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Home visiting programs can improve maternal health literacy for low-income women facing severe social challenges. Consistent support from Registered Nurse Case Managers is a key protective factor for positive life changes.

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Area of Science:

  • Public Health
  • Maternal Health
  • Health Literacy

Background:

  • High-risk, low-income women in the Southern US face significant social and economic challenges impacting maternal health.
  • The Life Course Health Development (LCHD) Model provides a framework for understanding health influenced by risk and protective factors.
  • Maternal health literacy is crucial for navigating complex health systems and achieving positive life changes.

Purpose of the Study:

  • To describe the conditions and dynamics affecting prenatal-interconceptional women in a home visiting program.
  • To evaluate the impact of a program promoting maternal health literacy progression.
  • To identify key factors influencing health outcomes in a vulnerable population.

Main Methods:

  • Retrospective mixed methods study utilizing women's service records (prenatal to 24 months post-delivery).
  • Quantitative measurement of maternal health literacy using the Life Skills Progression Instrument (LSP).
  • Qualitative ethnographic content analysis of visit notes, triangulated with quantitative data and a focus group with Registered Nurse Case Managers (RNCMs).

Main Results:

  • Severe social conditions included poverty, low education, housing instability, incarceration, and lack of insurance.
  • Psychosocial stressors, domestic violence, unemployment, and social restraints were significant dynamics.
  • A consistent, evidence-informed relationship with RNCMs emerged as a critical protective factor.

Conclusions:

  • Home visiting programs can facilitate positive life changes by addressing social conditions and dynamics.
  • Promoting maternal health literacy is essential for empowering women to navigate challenges.
  • The RNCM relationship is vital for supporting health literacy progression and improving outcomes.