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BACKGROUND: Home visiting programs have gained momentum with the recent re-appropriation of federal funds for states to implement evidence-based maternal and child health home visiting programs. Virginia will be implementing several evidence-based models and evaluating the effectiveness of home visiting. However, currently, the effects of having a home visit by a health care worker or trained lay outreach worker are unknown at the state level.
METHODS: Using cross-sectional data from the 2007-2011 Virginia Pregnancy Risk Assessment Monitoring System (PRAMS), several maternal and infant health outcomes were examined. Women who reported receiving a home visit by a healthcare worker or nurse during pregnancy on the PRAMS survey were assigned into the Home Visiting (HV) participation group. Women who did not have a home visit, but had risk factors similar to participants, were assigned to the comparison group. Multivariate logistic regression was used to measure the association between HV and the selected birth outcomes of interest. Characteristics of the HV participation and comparison groups were compared using chi-square tests and statistically significant differences were accounted for in the final adjusted models.
RESULTS: Controlling for socioeconomic status and selected maternal characteristics, women who had a home visit by a healthcare worker or nurse during pregnancy showed a 87.5% reduction in the risk of having a low birth weight infant [0.13, 95% CI: (0.02, 0.78)], a 4.5 times greater odds of initiating breastfeeding [AOR: 4.50 95% CI: (1.05, 19.54)], and a 38.6 times greater odds of using contraceptives postpartum [AOR: 38.55, 95% CI: (3.14, 473.21)] than women in the comparison group.
CONCLUSIONS: Receiving home visiting services during pregnancy increased breastfeeding initiation and postpartum contraceptive use and reduced the risk of low birth weight.