A Methodological Approach for Evaluating the Enterprise Community Healthy Start Program in Rural Georgia: An Analysis...

Area of Science:

• Public Health
• Maternal and Child Health
• Health Services Research

Background:

• Community Healthy Start program evaluations often lack robust data and rigorous designs.
• This study introduces an enhanced methodological approach for evaluating such programs.
• The approach utilizes local program data linked with population-level datasets for external comparison.

Purpose of the Study:

• To evaluate the Enterprise Community Healthy Start (ECHS) program in two rural Georgia counties.
• To describe an enhanced methodological approach for program evaluation.
• To assess the association between ECHS participation and maternal health indicators and pregnancy outcomes.

Main Methods:

• Linked ECHS program data with birth records and the Pregnancy Risk Assessment Monitoring System (PRAMS).
• Included 869 women who delivered live births in Burke and McDuffie counties (2010-2011).
• Employed multivariate logistic regressions with and without propensity score methods.

Main Results:

• ECHS participants had a positive association with receiving adequate or adequate plus prenatal care (p < 0.05).
• No statistically significant associations were found for other health behaviors, healthcare access, or pregnancy outcomes.
• Propensity score weighting yielded similar results to unweighted models.

Conclusions:

• Rigorous evaluation of local Healthy Start programs is feasible using linked PRAMS and birth records.
• This enhanced approach, incorporating population-based external comparison and propensity scores, can be applied in other jurisdictions.
• The findings support the effectiveness of the ECHS program in improving prenatal care access.