Year of Publication

2021

College

Public Health

Date Available

5-17-2021

Degree Name

Master of Public Health (M.P.H.)

Committee Member

Dr. Jerod Stapleton

Advisor

Dr. Corrine Williams

Co-Director of Graduate Studies

Dr. Angela Carman

Abstract

Hamilton County Ohio currently has poor outcomes related to maternal and infant health, specifically among African Americans. Compared to the Healthy People 2020 goals, Hamilton County has higher rates of infant mortality, preterm birth, neonatal infant mortality, and conception within 18 months of previous pregnancies. These rates are disproportionate among African Americans. For instance, African American babies born in Ohio have higher infant mortality rate (14.3 per 1,000) prematurity as a cause of death (4 per 1,000) and neonatal mortality rate (9.2 per 1,000). These are compared to White babies in Ohio with infant mortality rate (5.1 per 1,000), prematurity as a cause of death (1.4 per 1,000) and neonatal mortality rate (3.4 per 1,000). Similar disparities among maternal health is seen between Black and White women. In order to address these disparities in maternal and infant health, we are proposing a 3 year evidence-based nurse home visitation program that will decrease modifiable risk factors that pertain to poor birth outcomes, decrease modifiable risk factors that pertain to child abuse and neglect, and to help with the parental life course in ways of helping maternal life development in education and the workforce, and decreasing rapid successive pregnancies. This nurse home visitation program has shown great success across the country and we hope to bring it to Hamilton County. Women in the program must be enrolled at or before 28 weeks of pregnancy, and will spend 60-90 minutes with nurses in the homes focusing on the six domains of home visitation (personal health, environmental health, life course development, maternal role, family and friends, and health and human services). Recruitment of participants will occur at the Hamilton County Health Department, Planned Parenthood, and the OBGYN offices of UC Health, Mercy Health and TriHealth. Process evaluations will occur during recruitment and implementation of the program. Outcome evaluations will include questionnaires and biometric data to access our goals of the program. Short term outcomes include having mothers complete the program, mothers receive adequate prenatal care, they deliver full term and appropriate gestational weight babies, and they have knowledge of relaxation and stress relieving techniques. Our medium term outcomes include increasing knowledge of proper prenatal care, increase the knowledge of proper childcare, and mothers better care for their children. Finally, our long term goals for this program include lowering the rates of maternal and infant mortality, lowering the rates of child abuse and neglect, and bettering the lives of the mothers.

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