Participant Perspectives on a Community Health Worker Intervention to Reduce Infant Mortality: A Mixed Methods Assessment of the Bronx Healthy Start Partnership.

INTRODUCTION

Healthy Start is an initiative to reduce infant mortality and improve birth equity throughout the US, in large part by deploying community health workers (CHWs) to conduct home visits and provide educational and emotional support to new and expectant parents.

METHODS

A mixed-methods assessment of the Bronx Healthy Start Partnership (BxHSP) was conducted as part of a quality improvement initiative to understand client perspectives regarding the impact of BxHSP on short- and intermediate-term outcomes that affect long-term well-being. Phone interviews (n = 16) and online surveys (n = 62) were conducted in English and Spanish with BxHSP participants in 2020 and 2022. The interview sample was selected purposefully; interview participants were eligible if they gave birth prior to mid-March 2020 and had received at least one CHW home visit. All individuals with open BxHSP cases (n = 379) were invited to complete the survey.

RESULTS

Findings suggest that BxHSP CHWs can provide vital psychosocial, material, and educational resources that help engaged participants feel supported as new parents and develop knowledge and skills related to infant care. Results further suggest that these short-term outcomes contribute to lower stress, increased self-efficacy, and health-promoting infant care practices, enabling participants to feel more confident and capable as new parents.

DISCUSSION

Findings underscore how programs like BxHSP can help address gaps in resources and improve health and well-being for pregnant and postpartum participants. Limitations include possible selection, recall, and/or social desirability biases as response rates were low and data were self-reported and retrospective. Limitations were addressed in part through triangulation of qualitative and quantitative data.