d’intervention nécessaire pour ce faire. Cette étude avait deux objectifs: (a) étudier le rôle du programme HBP (Healthiest Babies Possible) de Toronto en tant qu’élément pour atténuer l’impact du tabagisme, de l’adolescence, de l’insuffisance pondérale et de la prise de poids erratique/perte de poids initiale avant la grossesse sur les naissances de faible poids, et (b) déterminer la relation dose-réponse entre le nombre de visites à domicile et le faible poids à la naissance. Les résultats de l’étude semblent indiquer que la stratégie suivie par le programme HBP change les choses pour les clients concernés par les trois facteurs de risque susmentionnés, et que la „ dose ” d’intervention la plus efficace pour réduire le faible poids à la naissance est de l’ordre de 9 à 11 visites. Ce type d’étude pourra servir de référence à l’évaluation d’autres programmes analogues.

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Authors and Affiliations

  1. Toronto Public Health, Canada

    Ellen Desjardins MHSc & Deborah Hardwick MA

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  1. Ellen Desjardins MHSc
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  2. Deborah Hardwick MA
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Correspondence to Ellen Desjardins MHSc or Deborah Hardwick MA.

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Desjardins, E., Hardwick, D. How Many Visits by Health Professionals are Needed to Make a Difference in Low Birthweight? A Dose-response Study of the Toronto Healthiest Babies Possible Program. Can J Public Health 90, 224–228 (1999). https://doi.org/10.1007/BF03404120

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  • DOI: https://doi.org/10.1007/BF03404120

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