Israel Getty
J Perinat Educ. 2023 Jan 1;32(1):8-13. doi: 10.1891/JPE-2022-0025.
A plethora of international research has consistently demonstrated the efficacy of both the nurse-midwifery model and the community health worker (CHW) model in improving birth and breastfeeding outcomes, particularly among low-income women. However, these two professional groups rarely work as a team in the U.S. health-care system. Typically, certified nurse midwives are on staff at clinics and hospitals; conversely, CHWs tend to work at non-profit community organizations. Although the Community Preventive Services Task Force concluded that integrating CHWs on clinical care teams is effective, these paraprofessionals remain nearly excluded from the healthcare organization because they are not licensed healthcare professionals, hence, non reimbursable. We integrated these two health professional groups within a small, community-based, nonprofit, and charitable women's clinic in Jackson, Mississippi, serving a predominantly Medicaid population to determine if their combined health services would significantly improve birth and breastfeeding outcomes among an intervention group compared with a control group that received usual standard care from an obstetrician.
大量国际研究一致证明，护士助产模式和社区卫生工作者（CHW）模式在改善分娩和母乳喂养结果方面均有效，尤其是在低收入女性中。然而，在美国医疗保健系统中，这两个专业群体很少作为一个团队开展工作。通常，认证护士助产士在诊所和医院工作；相反，社区卫生工作者倾向于在非营利性社区组织工作。尽管社区预防服务工作组得出结论，将社区卫生工作者纳入临床护理团队是有效的，但这些辅助专业人员几乎仍被排除在医疗机构之外，因为他们不是有执照的医疗专业人员，因此不可报销。我们将这两个卫生专业群体整合到密西西比州杰克逊市一家小型、以社区为基础、非营利性的慈善妇女诊所中，该诊所主要服务于医疗补助计划人群，以确定与接受产科医生常规标准护理的对照组相比，其联合卫生服务是否能显著改善干预组的分娩和母乳喂养结果。
