BACKGROUND: In 1994, the Wyoming Legislature mandated Public Health Nursing (PHN) provide home visitation to eligible pregnant women and new mothers. The legislation sites specific criteria for prioritization of services including: Medicaid or WIC enrollment, domestic violence, teens, and substance use. PHN provides this service to women through a homegrown nurse home visitation program, Best Beginnings (BB). In 2014, the BB database was upgraded to track longitudinal data for women throughout program participation. This new data system improved tracking of the population served.
METHODS: We used data from the BB database on maternal intake, assessment, and prenatal and postnatal visits from fiscal year (FY) 2015 (August 7, 2014-June 30, 2015) to describe the BB population based on the criteria established in the legislation. Analysis will benefit practices of PHN recruitment. We included women who had at least one intake, assessment, and visit during the study timeframe. Descriptive statistics were conducted using SAS 9.2 to evaluate demographic characteristics, specifically related to the eligible population described in the legislation including teen mothers, and Medicaid and WIC clients.
RESULTS: In FY15, 5,411 women were referred to PHN for home visitation. Wyoming PHN served 1,149 through BB; 21.2% of all women referred. Prenatally, 534 women received visits, 912 women received postnatal visits, and 184 received both prenatal and postnatal visits. Among women receiving a home visit, 32.6% were enrolled in WIC, 37.9% were enrolled in Medicaid, and 18.8% were uninsured at the time of referral. In the assessment, nearly half of women (47.4%) had a high school education or less, 27.1% of women were less than 20 years old and 3.1% of women reported a partner or ex-partner pushed, hit, choked, kicked or slapped her in the last 12 months. At the time of the first prenatal visit, 15.1% of pregnant women reported smoking and 3.8% reported using alcohol.
CONCLUSIONS: Wyoming’s upgrade to the BB system enables collection and reporting on client characteristics related to the home visiting legislation. Additionally, this information can be used to improve client recruitment and ensure high need clients are receiving necessary services. Additional analysis of newly available data from the BB database on maternal and infant outcomes and operational data will further benefit the activities of PHN.