Impact of a mobile van on prenatal care utilization and birth outcomes in Miami-Dade County.
The study aimed to determine if there was a difference in prenatal care utilization and birth outcomes among demographically similar women who used or did not use a mobile van for prenatal care. Mothers who utilized the mobile van at least one time for their prenatal care and delivered between August 2007 through September 2008 were considered the Mobile group (n = 182) and a Comparison group of the same size who delivered within the same time period was randomly matched by sociodemographic characteristics. Birth data was obtained from Florida Department of Health Office of Vital Statistics and from the mobile clinic's Health Management System (HMS) database. Nearly 95% of mothers in both groups were foreign born, with the majority from Mexico. The evaluation of prenatal care showed that there was a significant difference (P = 0.0006) in the trimester in which mothers began care. Both the Kessner (P = 0.0003) and Kotelchuck (<0.0001) Indices demonstrated a statistically significant difference in that more mothers in the Mobile group had adequate care. Birth weight distribution did not reveal a statistically significant difference (P = 0.0911) however the Mobile group did have a lower percentage of low birth weight infants (4.4% vs. 8.8%). There was a statistically significant difference in the amount of pre-term births (P = 0.0492) between the groups. The results suggest that a mobile van can be used to improve both early access to adequate prenatal care as well as birth outcomes such as prematurity.
O'Connell
Erin
E
Miami-Dade County Health Department, Epidemiology Disease Control and Immunization Services, 8600 NW 17th Street, Suite 200, Miami, FL 33126, USA. Erin_OConnell@doh.state.fl.us
Zhang
Guoyan
G
Leguen
Fermin
F
Prince
Jennifer
J
D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D000013:Congenital Abnormalities / Q000453:epidemiology / Q000208:ethnology; D054242:Emigrants and Immigrants; D005260:Female; D005431:Florida; D005865:Gestational Age; D006630:Hispanic or Latino; D006801:Humans; D007231:Infant, Newborn; D008423:Maternal Age; D008484:Medicaid; D008952:Mobile Health Units / Q000706:statistics & numerical data*; D011204:Poverty Areas; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology* / Q000208:ethnology; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
N Engl J Med. 1994 Nov 10;331(19):1303-7
7935689
J Leg Med. 1992 Sep;13(3):271-332
1402383
Am J Public Health. 1996 Mar;86(3):394-6
8604766
Public Health Rep. 1994 Sep-Oct;109(5):647-52
7938385
Matern Child Health J. 1999 Mar;3(1):39-52
10728288
J Health Care Poor Underserved. 2000 May;11(2):243-57
10793518
JAMA. 1992 Apr 22-29;267(16):2204-8
1556798
J Obstet Gynecol Neonatal Nurs. 2004 Nov-Dec;33(6):783-90
15561667
Arch Dis Child Fetal Neonatal Ed. 2002 Jan;86(1):F4-6
11815538
Public Health Rep. 1996 Sep-Oct;111(5):408-18; discussion 419
8837629
Obstet Gynecol. 2007 Apr;109(4):813-22
17400841
Matern Child Health J. 2007 May;11(3):235-9
17243022
Am J Obstet Gynecol. 2000 Jan;182(1 Pt 1):233-9
10649184
J Pediatr Health Care. 1994 Jan-Feb;8(1):12-7
8120776
Future Child. 1995 Spring;5(1):103-20
7633858