CONCLUSIONS: Widening disparities in SMM during the pandemic were only observed in the most deprived neighborhoods, rather than being universally prevalent across neighborhood contexts. Community-engaged solutions are needed to improve neighborhood conditions and reduce maternal health inequities during times of crisis.
Home Visiting to Prevent Unintended Pregnancies
No abstract
CONCLUSIONS: A statewide Medicaid-sponsored home visiting program achieved high rates of service coverage in highly deprived neighborhoods. Program participation may help to mitigate the negative relationship between neighborhood polarization and birth outcomes, and more so among Black inpiduals. Continued support for home visiting services is required to better engage birthing inpiduals in neighborhoods with concentrated deprivation and to decrease disparities.
Severe Maternal Morbidity Disparities Before and During the COVID Pandemic in a Medicaid Population
This study assessed racial and ethnic disparities in severe maternal mortality during delivery through 6 weeks postpartum, before and during the COVID pandemic, in a statewide Medicaid population. This retrospective, population-based, cohort study used Medicaid claims data linked to birth certificates from the Michigan Department of Health and Human Services Health Services Data Warehouse that included all inpiduals giving birth between January 1, 2017, and October 31, 2021, in Michigan who...
CONCLUSIONS: An HV program provided by CHWs working with nurses and social workers was associated with an increase in penetration and dosage in segregated neighborhoods, compared with HV without CHW involvement. This underscores the value of CHWs partnering with licensed professional workers in improving HV engagement in disadvantaged communities.
Neighborhood Deprivation and Severe Maternal Morbidity in a Medicaid Population
CONCLUSIONS: Neighborhood deprivation may be used as an effective tool to identify at-risk inpiduals within a low-income population. Community-engaged interventions aiming at improving neighborhood conditions may be helpful to reduce both SMM prevalence and racial inequity in SMM.
CONCLUSIONS AND RELEVANCE: Participation in a home visiting program provided by community health workers working with nurses and social workers, compared with usual care, was associated with reduced risk for adverse birth outcomes, improved prenatal and postnatal care, and reductions in disparities, among birthing inpiduals with Medicaid. The risk reductions in adverse birth outcomes were greater among Black inpiduals.
Breaking Barriers to Rapid Whole Genome Sequencing in Pediatrics: Michigan's Project Baby Deer
The integration of precision medicine in the care of hospitalized children is ever evolving. However, access to new genomic diagnostics such as rapid whole genome sequencing (rWGS) is hindered by barriers in implementation. Michigan's Project Baby Deer (PBD) is a multi-center collaborative effort that sought to break down barriers to access by offering rWGS to critically ill neonatal and pediatric inpatients in Michigan. The clinical champion team used a standardized approach with inclusion and...
CONCLUSION: This study is among the first to examine effects of any multilevel intervention on AA severe maternal morbidity and mortality. It features a rigorous quasi-experimental design, multilevel multi-partner county-wide interventions developed by community partners, and assessment of intervention effects using population-level data.
Successful Strategies to Increase Cessation Rates Among Low-Income Maternal Smokers
No abstract
CONCLUSIONS: A population systems approach improved selected enhanced prenatal care participation and service utilization for Medicaid-insured women in a county population, those in practices with established clinical-community linkages, and Black women.
CONCLUSIONS: The FCHES research funding yields significant direct economic impacts above and beyond the direct NIH investment of $11 million. The economic impact estimation method may be relevant and generalizable to other large research centers such as FCHES.
OBJECTIVES: Evaluating population health initiatives at the community level necessitates valid counterfactual communities, which includes having similar population composition, health care access, and health determinants. Estimating appropriate county counterfactuals is challenging in states with large intercounty variation. We describe an application of K-means cluster analysis for determining county-level counterfactuals in an evaluation of an intervention, a county perinatal system of care...
CONCLUSIONS: Clinical-community linkages can significantly improve participation of Medicaid-insured women in an evidence-based home visiting program and other prenatal services. This work is important because health providers are looking for ways to create clinical-community linkages.
Is a school's neighborhood physical disorder related to its academic outcomes?
CONCLUSIONS: This study supplements existing literature by focusing on neighborhood physical disorder at the school. We found evidence that school neighborhood may impact academic achievement. These findings complement previous research showing that neighborhood of residence factors, such as structural disadvantage, impact school performance. Students exposed to economically disadvantaged neighborhoods at school, regardless of where they live, may have poorer academic skills.
CONCLUSIONS: More than one-third of pregnant Romanian women appear to believe that smoking 'a few' cigarettes during pregnancy is safe for them and their fetuses. Those who are told by their health-care providers that it is acceptable to smoke in small amounts during pregnancy have higher odds of perceiving smoking 'a few' cigarettes during pregnancy as safe compared with other pregnant Romanian women.