Intermediate Outcomes Strategies and Challenges of Eight Healthy Start Projects

Autor: Margo Rosenbach, Deborah Klein Walker, Margaret Hargreaves, Andrea Brand
Rok vydání: 2010
Předmět:
Program evaluation
medicine.medical_specialty
Outreach
Epidemiology
Culture
Pilot Projects
Infant mortality
Risk Assessment
jel:I
Article
Case management
Infant Mortality Health Disparities Consumer Voice Cultural Competence
Nursing
Systems development
Obstetrics and Gynaecology
medicine
Humans
Maternal Health Services
Pediatrics
Perinatology
and Child Health
Service (business)
Medical education
business.industry
Public health
Community Participation
Infant
Newborn
Public Health
Environmental and Occupational Health
ComputingMilieux_PERSONALCOMPUTING
Infant
Obstetrics and Gynecology
Cultural competence
Health Status Disparities
United States
Health equity
Consumer voice
Health education
Action plan
Pediatrics
Perinatology and Child Health
Health disparities
InformationSystems_MISCELLANEOUS
business
Consortium
Program Evaluation
Infant Mortality
Health Disparities
Consumer Voice
Cultural Competence
Zdroj: Maternal and Child Health Journal
Popis: Site visits were conducted for the evaluation of the national Healthy Start program to gain an understanding of how projects design and implement five service components (outreach, case management, health education, depression screening and interconceptional care) and four system components (consortium, coordination/collaboration, local health system action plan and sustainability) as well as program staff's perceptions of these components' influence on intermediate outcomes. Interviews with project directors, case managers, local evaluators, clinicians, consortium members, outreach/lay workers and other stakeholders were conducted during 3-day in-depth site visits with eight Healthy Start grantees. Grantees reported that both services and systems components were related to self-reported service achievements (e.g. earlier entry into prenatal care) and systems achievements (e.g. consumer involvement). Outreach, case management, and health education were perceived as the service components that contributed most to their achievements while consortia was perceived as the most influential systems component in reaching their goals. Furthermore, cultural competence and community voice were overarching project components that addressed racial/ethnic disparities. Finally, there was great variability across sites regarding the challenges they faced, with poor service availability and limited funding the two most frequently reported. Service provision and systems development are both critical for successful Healthy Start projects to achieve intermediate program outcomes. Unique contextual and community issues influence Healthy Start project design, implementation and reported accomplishments. All eight projects implement the required program components yet outreach, case management, and health education are cited most frequently for contributing to their perceived achievements.
Databáze: OpenAIRE
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