Selected Findings from the Cross-Site Evaluation of the Federal Healthy Start Program
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Selected Findings from the Cross-Site Evaluation of the Federal Healthy Start Program Vonna Lou Caleb Drayton • Deborah Klein Walker Sarah W. Ball • Sara M. A. Donahue • Rebecca V. Fink
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Ó Springer Science+Business Media New York 2014
Abstract Initiated in 1991, the Federal Healthy Start Program includes 105 community-based projects in 39 states, the District of Columbia and Puerto Rico. Healthy Start projects work collaboratively with stakeholders to ensure participants’ continuity of care during pregnancy through 2 years postpartum. This evaluation of Healthy Start projects examined relationships between implementation of nine core service and system program components and improvements in birth and project outcomes. Program components and outcomes were examined using data from a 2010 Healthy Start project director (PD) survey (N = 104 projects) and 2009 performance measure data from the Maternal and Child Health Bureau Discretionary Grant Information System (N = 98 projects). We explored bivariate relationships between the nine core program components and (a) intermediate and long-term project outcomes and (b) birth outcomes. We assessed independent associations of implementation of all core program components with birth outcomes, adjusting for project characteristics and activities. In 2010, 57 projects implemented all V. L. C. Drayton (&) Booz Allen Hamilton, One Preserve Parkway, Rockville, MD 20852, USA e-mail: [email protected] D. K. Walker S. W. Ball S. M. A. Donahue R. V. Fink Abt Associates, 55 Wheeler Street, Cambridge, MA 02138-1168, USA e-mail: [email protected] S. W. Ball e-mail: [email protected] S. M. A. Donahue e-mail: [email protected] R. V. Fink e-mail: [email protected]
nine core program components: 104 implemented all five core service components and 69 implemented all four core systems components. Implementation of all core program components was significantly associated with several PDreported intermediate and long-term project outcomes, but was not associated with singleton low birth weight or infant mortality among participants’ infants. This evaluation revealed a mixed set of relationships between Healthy Start projects’ implementation of the core program components and achievement of project outcomes. Although the findings demonstrated a positive impact of Healthy Start projects on birth outcomes, only a few associations were statistically significant. Keywords Maternal and child health Healthy Start Program Cross-site evaluation Program evaluation
Introduction The Federal Healthy Start Program began in 1991 as a response to high infant mortality rates (IMR) in the United States as well as the large gap in these rates between white and non-white infants. The first Healthy Start projects were funded as demonstration sites in 15 communities with IMR 1.5–2.5 times the national average. By 2012, the program had expanded in size and mission to include 105 projects in 39 states, the District of Columbia and Puerto Rico, including projects in
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