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利用社区卫生工作者改善西班牙裔妇女及其婴儿的健康结果:一项随机对照试验的结果。

Using Community Health Workers to Improve Health Outcomes in a Sample of Hispanic Women and Their Infants: Findings from a Randomized Controlled Trial.

机构信息

Vanderbilt University School of Nursing, Nashville, TN, USA.

Vanderbilt University School of Medicine (Biostatistics, Hearing and Speech), Nashville, TN, USA.

出版信息

Hisp Health Care Int. 2023 Sep;21(3):129-141. doi: 10.1177/15404153221107680. Epub 2022 Jun 14.

Abstract

The Maternal Infant Health Outreach Worker (MIHOW) program, an early childhood home visiting program, uses community health workers (CHWs) to improve health outcomes in underserved communities. This randomized clinical trial evaluated the impact of MIHOW's use of CHWs on selected maternal/infant outcomes up to 15 months postpartum. We hypothesized outcomes would be better among Hispanic women receiving MIHOW compared to a similar group of women eligible for MIHOW who received only a minimal education intervention (MEI). The study also expanded earlier research testing MIHOW's efficacy among Hispanic families using criteria set forth by federal guidelines. Women living in middle Tennessee enrolled during pregnancy (≤26 weeks gestation) and continued through 15 months postpartum. Enrolled women ( = 132) were randomly assigned, with 110 women completing the study ( = 53;  = 57). Positive and statistically significant ( < .01) effects of MIHOW were observed on breastfeeding duration, safe sleep practices, stress levels, depressive symptoms, emotional support, referral follow through, parental confidence, and infant stimulation in the home. Findings provided strong evidence of the effectiveness of MIHOW for improving health outcomes in this sample. Using trained CHWs makes programs such as MIHOW a viable option for providing services to immigrant and underserved families.

摘要

母婴健康外展工作者(MIHOW)计划是一个儿童早期家访计划,利用社区卫生工作者(CHWs)来改善服务不足社区的健康结果。这项随机临床试验评估了 MIHOW 使用 CHWs 对产后 15 个月内特定母婴结果的影响。我们假设接受 MIHOW 的西班牙裔妇女的结果会比符合 MIHOW 条件但仅接受最低限度教育干预(MEI)的类似妇女群体更好。该研究还扩展了早期研究,使用联邦指南规定的标准测试了 MIHOW 在西班牙裔家庭中的功效。中田纳西州的孕妇(妊娠≤26 周)参加并持续到产后 15 个月。参加的妇女(n=132)随机分配,110 名妇女完成了研究(n=53;n=57)。MIHOW 在母乳喂养持续时间、安全睡眠实践、压力水平、抑郁症状、情感支持、转介后续、父母信心和婴儿在家中的刺激方面产生了积极和统计学上显著的(<0.01)效果。这些发现为 MIHOW 在改善该样本健康结果方面的有效性提供了有力证据。使用经过培训的 CHWs 使 MIHOW 等计划成为向移民和服务不足家庭提供服务的可行选择。

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