Benefits of Nurse-Community Health Workers for Low-income Mothers

In Maternal Perceptions of Help From Home Visits by Nurse–Community Health Worker Teams, published in the American Journal of Public Health, authors Lee Anne Roman, et al, explored how low-income mothers perceive the type of help they receive in home visits, whether mothers’ perceptions of help are consistent with program evaluations, or whether there are differences in perceptions of help based on type of home visiting provider.

The authors developed a nurse–community health worker (CHW) team intervention in the context of a Medicaid, state-sponsored enhanced prenatal and infant services (EPS) home visiting program in Michigan. Given low enrollment in EPS during pregnancy (only 28% of Medicaid-enrolled women in Michigan participated in EPS), the team intervention was designed to use CHWs to improve engagement, increase service delivery, and address stress and mental health. Trained CHWs used empowerment strategies to provide intensive, relationship-based support; deliver health education; and help with service navigation. The team model was tested in a trial comparing usual community care (CC)—that is, EPS delivered by nurses—and EPS delivered by a nurse–CHW team.

In both the nurse–community health worker (CHW) group and the community care (CC) group, more mothers endorsed “gave you things to read when you wanted to know something,” “helped you learn about child development,” and “taught about birth control” than other types of help. More mothers in the nurse–CHW group than in the CC group reported receiving help in all of the categories assessed. For both groups, assistance with health education ranked highest among the types of assistance received. A higher percentage of women in the nurse–CHW group than the CC group reported that they received psychosocial help.

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