An Evaluation of the Pathways Community HUB Approach To Improving Birth Outcomes: A Retrospective Study Using Propensity Score Matching in Richland, Ohio.

IF 1.7 4区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Maternal and Child Health Journal Pub Date : 2025-10-01 Epub Date: 2025-09-11 DOI:10.1007/s10995-025-04172-w

Edward T Chiyaka, Vinay K Cheruvu, John A Hoornbeek

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引用次数: 0

Abstract

Introduction: Low birth weight (LBW) is one of the most important factors affecting neonatal mortality and is a determinant of post-neonatal mortality. This study aimed to assess the effectiveness of the Pathways Community HUB Institute^® Model (PCHI^® Model) in improving birth outcomes among high-risk pregnant women.

Methods: In this retrospective study, data were drawn from the Pathways Community HUB Program (Community Health Access Project - CHAP) in Richland, Ohio, and the Ohio Department of Health from 2014 to 2017. We employed a 1:1 nearest neighbor propensity score matching for 315 participating and 315 non-participating women and used conditional logistic regression to analyze our data. The pregnancy outcomes we assessed included preterm birth and birth weight.

Results: The incidence of LBW in the Community Health Access Program (CHAP) group was 8.6% compared to 12.4% in the non-CHAP group. CHAP participants had a 43% lower chance of low birth weight births (OR = 0.572, 95% CI = 0.335-0.979), while the program's effect on preterm delivery approached but did not achieve statistical significance (OR = 0.640, 95% CI = 0.407-1.007). We also found that those who entered the CHAP program and those who had their first prenatal care appointment in the first trimester of their pregnancies were less likely to deliver a LBW infant than those who entered the program and had their first prenatal care appointment later in their pregnancies.

Conclusions: Among high-risk pregnant women, the PCHI^® Model can significantly improve prenatal care utilization and reduce the incidence of LBW infants. In addition, pregnant women participating in the Pathways Community HUB program appeared to benefit more if they entered the program in their first trimester rather than later in their pregnancy, suggesting that longer durations of program participation are associated with better birth outcomes.

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评价途径社区中心方法改善出生结果：在俄亥俄州里奇兰使用倾向评分匹配的回顾性研究。

低出生体重（LBW）是影响新生儿死亡率的最重要因素之一，也是新生儿后期死亡率的决定因素。本研究旨在评估Pathways社区中心研究所®模型（PCHI®模型）在改善高危孕妇分娩结局方面的有效性。方法：在这项回顾性研究中，数据来自2014年至2017年俄亥俄州里奇兰市的Pathways社区HUB计划（社区卫生获取项目- CHAP）和俄亥俄州卫生部。我们对315名参与和315名未参与的妇女采用1:1的最近邻倾向评分匹配，并使用条件逻辑回归分析我们的数据。我们评估的妊娠结局包括早产和出生体重。结果：社区卫生服务项目（CHAP）组LBW发生率为8.6%，非CHAP组为12.4%。CHAP参与者低出生体重的几率降低了43% (OR = 0.572, 95% CI = 0.335-0.979)，而该计划对早产的影响接近但没有达到统计学意义（OR = 0.640, 95% CI = 0.407-1.007）。我们还发现，那些参加CHAP计划并在怀孕前三个月接受第一次产前护理预约的人比那些参加该计划并在怀孕后期接受第一次产前护理预约的人分娩低体重婴儿的可能性更小。结论：在高危孕妇中，PCHI®模型可显著提高产前护理的利用率，降低LBW儿的发生率。此外，参加Pathways Community HUB项目的孕妇如果在怀孕的前三个月参加该项目，比在怀孕的后期参加该项目受益更多，这表明参与该项目的时间越长，分娩结果越好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Maternal and Child Health Journal PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

3.20

自引率

4.30%

发文量

271

期刊介绍： Maternal and Child Health Journal is the first exclusive forum to advance the scientific and professional knowledge base of the maternal and child health (MCH) field. This bimonthly provides peer-reviewed papers addressing the following areas of MCH practice, policy, and research: MCH epidemiology, demography, and health status assessment Innovative MCH service initiatives Implementation of MCH programs MCH policy analysis and advocacy MCH professional development. Exploring the full spectrum of the MCH field, Maternal and Child Health Journal is an important tool for practitioners as well as academics in public health, obstetrics, gynecology, prenatal medicine, pediatrics, and neonatology. Sponsors include the Association of Maternal and Child Health Programs (AMCHP), the Association of Teachers of Maternal and Child Health (ATMCH), and CityMatCH.