Project Number: R40 MC 06630-03 Project Date: 01/01/2006 Grantee: The Pennsylvania State University Department/Center: Pediatrics
Final Report
Pending
Principal Investigator
Ian M. Paul M.D., M.Sc., Assistant Professor, The Pennsylvania State University Pediatrics, H085 Pediatrics, Postal Office Box 850 Hershey, PA 17033-0850 ipaul@psu.edu
Abstract
Because adherence to postnatal care guidelines is poor, newborns and mothers are often placed at undue risk for adverse medical and social outcomes. This proposal aims to improve health care delivery to and reduce health disparities for "well" newborns and mothers after hospital discharge by using single postnatal home nurse visits. The PI has previously shown a reduction in poor outcomes for infants receiving a home visit after discharge when studied retrospectively. The proposed research will build on his previous study and prospectively evaluate the impact of a single home nursing visit on morbidities and health disparities for at-risk newborns and mothers in a randomized, controlled trial. Outcomes for newborns include hospital readmission, acute care utilization, compliance with primary care visits, and breastfeeding rates. For mothers, confidence in parenting, satisfaction with care, and incidence of postpartum depression will be evaluated. A cost-effectiveness analysis will also be performed. This application addresses 3 of the current MCHB Strategic Research Issues. First, this study seeks to improve health outcomes for minorities and Medicaid recipients while improving compliance with care guidelines, addressing Strategic Research Issue #II that seeks to study health services and systems of care efforts to eliminate health disparities and barriers to health care access. Next, by attempting to show improved health outcomes through the use of a home visit, Strategic Research Issue #III related to quality of care, health care delivery, and use of emergency medical services will be covered. Finally, in addressing the outcomes of postpartum depression and parenting confidence as well as the health outcomes for newborns such as breastfeeding rates, this application also will attend to Strategic Research Issue #IV that promotes healthy development of MCH populations.
Publications
Listed is descending order by year published.
Paul IM, Lehman EB, Suliman AK, Hillemeier MM. Perinatal disparities for black mothers and their newborns in Pennsylvania. Maternal and Child Health Journal, 2007. epub ahead of print, doi 10.1007/s10995-007-0280-6.
Paul IM, Lehman EB, Hollenbeak CS, Maisels MJ. Preventable newborn readmissions in the era of the newborns and mothers Health Protection Act. Pediatrics 2006; 118: 2349-58.
Keywords
Home Visiting for At-Risk Families, Home Visiting Services, Infant Health Services, Infant Morbidity, Breastfeeding, Depression, Community Based Services
