THE IMPACT OF CARE COORDINATION PROVIDED TO LOW-INCOME PREGNANT WOMEN IN AN INNER CITY NEIGHBORHOOD.
Contributors: Indiana University School of Nursing.
Published: 1993
Number of pages: 276
Subjects: Health Sciences, Public Health.; Health Sciences, Nursing.
Description: The purpose of this retrospective descriptive study was to examine the impact of care coordination on enrollment in pregnancy related services, pregnancy risk behaviors, and pregnancy outcomes. The services were provided via home visits to Medicaid beneficiaries who resided in Indianapolis neighborhoods with high black infant mortality rates.

Data were collected from the care coordination records of 381 participants who delivered infants between July 1, 1990 and January 1, 1992. The majority of the sample was black, was not married, had not graduated from high school, and had an income level below the federal poverty level. Most were admitted to care coordination in the second or third trimester. They received an average of 3.1 home visits prenatally.

Enrollment in Medicaid; the Supplemental Food Program for Women, Infants, and Children (WIC); prenatal care; and Food Stamps increased significantly following admission. Tobacco and alcohol utilization decreased significantly. The self-reported illicit drug use measure was deemed unreliable for analysis. No program impact on pregnancy weight gain was demonstrated.

The mean birthweight of the live singleton births was 3143 g (SD = 543.11). The mean gestation was 39.17 weeks (SD = 2.13). Using multiple regression, the number of home visits did not have a significant impact on birthweight or length of gestation when controlling for other study variables. Possible reasons identified were that the variable did not adequately capture the onset, spacing, or quality of the visits and that the low number of participants admitted in the first trimester decreased the variability of the variable. Missing data decreased sample sizes and precluded inclusion of several key independent variables in the analysis. Trend analysis showed a decline in the black neonatal mortality and low birthweight rates in the first full year of service compared to that predicted from the previous 10 years of rates.

Further research using an experimental design with pre- and post-measurement of stress and social support, participant interviews, and cost effectiveness analysis is recommended. The trends in the neonatal mortality and low birthweight rates should be monitored over the next three to five years.
Notes: Source: Dissertation Abstracts International, Volume: 54-03, Section: B, page: 1357.

Thesis (D.N.S.)--INDIANA UNIVERSITY SCHOOL OF NURSING, 1993.

School code: 0815.