|Health Factors:||Access to Care|
|Decision Makers:||Healthcare Professionals & Advocates Nonprofit Leaders|
|Population Reach:||<1% of WI's population|
|Impact on Disparities:|
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Grady Memorial Hospital’s interpregnancy care program served black women in the Atlanta area who had recently delivered a very low birthweight infant. Participants received case management, care coordination, and medical care including reproductive care, oral health services, and chronic disease management, as well as treatment and referral for alcohol, tobacco, and substance abuse. A medical provider educated patients about the health benefits of spacing pregnancies, and helped them develop reproductive plans. Trained laypeople called Resource Mothers also visited patients’ homes to assist with psychosocial stressors, life skills, parenting, employment, and housing and relationship issues. Services were provided for 24 months or until a subsequent pregnancy (Biermann 2006, Dunlop 2008).
Grady Memorial Hospital’s model of interpregnancy care is a suggested strategy to increase access to care and improve subsequent birth outcomes for women with previous adverse birth outcomes (March of Dimes-Pregnancy). Available evidence suggests that such care may reduce rates of stillbirth and low birthweight births (Dunlop 2008, Kent County 2010), reduce the likelihood of closely spaced pregnancies, increase identification of chronic conditions, and improve acquisition of life skills (Dunlop 2008). However, additional evidence is needed to confirm effects.
The Grady Memorial Hospital intervention originally cost $2,397 per participant (Dunlop 2008). In Michigan’s Kent County Infant Health Initiative, partially modeled on Grady’s approach, potential treatment costs for infants with poor birth outcomes far outweighed program expenditures (Kent County 2010).
Many programs are modeled after or similar to Grady Memorial Hospital’s interpregnancy care program. Examples of these programs include the Louisiana Birth Outcomes Initiative’s Healthy Start New Orleans Project (CWF-Foubister 2013), the Kent County Infant Health Initiative in Michigan (Kent County 2010), Christiana Care Healthy Beginnings in Delaware (Kroelinger 2008), the Mississippi Interpregnancy Care Project, and the Internatal Care Program in Arizona (AMCHP-EPBP).
Preliminary results from an evaluation of the Healthy Start New Orleans Inter-Pregnancy Care project indicate that such programs must consider patients’ clinical and socioeconomic needs when determining how to effectively deliver care (Venturanza 2014).
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