Slawa Rokicki, Dea Oviedo, Nicolas Perreault, Mary Ann Bates, R Annetta Zhou, Katherine Baicker, Margaret A McConnell
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引用次数: 0
摘要
童年贫困会影响一生的健康和发展。获得社会安全网计划可以减轻低收入家庭的粮食不安全等与贫困有关的困难,但许多符合条件的家庭没有参加。我们采用一项随机对照试验(n = 5670)来评估护士-家庭伙伴关系(NFP)在怀孕期间和分娩后头两年家访计划对妇女、婴儿和儿童特殊补充营养计划(WIC)和补充营养援助计划(SNAP)等社会计划的影响。NFP服务是南卡罗来纳州1915年医疗补助法案(b)豁免的一部分。我们发现,NFP参与者在怀孕期间更有可能参加SNAP或WIC (87.8% vs 86.0%),并且在分娩后的前两年,SNAP的参加时间比对照组参与者长0.6个月。即使在参与率已经很高的情况下,护士家访也适度增加了孕期和生命最初几年社会安全网方案的参与率。本研究为解决低收入家庭社会需求的医疗补助计划的有效性提供了重要证据。临床试验注册:ClinicalTrials.gov;ID NCT03360539 (https://clinicaltrials.gov/study/NCT03360539)。
Impact of nurse home visiting on take-up of social safety net programs in a Medicaid population.
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).