STATE HEALTH DEPARTMENT AND UNIVERSITY EVALUATION OF NORTH-CAROLINA MATERNAL OUTREACH WORKER PROGRAM

Introduction: The Maternal Outreach Worker (MOW) Program is a social s upport intervention using lay helpers to provide support, health educa tion, and outreach to Medicaid eligible women at risk for poor pregnan cy and parenting outcomes. State Health Department and University coll aborators designed a two-pronged evaluation comprised of programwide a nd interview study components to assess the impact of the program on p regnancy outcomes, health behaviors, and infant health status. Methods : Programwide evaluation data are based on 1992-1995 N.C. birth files for the original 24 participating counties and include 1,726 MOW parti cipant births and 12,988 comparison births whose records were linked t o birth files and met the study criteria. For the interview study 373 MOW participants and 332 comparison women were personally interviewed three times: during pregnancy, one month postpartum, and one year afte r delivery. Results: Risk factors associated with poor pregnancy and p arenting outcomes were greater among MOW participants than comparisons in both the programwide and intensive study components. Caucasian MOW participants had slightly higher rates of adequate prenatal care. Afr ican Americans were found to have less adequate prenatal care. Fewer t han expected LBW and VLBW births were observed for African-American MO W participants. MOW Program participation did not affect the utilizati on of health and social services for infants. African Americans, regar dless of whether they received MOW services, fared better than Caucasi ans in terms of having their pregnancy needs fulfilled. Conclusions: F indings show the need to further explore appropriate measures of mater nity support program outcomes and indicate inconsistent program benefi t among subpopulations.