Use of home visit and developmental clinic services by high risk Mexican-American and white non-Hispanic infants.
OBJECTIVE
To investigate whether US-born infants of mothers of Mexican descent who were enrolled in Arizona's Newborn Intensive Care Program (NICP) received follow-up services (developmental clinic and community health nurse [(CHN)] home visits) at the rates similar to White non-Hispanic (WNH) infants. Socio-economic and health status characteristics were controlled using stepped regressions in order to assess the impact of each on service use.


METHODS
This population-based study used retrospective data from the NICP administrative database that were linked to birth certificates for years 1994-1998. The study population was limited to Arizona-born infants; it included 7442 infants of WNH mothers, 2612 infants of US-born Mexican American (MA) mothers and 2872 infants of Mexico-born mothers. Four service use indicators were used in the analysis.


RESULTS
Both Hispanic infant subgroups were less likely to have a CHN visit by 6 months and by 1 year, and to average fewer CHN visits. A smaller percent attended the developmental clinic by age one. After controlling for language, demographics, health status, socio-economic characteristics, and mothers' prenatal care use, infants of US-born MA mothers had rates of use similar to WNH. However, even after controlling for the study variables, infants of Mexico-born mothers were less likely (OR = .83) to use the developmental clinic. Hispanics continued to lag behind in the use of services compared with WNHs. The disparity is not a function of ethnicity, but appears attributable to demographic and socio-economic characteristics. Infants who had a CHN visit were significantly more likely (OR = 2.51) to use the developmental clinic than those without a nurse visit. Infants whose mothers had inadequate prenatal care were less likely to use these follow-up services even after controlling for study variables.


CONCLUSIONS
Infants whose mothers had inadequate prenatal care should be targeted for more intense CHN visits. Infants of mothers born in Mexico may need additional support/assistance in using the developmental clinic.
Moore
Patricia D
PD
College of Nursing, Arizona State University, Tempe, Arizona 85287, USA. patricia.moore@asu.edu
Bay
R Curtis
RC
Balcazar
Hector
H
Coonrod
Dean V
DV
Brady
Jane
J
Russ
Robert
R
D000328:Adult; D001130:Arizona; D001719:Birth Certificates; D002662:Child Health Services / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008423:Maternal Age; D017058:Mexican Americans; D008800:Mexico / Q000208:ethnology; D009035:Mothers; D012044:Regression Analysis; D012923:Social Class