Abstract
Introduction
This investigation examines the outcomes of the Pathways HUB Community Action, a Maternal and Infant Mortality HUB in NE Ohio. The purpose of a HUB is to provide a one-stop point of contact for primarily minority pregnant women who are low-income and are at high risk for pregnancy complications. As a HUB client, each mother is assigned a community health worker who provides wrap-around support across 20 identified areas of potential need.
Methods
The focus of this evaluation is on the women who were enrolled in the PHCA and gave birth between 2016 and 2020. Pre-existing data was used to examine the association between mother variables and birth outcomes using odds ratio and correlation analysis.
Results
Using a within-subjects design, results indicate that there is no significant association between preterm rates for women who have previously experienced one or more preterm deliveries. Likewise, results indicate that there is no significant association on the birth weight of infants of enrolled women who have previously given birth to a low-birth-weight infant. Results indicate that there is a strong significant association between 1st and 2nd-trimester enrollee’s dosage of PHCA services and supports and positive birth outcomes.
Discussion
These findings suggest that the PHCA is providing needed support and assistance to at-risk pregnant women who are mitigating the likelihood of repeated preterm and low-weight births, therefore lowering the likelihood of infant mortality for their clients in Summit County.
Significance
This research is the first known study to investigate the impact of HUB services in reducing infant mortality. Since preterm births are the greatest predictor of infant mortality, reducing the number of preterm births can result in better outcomes. Prior preterm births, for those women receiving support from the PHCA, is not longer a significant predictor of another preterm birth.
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References
Boyd, L. M., Mehra, R., Thomas, J., Lewis, J., & Cunningham, S. (2019). Features and impact of trust-based relationships between community health workers and low-income pregnant women with chronic health conditions: A focus group study. Maternal and Fetal Medicine. https://doi.org/10.21203/rs.2.13556/v1
CDC. (2018a). 2016 Ohio infant mortality data: General findings. pp. 1–20. Retrieved from https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_10-508.pdf
CDC. (2018b). CDC: Ohio’s infant mortality rate remains one of the highest in US | News | ideastream. http://www.ideastream.org/news/cdc-ohios-infant-mortality-rate-remains-one-of-the-highest-in-us
CDC. (2020). Social determinants of health. https://www.cdc.gov/socialdeterminants/index.htm
Chiyaka, E. T. (2019). Effectiveness of the pathways community HUB model in reducing low birth weight among high-risk pregnant women. Kent State University.
Clark, R. E., Weinreb, L., Flahive, J. M., & Seifert, R. W. (2019). Homelessness contributes to pregnancy complications. Health Affairs. https://doi.org/10.1377/hlthaff.2018.05156
Cnattingius, S. (2004). The epidemiology of smoking during pregnancy: Smoking prevalence, maternal characteristics, and pregnancy outcomes. Nicotine & Tobacco Research, 6(Suppl 2), 125–140.
Cunningham, S. D., Riss, V., Line, L., Patti, M., Bucher, M., Dumwald, C., & Srinivas, S. K. (2020). Safe start community health work program: A multi-sector partnership to improve perinatal outcomes among low-income pregnant women with chronic health conditions. American Journal of Public Health, 110, 836–839.
Cutts, D. B., Coleman, S., Black, M. M., Chilton, M. M., Cook, J. T., Cuba, S. E., Heeren, T. C., Meyers, A., Sandel, M., Casey, P. H., & Fran, D. A. (2015). Homelessness during pregnancy: A unique, time-dependent risk factor of birth outcomes. Maternal & Child Health, 19, 1276–1283.
Gleason, J., & Jones, M. M. (2019). Exploring the roles of community health workers and patient navigators to improve birth outcomes: A literature review. https://mhcc.maryland.gov/mhcc/pages/home/workgroups/documents/african_american_study/PrgncyNavCHW_LitRev_MHCCed_PRELIMDRFT4WG.pdf
Hill, K. (2019). Reducing infant mortality through the nurse family partnership home visitation program in Montgomery County, Alabama. University of Kentucky.
Nash, D. B., Fabius, R. J., Skoufalos, A., Clarke, J., & Horowitz, M. R. (2017). Population health: Creating a culture of wellness. Jones & Bartlett Publishers.
ODH. (2017). Total Ohio infant deaths rise in 2016 while sleep-related deaths declined. http://cim.legislature.ohio.gov/Assets/Files/ohio-department-of-health-news-release-total-ohio-infant-deaths-rise-in-2016-while-sleep-related-deaths-decline.pdf
ODH. (2018). Ohio’s infant mortality report. https://odh.ohio.gov/wps/portal/gov/odh/know-our-programs/infant-vitality/infant-vitality
Prather, C., Fuller, T. R., Marshall, K. J., & Jeffries, W. L. (2016). The impact of racism on the sexual and reproductive health of African American women. Journal of Women’s Health, 25(7), 664–671.
Redding, S., Conrey, E., Porter, K., Paulson, J., Hughes, K., & Redding, M. (2015). Pathways community care coordination in low birth weight prevention. Maternal and Child Health Journal, 19, 643–650.
Rose, P. R. (2017). Health disparities, diversity, and inclusion: Context, controversies, and solutions (1st ed.). Jones & Bartlett Learning.
Shapiro-Mendoza, C. K., Barfield, W. D., Henderson, Z., et al. (2016). CDC Grand Rounds: Public Health Strategies to Prevent Preterm Birth. MMWR Morbidity Mortality Weekly Report, 65, 826–830.
Statistica. (2020). Infant mortality rate by US state 2016 | Statistics. https://www.statista.com/statistics/252064/us-infant-mortality-rate-by-ethnicity-2011/
Steyn, K., de Wet, T., Saloojee, Y., Nel, H., & Yach, D. (2006). The influence of maternal cigarette smoking, snuff use, and passive smoking on pregnancy outcomes: The Birth to Ten Study. Pediatric and Perinatal Epidemiology, 20(2), 90–99.
Swoboda, C. M., McAlearney, A. S., Menser, T., Sieck, C. J., Hefner, J. L., Walker, D. M., & Huerta, T. R. (2019). Lessons from community health worker home visitation program to reduce infant mortality among Black mothers in Ohio. Journal of Community Medicine & Public Health, 3, 151. https://doi.org/10.29011/2577-2228.100051
Zeigler, B. P., Carter, E. L., Redding, S. A., & Leath, B. A. (2014). Pathways Community HUB: A model for coordination of community health care. Population Health Management, 17(4), 199.
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Permission to use the data for the purpose of research and dissemination was provided in a written letter from the ASPH HUB in September 2020. The Youngstown State University IRB provided oversight and approval for the project to use pre-existing data.
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Larwin, K.H., Larwin, D.A. Maternal and Infant Pathways HUB in NE Ohio: Influence on Birth Outcomes. Matern Child Health J 28, 83–92 (2024). https://doi.org/10.1007/s10995-023-03799-x
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DOI: https://doi.org/10.1007/s10995-023-03799-x