Peoples M D, Siegel E
Med Care. 1983 Jun;21(6):586-608. doi: 10.1097/00005650-198306000-00002.
During the past two decades, intervention strategies designed to improve the health status of mothers and infants have been widely disseminated, yet relatively few have been evaluated for effectiveness. Moreover, most reported investigations have involved straightforward comparisons of aggregate data, employing various degrees of methodological control. In this study, vital statistics data were used to assess the effects of the North Carolina Maternity and Infant Care (MIC) Project on use of prenatal care and low birth weight. A weighted least squares procedure was used to control for selected maternal characteristics and identify significant interactions. Analyses of total population data indicated only minor MIC effects. However, more careful scrutiny of subpopulation data suggests that MIC impacts differed across categories of maternal risk status, with the greatest influence observed among mothers and infants at greatest risk. These findings raise several questions regarding the genesis of differential effects and suggest areas of special concern in conducting, interpreting, and using evaluations of programs for mothers and infants.
在过去二十年中，旨在改善母婴健康状况的干预策略已得到广泛传播，但对其有效性进行评估的却相对较少。此外，大多数已报道的调查都涉及对汇总数据的直接比较，并采用了不同程度的方法控制。在本研究中，生命统计数据被用于评估北卡罗来纳州母婴护理（MIC）项目对产前护理使用情况和低出生体重的影响。采用加权最小二乘法来控制选定的母亲特征并识别显著的相互作用。对总人口数据的分析仅表明MIC项目的影响较小。然而，对亚群体数据更仔细的审查表明，MIC项目的影响在母亲风险状况类别中存在差异，在风险最高的母亲和婴儿中观察到的影响最大。这些发现引发了几个关于差异效应成因的问题，并指出了在开展、解释和使用母婴项目评估时特别需要关注的领域。
