Abstract
Introduction
The THRIVE (Toward Health Resiliency and Infant Vitality & Equity) program aims to reduce racial disparities in birth outcomes by addressing individual risks and social determinants of health using the Pathways Community HUB model. This study examines (1) racial disparities among THRIVE participants and propensity score matched (PSM) comparisons in adequacy of prenatal care, and whether THRIVE participation (2) attenuates such disparities, and (3) improves odds of having adequate prenatal care.
Methods
Birth certificate and Care Coordination Systems client data were merged for analysis. PSM was employed for 1:1 matching per birth year (2017–2020) and race for participating and non-participating first-time births in Stark County, Ohio. Additional matching variables were age, marital status, education attainment, birth quarter, census tract poverty rate, and Women Infant & Children (WIC) enrollment. Logistic regression assessed racial differences in adequate prenatal care utilization (APNCU) and examined differences between the intervention and comparison groups on APNCU.
Results
THRIVE participants averaged more prenatal care visits and had a higher percentage of adequate care utilization than the comparison group. THRIVE program participation, educational attainment, and WIC enrollment were associated with higher odds of adequate prenatal care utilization (OR 4.74; 95% CI 2.62, 8.57). Race was not significant for APNCU.
Discussion
Although accessing and maintaining prenatal care is only one aspect of improving birth outcomes, the findings contribute to the understanding of the effects of the program of interest and other similar programs on factors which may promote desired birth outcomes in high-risk populations.
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Data Availability
(data transparency): Data are not publicly available. Authors received access to data under a data use agreement with the Canton City Health Department and are prohibited from further disclosure.
Code Availability
(software application or custom code): IBM SPSS Statistics for Windows, version 27 was used for data management, propensity score matching and logistic regression analysis. Syntax is available upon request.
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Acknowledgements
The evaluation of THRIVE is funded by the Sisters of Charity Foundation of Canton. The authors would like to thank the Canton City Health Department, especially Dawn Miller and Jessica Boley. Finally, we would like to thank Peter Leahy.
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Sisters of Charity Foundation, Canton, Ohio.
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BL contributed to the full manuscript drafting and editing. SA conducted the data analysis and interpretation, manuscript drafting, and editing. AE assisted with the data analysis consultation/interpretation and manuscript editing. LF conducted the manuscript drafting, editing, and contributed to the data analysis interpretation. All authors reviewed and approved the final version.
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The authors receive funding from the Sisters of Charity Foundation to perform evaluation services for the THRIVE program directed by the Canton City Health Department.
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Approved by Kent State Institutional Review Board, protocol #17–155.
Consent to Participate
Data for these analyses are from two unique sources. The first source is the Care Coordination System (CCS) for individuals who are enrolled in the THRIVE program. THRIVE participants complete a consent form to participate in the program and to have their information entered into the CCS system. The THRIVE program requested a waiver of Kent State University informed consent due to paperwork burden, which was granted by the Kent State University IRB #17–155 Amendment 4, dated November 29, 2017. Data from the CCS system are provided via a data use agreement with the Canton City Health Department in which a limited data set is provided to the researchers/authors for evaluation purposes. The second source is Ohio Department of Health (ODH) Stark County Vital Statistics Birth Files (birth certificate data). Data from this system are provided via a data use agreement with the Canton City Health Department in which a limited data set is provided to the researchers/authors for the purpose of evaluating participants’ and non-participants’ birth outcomes.
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(consent statement regarding publishing an individual’s data or image): We are not reporting individual-level data for this manuscript. All data received are via a data use agreement and are in the form of a limited data set.
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Lanese, B.G., Abbruzzese, S.A.G., Eng, A. et al. Adequacy of Prenatal Care Utilization in a Pathways Community HUB Model Program: Results of a Propensity Score Matching Analysis. Matern Child Health J 27, 459–467 (2023). https://doi.org/10.1007/s10995-022-03522-2
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DOI: https://doi.org/10.1007/s10995-022-03522-2