Background
Nurse-Family Partnership (NFP) is a rigorously evaluated home visiting program that serves first-time, low-income mothers. The current study compares perinatal outcomes of NFP participants to matched non-participants and estimates heterogeneous program effects by participant race and ethnicity.
Methods
A cohort of mothers enrolled in NFP between 2009 and 2019 was compared to a comparison group of similarly situated first-time mothers using Texas Department of State Health Services birth record data. We used 1-to-1 coarsened exact matching and matched 10,533 NFP mothers to non-participant mothers based on maternal race and ethnicity, age, education, and other salient characteristics for an overall sample of 21,066 mothers. We compared binomial measures of low birthweight, preterm birth, prenatal care adequacy, and breastfeeding initiation between participant and comparison mothers using logistic regression models. We also estimated the effects of the program separately by participant race and ethnicity for each outcome through subgroup analyses.
Results
NFP participants were significantly more likely to receive adequate prenatal care and attempt breastfeeding than the matched comparison sample. We found no significant differences in the odds of low birthweight or preterm birth between the groups. NFP had significantly stronger positive effects for Black and Hispanic mothers compared to White mothers for prenatal care adequacy. No significant heterogeneous program effects were observed for any other outcomes.
Discussion
The current study overcomes limitations of previous work by leveraging a large, diverse, single-state sample and employing analysis specifically designed to identify heterogeneous NFP effects by race and ethnicity. Findings could have implications for mitigating historical racial and ethnic disparities in perinatal health.
扫码关注我们
求助内容:
应助结果提醒方式:
