Skip to main content

Examining the Causal Impact of Prenatal Home Visiting on Birth Outcomes: A Propensity Score Analysis

Maternal and Child Health Journal volume 25, pages 947–955 (2021)Cite this article

Abstract

Objectives

In Ohio, African American babies die at 2.5–3 times the rate of White babies. Preterm birth and low birth weight are the leading causes of infant mortality. Home visiting is an evidence-based strategy for serving low-income pregnant women; however, there are relatively few rigorous studies examining its effect on birth outcomes.

Methods

This study uses a propensity score technique to estimate the causal effect of participation in home visiting on prematurity and low birth weight among a low-income, predominantly African American sample (N = 26,814).

Results

We found that participation in home visiting significantly reduced the odds of experiencing both adverse birth events, with a larger program effect for the low birth weight outcome.

Conclusions for Practice

Results suggest that selective prevention strategies must be accompanied by universal attempts to improve the health and life circumstances of low income and minority women.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

References

  • Austin, P. C. (2011). An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behavioral Research, 46(3), 399–424.

    Article  Google Scholar 

  • Austin, P. C., & Stuart, E. A. (2015). Moving towards best practice when using inverse probability of treatment weighting (IPTW) using the propensity score to estimate causal treatment effects in observational studies. Statistics in Medicine, 34(28), 3661–3679.

    Article  Google Scholar 

  • Bale, J. R., Stoll, B. J., & Lucas, A. O. (2001). The executive summary: Improving birth outcomes—Meeting the challenge in the developing world. Washington DC: Institute of Medicine. The National Academy Press.

    Google Scholar 

  • Barth, R. P. (1991). An experimental evaluation of in-home child abuse prevention services. Child Abuse & Neglect, 15(4), 363–375.

    Article  CAS  Google Scholar 

  • Brookhart, M. A., Wyss, R., Layton, J. B., & Stürmer, T. (2013). Propensity score methods for confounding control in nonexperimental research. Circulation: Cardiovascular Quality and Outcomes, 6(5), 604–611.

    Google Scholar 

  • Child Health USA. (2014). Preterm birth and low birth weight. Retrieved from https://mchb.hrsa.gov/sites/default/files/mchb/Data/Chartbooks/child-health-2014.pdf.

  • Goldenberg, R. L., & Culhane, J. F. (2007). Low birth weight in the United States. The American Journal of Clinical Nutrition, 85(2), 584S-590S.

    Article  CAS  Google Scholar 

  • Gomby, D. S. (2007). The promise and limitations of home visiting: Implementing effective programs. Child Abuse & Neglect, 31(8), 793–799.

    Article  Google Scholar 

  • Gomby, D. S., Culross, P. L., & Behrman, R. E. (1999). Home visiting: Recent program evaluations—Analysis and recommendations. The Future of Children, 9(1), 4–26.

    Article  CAS  Google Scholar 

  • Johnson, K., Posner, S. F., Biermann, J., Cordero, J. F., Atrash, H. K., Parker, C. S., et al. (2006). Recommendations to improve preconception health and health care—United States report of the CDC/ATSDR preconception care work group and the select panel on preconception care. Morbidity and Mortality Weekly Report: Recommendations and Reports, 55(6), 1–23.

    Google Scholar 

  • Kemp, L., Harris, E., McMahon, C., Matthey, S., Vimpani, G., Anderson, T., et al. (2011). Child and family outcomes of a long-term nurse home visitation programme: A randomised controlled trial. Archives of Disease in Childhood, 96, 533–540.

    Article  Google Scholar 

  • Kitzman, H., Olds, D. L., Henderson, C. R., Hanks, C., Cole, R., Tatelbaum, R., et al. (1997). Effect of prenatal and infancy home visitation by nurses on pregnancy outcomes, childhood injuries, and repeated childbearing. A randomized controlled trial. JAMA: The Journal of the American Medical Association, 278(8), 644–652.

    Article  CAS  Google Scholar 

  • Kochanek, K. D., Murphy, S. L., Xu, J., & Tejada-Vera, B. (2016). Deaths: Final data for 2014. National Vital Statistics Reports, 65(4), 1–122.

    PubMed  Google Scholar 

  • Koniak-Griffin, D., Anderson, N. L., Verzemnieks, I., & Brecht, M. L. (2000). A public health nursing early intervention program for adolescent mothers: Outcomes from pregnancy through 6 weeks postpartum. Nursing Research, 49(3), 130–138.

