Maternal and Child Health Research Program

Advancing Applied MCH Research

Single Home Visits to Improve Health Outcomes

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Project Number: R40 MC 06630-03
Grantee: The Pennsylvania State University
Department/Center: Pediatrics
Project Date: 01/01/2006

Final Report

Single Home Visits to Improve Health Outcomes Final Report (PDF) Exit Disclaimer

Principal Investigator

Ian M. Paul, M.D., M.Sc.
Assistant Professor
H085 Pediatrics, Postal Office Box 850
Hershey, PA  17033-0850
Phone: (717) 531-8006
Email: ipaul@psu.edu

Age

  • Maternal
  • Infancy (0-12 months)

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.

Beiler JS, Schaefer EW, Alleman N, Paul IM. Newborn Anticipatory Guidance Delivered at Office-based vs. Home Nurse Visits. J Community Med Health Educ. 2013; 3: 228. doi:10.4172/2161-0711.1000228

Bartok CJ, Schaefer EW, Beiler JS, et al. Role of body mass index and gestational weight gain in breastfeeding outcomes. Breastfeeding Medicine. 2012;7(6):448-456.

Camacho FT, Weisman CS, Anderson RT, Hillemeier MM, Schaeffer EW, Paul IM. Development and validation of a scale measuring satisfaction with maternal and newborn healthcare following childbirth. Maternal Child Health J 2012; 16: 997-1007.

Paul IM, Beiler J, Schaefer E, Hollenbeak CS, Alleman N, Sturgis SA, Yu S, Camacho FT, Weisman CS. A randomized trial of nurse home visits vs. office-based care after nursery/maternity discharge. Arch Ped Adolesc Med 2012; 166: 263-270.

Paul IM, Lehman EB, Widome R. Maternal tobacco use and shorter newborn nursery stays. Am J Prev Med. 2009; 37(2S):S172-S178.

Paul IM, Lehman EB, Suliman AK, Hillemeier MM. Perinatal disparities for black mothers and their newborns. Matern Child Health J. 2008; 12:452-60. Epub 2007 Aug 22.

Paul IM, Lehman EB, Hollenbeak CS, Maisels MJ. Preventable newborn readmissions since passage of the Newborns' and Mothers' Health Protection Act. Pediatrics. 2006 Dec;118(6):2349-58.

Keywords

Home Visiting, Depression, Breastfeeding, Health Disparities, Postpartum, Parenting

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