Impact of nurse home visiting on take-up of social safety net programs in a Medicaid population.

Abstract

Childhood poverty can affect health and development across the life course. Access to social safety net programs may alleviate poverty-related hardships like food insecurity among low-income families, yet many eligible households do not enroll. We used a randomized controlled trial (n = 5670) to evaluate the impact of the Nurse-Family Partnership (NFP) home visiting program during pregnancy and the first 2 years after delivery on take-up of social programs including the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Supplemental Nutrition Assistance Program (SNAP). The NFP services were funded as part of a Medicaid Section 1915(b) waiver in South Carolina. We found that NFP participants were more likely to be enrolled in SNAP or WIC during pregnancy (87.8% vs 86.0%) and were enrolled in SNAP for 0.6 months longer in the first 2 years after delivery than control participants. Nurse home visiting moderately increased take-up of social safety net programs in pregnancy and the first years of life, even in a context with already high rates of participation. This study contributes important evidence on the effectiveness of Medicaid-funded initiatives for addressing social needs of low-income families.

Clinical trial registration: ClinicalTrials.gov; ID NCT03360539 (https://clinicaltrials.gov/study/NCT03360539).