    Article  CAS  Google Scholar 

  • Lanza, S. T., Moore, J. E., & Butera, N. M. (2013). Drawing causal inferences using propensity scores: A practical guide for community psychologists. American Journal of Community Psychology, 52, 380–392.

    Article  Google Scholar 

  • Lee, E., Mitchell-Herzfeld, S., Lowenfels, A. A., Greene, R., Dorabawila, V., & DuMont, K. A. (2009). Reducing low birth weight through home visitation: A randomized controlled trial. American Journal of Preventive Medicine, 36(2), 154–160.

    Article  Google Scholar 

  • Olds, D. L., Henderson, C. R., Jr., Tatelbaum, R., & Chamberlin, R. (1986). Improving the delivery of prenatal care and outcomes of pregnancy: A randomized trial of nurse home visitation. Pediatrics, 77(1), 16.

    CAS  PubMed  Google Scholar 

  • Olds, D. L., & Kitzman, H. (1993). Review of research on home visiting for pregnant women and parents of young children. The Future of Children, 3(3), 53–92.

    Article  Google Scholar 

  • Robins, J. M., Hernan, M. A., & Brumback, B. (2000). Marginal structural models and causal inference in epidemiology. Epidemiology, 11(5), 550–560.

    Article  CAS  Google Scholar 

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

    Article  Google Scholar 

  • Royston, P., & White, I. R. (2011). Multiple imputation by chained equations (MICE): Implementation in Stata. Journal of Statistical Software, 45, 1–20.

    Article  Google Scholar 

  • Sweet, M. A., & Appelbaum, M. I. (2004). Is home visiting an effective strategy? A meta-analytic review of home visiting programs for families with young children. Child Development, 75(5), 1435–1456.

    Article  Google Scholar 

  • Thorland, W., & Currie, D. W. (2017). Status of birth outcomes in clients of the nurse-family partnership. Maternal and Child Health Journal, 21(5), 995–1001.

    Article  Google Scholar 

  • Williams, C. M., Asaolu, I., English, B., Jewell, T., Smith, K., & Robl, J. (2014a). Child health improvement by HANDS home visiting program (Unpublished manuscript). Lexington, KY: University of Kentucky Department of Obstetrics and Gynecology.

  • Williams, C. M., Asaolu, I., English, B., Jewell, T., Smith, K., & Robl, J. (2014b). Maternal and child health improvement by HANDS home visiting program in the Bluegrass area development district (Unpublished manuscript). Lexington, KY: University of Kentucky Department of Obstetrics and Gynecology.

  • Williams, C. M., Asaolu, I., English, B., Jewell, T., Smith, K., & Robl, J. (2014c). Maternal and child health improvement by HANDS home visiting program in the KIPDA area development district, Kentucky (Unpublished manuscript). Lexington, KY: University of Kentucky Department of Obstetrics and Gynecology.

  • Williams, C. M., Cprek, S., Asaolu, I., English, B., Jewell, T., Smith, K., et al. (2017). Kentucky health access nurturing development services home visiting program improves maternal and child health. Maternal and Child Health Journal, 21, 1166–1174.

    Article  Google Scholar 

  • World Health Organization. (2013). Social determination of health. Geneva: World Health Organization.

    Google Scholar 

Download references

Acknowledgements

This study is funded by the City of Cleveland Division of Public Health with support from the Maternal and Child Health Bureau of the U.S. Health Resources & Services Administration (Award #: SPC203894).

Author information

Authors and Affiliations

  1. Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 11235 Bellflower Road, Cleveland, OH, 44106-7164, USA

    Elizabeth R. Anthony & Robert L. Fischer

  2. Department of Social Welfare, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760, Republic of Korea

    Youngmin Cho

  3. MomsFirst, Cleveland Department of Public Health, 75 Bethel Ct, Cleveland, OH, 44114, USA

    Lisa Matthews

Authors
  1. Elizabeth R. Anthony
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Youngmin Cho
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robert L. Fischer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lisa Matthews
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Youngmin Cho.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Anthony, E.R., Cho, Y., Fischer, R.L. et al. Examining the Causal Impact of Prenatal Home Visiting on Birth Outcomes: A Propensity Score Analysis. Matern Child Health J 25, 947–955 (2021). https://doi.org/10.1007/s10995-020-03054-7

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-020-03054-7

Keywords

  • Home visiting
  • Birth outcomes
  • Preterm birth
  • Low birth weight
  • Propensity score