Healthy start program and feto-infant morbidity outcomes: evaluation of program effectiveness.
OBJECTIVE
We evaluate the impact of the Healthy Start intervention program on feto-infant morbidity within a community setting.


METHODS
Prospective data from 2002 to 2007 within the ongoing Federally funded Healthy Start intervention project in Central Hillsborough County were merged with corresponding birth outcomes data from the Florida Department of Health. The impact of the project on the following feto-infant morbidity indices was assessed among service recipients: low birth weight (LBW), very low birth weight (VLBW), preterm, very preterm, small for gestational age (SGA) and a composite feto-infant morbidity outcome. Program effectiveness and impact were measured using odds ratios from logistic regression models and number needed to treat (NNT).


RESULTS
The risk for low birth weight (OR = 0.7; 95% CI = 0.5-1.0), preterm (OR = 0.7; 95% CI = 0.5-0.9) and the composite feto-infant morbidity outcome (OR = 0.8; 95% CI = 0.6-0.9) was reduced among service recipients (N = 536) as compared to non-recipients (N = 2,815). A clinically important level of risk reduction was also noted for very low birth weight (OR = 0.5; 95% CI = 0.2-1.1) and very preterm (OR = 0.6; 95% CI = 0.3-1.2) although these did not reach statistical significance. The adjusted NNT was lowest for the composite feto-infant morbidity outcome (18), preterm birth (21) and low birth weight (24), and highest for very preterm (86) and very low birth weight (74) events.


CONCLUSIONS
In a disadvantaged community setting, the Healthy Start intervention program was found to reduce the risk for very low birth weight and preterm births by about one-third.
Salihu
Hamisu M
HM
Center for Research and Evaluation, Lawton and Rhea Chiles Center for Healthy Mothers and Babies, University of South Florida, 3111 E. Fletcher Avenue, Tampa, FL 33613, USA. hamisu.salihu@gmail.com
Mbah
Alfred K
AK
Jeffers
Delores
D
Alio
Amina P
AP
Berry
Lo
L
D000328:Adult; D015992:Body Mass Index; D005260:Female; D005315:Fetal Diseases / Q000453:epidemiology*; D005865:Gestational Age; D006293:Health Promotion; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology*; D016730:Program Development; D015397:Program Evaluation; D055815:Young Adult